Published online Sep 16, 2020. doi: 10.4253/wjge.v12.i9.266
Peer-review started: May 25, 2020
First decision: June 4, 2020
Revised: June 8, 2020
Accepted: August 1, 2020
Article in press: August 1, 2020
Published online: September 16, 2020
Many factors can affect endoscopic ultrasound fine needle biopsy (EUS-FNB) procedures tissue acquisition efficacy, with needle type and design being one of the possible factors.
Currently, there is no direct comparison of tissue acquisition efficacy between reverse bevel (RB) and Franseen geometry (FG) needles.
To look any for different in tissue acquisition performance between RB and FG needles, which can potentially be a modifiable factor to improve EUS-FNB accuracy in making a confident diagnosis.
A retrospective study of all EUS-FNA/FNB procedures by either 22G RB needle or 22G FG needle between January 2016 and February 2019. All cytology slides were reviewed by an independent gastrointestinal cytopathologist blinded to the needle used and the initial cytology report. The primary and secondary outcomes were to assess the sample adequacy using Euro-cytology criteria and the number of cell clusters, respectively.
A total of 226 procedures were included. RB needle was used in 128 procedures and FG needle in 98 procedures. The baseline characteristics of both groups were comparable. On multivariable analysis, FG needle (P = 0.02) and location of the lesion (P < 0.01) were independently associated with adequate. Further, the use of FG needle (P = 0.04) and the size of the lesion (P = 0.02) were independently associated with acquisition of increased number of cell clusters.
FG needle is superior to RB needle in acquiring adequate tissue and attaining higher number of cell clusters for solid and mixed lesions.
Multicentre prospective trials are needed to further evaluate the utility of different needle types.