Diagnostic yield of Franseen and Fork-Tip biopsy needles for endoscopic ultrasound-guided tissue acquisition: a meta-analysis.

Published on Oct 1, 2019in Endoscopy International Open
· DOI :10.1055/A-0982-2997
Antonio Facciorusso19
Estimated H-index: 19
(University of Foggia),
Valentina Del Prete13
Estimated H-index: 13
(University of Foggia)
+ 3 AuthorsNicola Muscatiello22
Estimated H-index: 22
(University of Foggia)
Background and study aims Although newer needle designs are thought to improve diagnostic outcomes of endoscopic ultrasound-guided fine-needle biopsy, there is limited evidence on their diagnostic performance. The aim of this meta-analysis was to provide a pooled estimate of the diagnostic performance and safety profile of Franseen and Fork-tip fine-needle biopsy needles. Patients and methods Computerized bibliographic search on the main databases was performed through March 2019. The primary endpoint was sample adequacy. Secondary outcomes were diagnostic accuracy, optimal histological core procurement, mean number of needle passes, pooled specificity and sensitivity. Safety data were also analyzed. Results Twenty-four studies with 6641 patients were included and pancreas was the prevalent location of sampled lesions. Overall sample adequacy with the two newer needles was 94.8 % (93.1 % – 96.4 %), with superiority of Franseen needle over Fork-tip (96.1 % versus 92.4 %, P  Conclusion Our meta-analysis speaks in favor of use of newer biopsy needles as a safe and effective tool in endoscopic ultrasound-guided tissue acquisition.
📖 Papers frequently viewed together
32 Citations
11 Citations
9 Citations
#1Masaki KuwataniH-Index: 24
#2Ryo SugiuraH-Index: 8
view all 13 authors...
Background: Recently, EUS-guided fine-needle biopsy (EUS-FNB) using a Franseen needle was developed for histological tissue acquisition. However, the yield of a 25G Franseen needle when acquiring histological core tissue has been unclear. Patients and Methods: We performed a prospective, multicenter, and observational cohort study that included 100 solid lesions scheduled for EUS-FNB using a 25G Franseen needle at eight centers in Hokkaido, Japan. Only EUS-FNB specimens acquired at the first pas...
9 CitationsSource
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Harshvardhan Singh Bajwa (Government Medical College, Thiruvananthapuram)H-Index: 1
Last. Nicola Muscatiello (University of Foggia)H-Index: 22
view all 5 authors...
Background and Objective: Robust data in favor of clear superiority of 22G fine-needle biopsy (FNB) over 22G FNA for an echoendoscopic-guided sampling of pancreatic masses are lacking. The objective of this study is to compare the diagnostic outcomes and sample adequacy of these two needles. Materials and Methods: Computerized bibliographic search on the main databases was performed and restricted to only randomized controlled trials. Summary estimates were expressed regarding risk ratio (RR) an...
11 CitationsSource
#1Ji Young Bang (Florida Hospital Orlando)H-Index: 28
#2Sachin Kirtane (Florida Hospital Orlando)H-Index: 2
Last. Shyam Varadarajulu (Florida Hospital Orlando)H-Index: 70
view all 7 authors...
BACKGROUND AND AIM: Fine-needle aspiration (FNA) cytology has been the preferred technique for procuring tissue at endoscopic ultrasound (EUS) procedures for the past 25 years. To overcome some of the limitations of FNA cytology, fine-needle biopsy (FNB) has been recently developed to yield histological tissue. Main objective was to compare the diagnostic yield of FNB compared to FNA for both onsite and offsite specimen assessment. METHODS: A retrospective study was conducted at a single tertiar...
34 CitationsSource
#1Douglas G. Adler (UofU: University of Utah)H-Index: 65
#2V. Raman Muthusamy (UCLA: University of California, Los Angeles)H-Index: 46
Last. Ali Siddiqui (Thomas Jefferson University)H-Index: 41
view all 12 authors...
Background and Objectives: We present a multicenter study of a new endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needle (Acquire, Boston Scientific, Natick, MA). The aim of the study was to analyze the needle's clinical performance when sampling solid lesions and to assess the safety of this device. Methods: We performed a multicenter retrospective study of patients undergoing EUS-FNB during July 1–November 15, 2016. Results: Two hundred patients (121 males and 79 females) underwent ...
33 CitationsSource
#1Takuya Ishikawa (Nagoya University)H-Index: 14
#2Hiroki Kawashima (Nagoya University)H-Index: 27
Last. Yoshiki Hirooka (Nagoya University)H-Index: 59
view all 14 authors...
Background and Aims. Several studies have shown the benefits of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) using a Franseen needle for histological assessment. However, studies focusing on pancreatic diseases are limited and the safety of this method has not been well assessed. We aimed to assess the current status and issues of EUS-FNB in the diagnosis of pancreatic diseases. Materials and Methods. We retrospectively reviewed 87 consecutive EUS-FNB specimens using either a 22-gau...
13 CitationsSource
Background and aims This study aimed to evaluate the performance of Macroscopic On-site Evaluation (MOSE) using a novel endoscopic ultrasound (EUS) fine needle biopsy (FNB) needle (22-G Franseen-tip needle, Acquire, Boston Scientific Incorporated, Boston, Massachusetts, United States), and without using Rapid On-Site Evaluation (ROSE). Method Between May 2016 and August 2016, all consecutive patients referred to our center for EUS tissue acquisition (TA) for solid lesions underwent EUS-FNB with ...
17 CitationsSource
#1Noor Bekkali (Freeman Hospital)H-Index: 7
#2Manu Nayar (Freeman Hospital)H-Index: 13
Last. Kofi Oppong (Freeman Hospital)H-Index: 22
view all 11 authors...
Background Stents are frequently placed in patients with biliary obstruction due to a mass in the head of the pancreas. The impact of plastic or self-expandable metal stents (SEMSs) on endoscopic ultrasound (EUS)-guided tissue sampling is unclear. This study aimed to assess, using strict pathological criteria, whether stents impair fine-needle aspiration (FNA) or fine-needle biopsy (FNB). Methods All patients with a solid mass in the head of the pancreas who underwent EUS-guided tissue sampling ...
1 CitationsSource
#1Shuntaro Mukai (TMU: Tokyo Medical University)H-Index: 23
#2Takao Itoi (TMU: Tokyo Medical University)H-Index: 76
Last. Yuichi Nagakawa (TMU: Tokyo Medical University)H-Index: 23
view all 14 authors...
Background and Objectives: Recently, a 22G Franseen needle for EUS-guided fine-needle biopsy (EUS-FNB) with three novel symmetric heels has been developed to adequately obtain a core tissue. Methods: All 38 consecutive patients with pancreatic masses who underwent EUS-FNB using a Franseen needle were investigated retrospectively to assess the efficacy and safety of EUS-FNB using the Franseen needle. Then, the EUS-FNB outcomes and histological assessments of the tissue obtained by EUS-FNB using t...
36 CitationsSource
#1Ji Young Bang (Florida Hospital Orlando)H-Index: 28
Last. Shyam VaradarajuluH-Index: 70
view all 6 authors...
As cytological aspirates from endoscopic-ultrasound-guided fine needle aspiration (EUS-FNA) has limited diagnostic sensitivity and are suboptimal for molecular profiling and morphological characterisation of certain neoplasms, a fine needle biopsy (FNB) with three-pronged (Franseen geometry) cutting edge has been developed to procure histology. In a randomised trial of 46 patients with pancreatic masses, procurement of histological core tissue as evidenced by total tissue and tumour areas was si...
42 CitationsSource
#1Akashi Fujita (Saitama Medical University)H-Index: 4
#2Shomei Ryozawa (Saitama Medical University)H-Index: 18
Last. Masafumi Mizuide (Saitama Medical University)H-Index: 4
view all 9 authors...
: The differential diagnosis of gastrointestinal subepithelial lesions (SELs) such as gastrointestinal stromal tumors from other benign tumors is important. In the present study, adequate sample rates of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with a 22G Franseen needle for SELs were evaluated. The present study included 57 consecutive lesions (61 sessions) of EUS-FNA using a 22G needle to evaluate SELs between July 2013 and October 2017. Adequate sample rates were compared...
10 CitationsSource
Cited By16
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Daryl Ramai (Brooklyn Hospital Center)H-Index: 9
Last. Stefano Francesco CrinòH-Index: 14
view all 0 authors...
There is scarce and conflicting evidence on the comparison between endoscopic ultrasound (EUS) and percutaneous (PC)-guided liver biopsy (LB). The aim of this study was to compare the two approaches in a series of patients with parenchymal and focal liver lesions. Fifty-four patients undergoing EUS-LB in two high-volume centers between 2017 and 2021 were compared to 62 patients who underwent PC-LB. The primary outcome was diagnostic adequacy rate. The secondary outcomes were diagnostic accuracy,...
#1Kazunaga Ishigaki (UTokyo: University of Tokyo)H-Index: 10
#2Yousuke Nakai (UTokyo: University of Tokyo)H-Index: 51
Last. Hiroyuki Isayama (Juntendo University)H-Index: 65
view all 15 authors...
BACKGROUND While encouraging data of EUS-guided fine-needle biopsy (EUS-FNB) using a 22-gauge Franseen needle have been reported, a large scale data of per pass and quantitative analyses are still lacking. METHODS This was a multicenter prospective study of EUS-FNB using the 22-gauge Franseen needle for a pancreatic solid lesion. Cytological and histological analyses per pass were evaluated and semi-quantitative analyses were performed on core tissue (1-4) and blood contamination (1-3). Primary ...
#1Rintaro Hashimoto (UCI: University of California, Irvine)H-Index: 6
#2David P. Lee (UCI: University of California, Irvine)H-Index: 3
Last. Kenneth J. Chang (UCI: University of California, Irvine)H-Index: 51
view all 7 authors...
BACKGROUND EUS-guided liver biopsy (EUS-LB) has been shown to be a safe and effective alternative to percutaneous liver biopsy. The optimal needle device and technique for EUS-LB is still evolving. The aim of this study was to compare the efficacy of two second-generation 19G fine-needle biopsy (FNB) (Franseen- and Fork-tip) devices for EUS-LB. METHODS This is a repeated-measure crossover study with a prospectively maintained cohort of patients. We performed EUS-LB with a one-pass and single-act...
1 CitationsSource
#1Priscilla A. van Riet (Erasmus University Medical Center)H-Index: 5
#2Nicole S. Erler (EUR: Erasmus University Rotterdam)H-Index: 16
Last. Djuna L. Cahen (EUR: Erasmus University Rotterdam)H-Index: 17
view all 4 authors...
BACKGROUND EUS-guided tissue acquisition is extensively used, but the optimal sampling device is still a matter of debate. We performed a meta-analysis on studies comparing FNA to FNB needles, in addition to a mutual comparison of FNB needles. METHODS Online databases were searched for randomized controlled studies of at least 50 cases with a suspected solid pancreatic or non-pancreatic lesion that compared FNA to FNB ProCore, SharkCore, or Acquire needles. Outcome measures included diagnostic a...
3 CitationsSource
#1Benjamin D. Renelus (Houston Methodist Hospital)H-Index: 3
#2Daniel S. JamoraboH-Index: 2
Last. John M. PonerosH-Index: 25
view all 5 authors...
BACKGROUND/AIMS Studies comparing the utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) for solid pancreatic lesions have been inconclusive with no clear superiority. The aim of this meta-analysis was to compare the diagnostic accuracy and safety between the two sampling techniques. METHODS We performed a systematic search of randomized controlled trials published between 2012 and 2019. The primary outcome was o...
3 CitationsSource
#2Serena AmmendolaH-Index: 3
Last. Erminia ManfrinH-Index: 24
view all 16 authors...
Abstract Background/objectives Studies comparing EUS-guided fine-needle aspiration (EUS-FNA) with EUS-guided fine-needle biopsy (EUS-FNB) for the evaluation of pancreatic neuroendocrine tumors (pNETs) are lacking. We aimed at comparing EUS-FNA with EUS-FNB in terms of Ki-67 proliferative index (PI) estimation capability, cellularity of the samples, and reliability of Ki-67 PI/tumor grading compared with surgical specimens. Methods Patients diagnosed with pNETs on EUS and/or surgical specimens we...
1 CitationsSource
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Babu P. Mohan (UofU: University of Utah)H-Index: 3
Last. Pietro Fusaroli (UNIBO: University of Bologna)H-Index: 28
view all 8 authors...
OBJECTIVES It is still unclear whether endoscopic ultrasound (EUS) contrast-enhanced fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses. Aim of this meta-analysis was to compare the diagnostic outcomes of these two techniques. METHODS We searched the PubMed/Medline and Embase database through October 2020 and identified 6 studies, of which 2 randomized controlled trials (recruiting 701 patients). We perform...
#1Laurent MoninoH-Index: 2
#2Pierre Henri DeprezH-Index: 36
#1John M. DeWitt (IU: Indiana University)H-Index: 65
#2Mustafa A. Arain (UCSF: University of California, San Francisco)H-Index: 21
Last. Joo Ha Hwang (Stanford University)H-Index: 57
view all 7 authors...
The evolution of endoscopic ultrasound (EUS) from a diagnostic to a therapeutic procedure has resulted in a paradigm shift toward endoscopic management of disease states that previously required percutaneous or surgical approaches. The past few years have seen additional techniques and devices that have enabled endoscopists to expand its diagnostic and therapeutic capabilities. Some of these techniques initially were reported more than a decade ago; however, with further device development and r...
1 CitationsSource
#1Antonio FacciorussoH-Index: 19
#2Nicola MuscatielloH-Index: 22