Comparison of fine-needle aspiration and fine-needle biopsy devices for endoscopic ultrasound-guided sampling of solid lesions: a systemic review and meta-analysis

Published on Apr 1, 2021in Endoscopy7.341
· DOI :10.1055/A-1206-5552
Priscilla A. van Riet5
Estimated H-index: 5
(Erasmus University Medical Center),
Nicole S. Erler16
Estimated H-index: 16
(EUR: Erasmus University Rotterdam)
+ 1 AuthorsDjuna L. Cahen26
Estimated H-index: 26
(Erasmus University Medical Center)
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 accuracy, adequacy, number of passes, presence of tissue cores, and adverse events. In addition, we performed a 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 to FNB cases were included, all involving ProCore FNB needles. FNB provided a higher pooled diagnostic accuracy (87% vs 80%, p=0.02) and tissue core rate (77% vs 57%, p=0.01), and allowed a diagnosis within less passes (p=0.03). This was true for pancreatic and non-pancreatic lesions. 93 studies were included to compare the FNB devices. Pooled diagnostic accuracy was higher for SharkCore, Acquire and the ProCore forward facing bevel needles than for the ProCore reverse bevel needle. In this analysis, study quality was low and heterogeneity high (I2=80%). CONCLUSION FNB ProCore outperformed FNA when sampling pancreatic and non-pancreatic lesions. SharkCore, Acquire and ProCore forward facing bevel FNB needles seem to outperform the ProCore reverse bevel needle, but the low quality of evidence prevents us from making strong recommendations on the optimal FNB design.
📖 Papers frequently viewed together
56 Citations
64 Citations
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Sumsum P. SunnyH-Index: 1
Last. Nicola Muscatiello (University of Foggia)H-Index: 22
view all 5 authors...
Abstract Background and Aims There is limited evidence on the diagnostic performance of endoscopic ultrasound-guided fine-needle biopsy in patients with subepithelial lesions. Aim of this meta-analysis was to compare EUS-guided fine-needle biopsy performance to fine-needle aspiration in patients with GI subepithelial lesions. Methods Computerized bibliographic search on the main databases was performed through May 2019. Primary endpoint was sample adequacy. Secondary outcomes were diagnostic acc...
12 CitationsSource
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Sachin Wani (Anschutz Medical Campus)H-Index: 68
Last. Siddharth Singh (UCSD: University of California, San Diego)H-Index: 67
view all 7 authors...
Abstract Background and Aims Variable diagnostic performance of sampling techniques during EUS-guided tissue acquisition of solid pancreatic masses based on needle type [fine-needle aspiration (FNA) versus fine-needle biopsy (FNB)] and gauge (19-gauge vs 22-gauge vs 25-gauge) has been reported. We performed a systematic review with network meta-analysis to compare the diagnostic accuracy of EUS-guided techniques for sampling solid pancreatic masses. Methods Through a systematic literature review...
32 CitationsSource
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Valentina Del Prete (University of Foggia)H-Index: 13
Last. Nicola Muscatiello (University of Foggia)H-Index: 22
view all 6 authors...
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 en...
16 CitationsSource
#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
#1Priscilla A. van Riet (EUR: Erasmus University Rotterdam)H-Index: 5
#2Djuna L. Cahen (EUR: Erasmus University Rotterdam)H-Index: 26
Last. Maoxin WuH-Index: 3
view all 34 authors...
textabstractBackground and Aim: A recently carried out randomized controlled trial showed the benefit of a novel 20-G fine-needle biopsy (FNB) over a 25-G fine-needle aspiration (FNA) needle. The current study evaluated the reproducibility of these findings among expert academic and non-academic pathologists. Methods: This study was a side-study of the ASPRO (ASpiration versus PROcore) study. Five centers retrieved 74 (59%) consecutive FNB and 51 (41%) FNA samples from the ASPRO study according ...
5 CitationsSource
#1Shinya FujieH-Index: 4
Last. Hiroyuki OnoH-Index: 20
view all 13 authors...
Background/Aims: To compare the diagnostic yield of 20-gauge forward-bevel core biopsy needle (CBN) and 22-gauge needle for endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of solid pancreatic masses. Methods: The use of 20-gauge CBN was prospectively evaluated for 50 patients who underwent EUS-FNA from June 2016 to December 2016. Data were compared with those obtained by a retrospective study of 50 consecutive patients who underwent EUS-FNA using standard 22-gauge needles between...
8 CitationsSource
#1Tadahisa InoueH-Index: 10
#2Fumihiro OkumuraH-Index: 17
Last. Masashi YonedaH-Index: 29
view all 12 authors...
BACKGROUND AND AIM: Immunohistological evaluations are essential for diagnosing subepithelial tumors (SET). However, endoscopic ultrasound-guided sampling using fine-needle aspiration (FNA) needles is limited in its ability to procure core tissue for immunostaining. Fine-needle biopsy (FNB) needles may mitigate this limitation. The present study aimed to examine the efficacy of FNB needles for procuring samples that enable the diagnosis of SET. METHODS: One hundred sixty patients were included i...
13 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
AbstractBackground: To overcome the limitations of using cytological specimen alone for the diagnosis of challenging pancreatic lesions, biopsy needles have been developed to procure histological s...
14 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
Cited By3
Background and study aims The standard method for obtaining samples during endoscopic ultrasonography (EUS) is fine-needle aspiration (FNA), the accuracy of which can be affected by the presence of a cytopathologist in endoscopy room (rapid on-site evaluation [ROSE]). With the introduction of fine-needle biopsy (FNB), macroscopic on-site evaluation (MOSE) of a acquired specimen has been proposed. Only a few studies have evaluated the role of MOSE and in all except one, a 19G needle was used. Our...
#1Yuki TanisakaH-Index: 6
#2Masafumi MizuideH-Index: 7
Last. Shomei RyozawaH-Index: 18
view all 11 authors...
The diagnostic process for biliary strictures remains challenging in some cases. A broad differential diagnosis exists for indeterminate biliary strictures, including benign or malignant lesions. The diagnosis of indeterminate biliary strictures requires a combination of physical examination, laboratory testing, imaging modalities, and endoscopic procedures. Despite the progress of less invasive imaging modalities such as transabdominal ultrasonography, computed tomography, and magnetic resonanc...
#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
#1Laurent MoninoH-Index: 2
#2Pierre Henri DeprezH-Index: 36
#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 8 authors...
Endoscopic ultrasound (EUS) is among the most important tools for the evaluation of gastrointestinal tumors and affected areas around the gastrointestinal tract. It enables the acquisition of material from abnormal lesions via the gastrointestinal wall for tissue confirmation via endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). EUS-FNA has played a vital role in oncological care and has become the standard method for tissue sampling. The choice of needle type is an important factor...