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World J Gastroenterol. Mar 7, 2014; 20(9): 2176-2185
Published online Mar 7, 2014. doi: 10.3748/wjg.v20.i9.2176
Endoscopic ultrasound guided fine needle tissue acquisition: Where we stand in 2013?
Zeid Karadsheh, Mohammad Al-Haddad
Zeid Karadsheh, Signature Healthcare, Brockton Hospital, Brockton, MA 02320, United States
Mohammad Al-Haddad, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, IN 46202, United States
Correspondence to: Mohammad Al-Haddad, MD, MSc, FASGE, Associate Professor of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, 550 N. University Blvd., UH 4100, Indianapolis, IN 46202, United States. moalhadd@iu.edu
Telephone: +1-317-9488125 Fax: +1-317-9488145
Received: October 28, 2013
Revised: December 19, 2013
Accepted: January 14, 2014
Published online: March 7, 2014
Abstract

Since its introduction, endoscopic ultrasound (EUS) guided fine needle aspiration and fine needle biopsy have become an indispensable tool for the diagnosis of lesions within the gastrointestinal tract and surrounding organs. It has proved to be an effective diagnostic method with high accuracy and low complication rates. Several factors can influence the accuracy and the diagnostic yield of this procedure including experience of the endosonographer, availability of onsite cytopathology services, the method of cytopathology preparation, the location and physical characteristics of the lesion, sampling techniques and the type and size of the needle used. In this review we will outline the recent studies evaluating EUS-guided tissue acquisition and will provide practical recommendations to maximize tissue yield.

Keywords: Endoscopic ultrasound, Fine needle aspiration, Endoscopic ultrasound guided sampling techniques, Cytological diagnosis, Core biopsy device, Gastrointestinal endoscopy

Core tip: The impact of the type and size of needles used for endoscopic ultrasound guided-guided tissue acquisition have been the center of recent studies aiming at maximizing tissue yield. In addition to needles, several other variables impact the final outcome of tissue acquisition including the location and characteristics of the lesion, the fine needle aspiration technique, and the availability of on-site cytopathology services. In this review we outline the results of these studies and summarize the recent advances in this field.