Priscilla A van Riet1, Nicole S Erler2, Marco J Bruno1, Djuna L Cahen1. 1. Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands. 2. Department of Biostatistics, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Abstract
BACKGROUND: Endoscopic ultrasound (EUS)-guided tissue acquisition is extensively used, but the optimal sampling device is still a matter of debate. We performed meta-analyses on studies comparing fine-needle aspiration (FNA) with fine-needle biopsy (FNB) needles, and studies comparing different FNB needles. METHODS: Online databases were searched for randomized controlled trials (RCTs) of at least 50 cases with a suspected solid pancreatic or nonpancreatic lesion that compared FNA with FNB needles. Outcome measures included diagnostic accuracy, adequacy, number of passes, presence of tissue cores, and adverse events. We also performed meta-regression analysis on the effect of FNB design on diagnostic accuracy. Quality was assessed using the QUADAS-2 tool. RESULTS: 18 RCTs comparing FNA with FNB needles were included. FNB provided a higher pooled diagnostic accuracy (87 % vs. 80 %; P = 0.02) and tissue core rate (80 % vs. 62 %; P = 0.002), and allowed diagnosis with fewer passes (P = 0.03), in both pancreatic and nonpancreatic lesions. A total of 93 studies were included comparing different FNB devices. Pooled diagnostic accuracy was higher for forward-facing bevel needles than for the reverse bevel needle. In this analysis, study quality was low and heterogeneity was high (I2 = 80 %). CONCLUSION: FNB outperformed FNA when sampling pancreatic and nonpancreatic lesions. Forward-facing bevel FNB needles seemed to outperform the reverse bevel FNB needle, but the low quality of evidence prevents us from making strong recommendations on the optimal FNB design. Thieme. All rights reserved.
BACKGROUND: Endoscopic ultrasound (EUS)-guided tissue acquisition is extensively used, but the optimal sampling device is still a matter of debate. We performed meta-analyses on studies comparing fine-needle aspiration (FNA) with fine-needle biopsy (FNB) needles, and studies comparing different FNB needles. METHODS: Online databases were searched for randomized controlled trials (RCTs) of at least 50 cases with a suspected solid pancreatic or nonpancreatic lesion that compared FNA with FNB needles. Outcome measures included diagnostic accuracy, adequacy, number of passes, presence of tissue cores, and adverse events. We also performed meta-regression analysis on the effect of FNB design on diagnostic accuracy. Quality was assessed using the QUADAS-2 tool. RESULTS: 18 RCTs comparing FNA with FNB needles were included. FNB provided a higher pooled diagnostic accuracy (87 % vs. 80 %; P = 0.02) and tissue core rate (80 % vs. 62 %; P = 0.002), and allowed diagnosis with fewer passes (P = 0.03), in both pancreatic and nonpancreatic lesions. A total of 93 studies were included comparing different FNB devices. Pooled diagnostic accuracy was higher for forward-facing bevel needles than for the reverse bevel needle. In this analysis, study quality was low and heterogeneity was high (I2 = 80 %). CONCLUSION: FNB outperformed FNA when sampling pancreatic and nonpancreatic lesions. Forward-facing bevel FNB needles seemed to outperform the reverse bevel FNB needle, but the low quality of evidence prevents us from making strong recommendations on the optimal FNB design. Thieme. All rights reserved.
Authors: Labrinus van Manen; Iris Schmidt; Akin Inderson; Ruben D Houvast; Jurjen J Boonstra; Jouke Dijkstra; Jeanin E van Hooft; Wouter B Nagengast; Dominic J Robinson; Alexander L Vahrmeijer; J Sven D Mieog Journal: Int J Med Sci Date: 2022-01-01 Impact factor: 3.738
Authors: Benedetto Mangiavillano; Leonardo Frazzoni; Thomas Togliani; Carlo Fabbri; Ilaria Tarantino; Luca De Luca; Teresa Staiano; Cecilia Binda; Marianna Signoretti; Leonardo H Eusebi; Francesco Auriemma; Laura Lamonaca; Danilo Paduano; Milena Di Leo; Silvia Carrara; Lorenzo Fuccio; Alessandro Repici Journal: Endosc Int Open Date: 2021-05-27