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Li J, Feng J, Gao S, Wang W, Huang L, Yi S, Xu H, Ding XW. Comparison of 19G FNA Versus 22G FNB Needles for Endoscopic Ultrasound-Guided Fine-Needle Sampling of Subepithelial Tumors: Is Bigger Better? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:761-770. [PMID: 38167820 DOI: 10.1002/jum.16405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/27/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To compare the diagnostic efficiency of 19G fine-needle aspiration (FNA) and 22G fine-needle biopsy (FNB) in endoscopic ultrasound (EUS)-guided sampling for subepithelial tumors (SETs). METHODS The data of patients with SETs who underwent 19G FNA or 22G FNB were reviewed retrospectively in two tertiary hospitals. Tissue cores were assessed by macroscopic on-site evaluation (MOSE). Cytological or histological diagnosis were classified as definite, suspect, or no diagnosis. RESULTS Seventy five patients (mean age: 55 years, 44 males) underwent 19G EUS-FNA (31) or 22G EUS-FNB (44). The overall diagnostic yield was 82.7%. The rate of definite cytological diagnoses was 9.7% (3/31) in 19G and 13.6% (6/44) in 22G group (x2 = 1.520, P = .468). In terms of MOSE, 19G needle, requiring only two punctures, achieved a higher good tissue core rate than 22G group (100.0% [31/31] versus 84.1% [37/44], x2 = 5.440, P = .020]). For histological diagnosis, the 19G group achieved higher definite rate than the 22G group, 93.6% (29/31) versus 65.9% (29/44) (x2 = 7.957, P = .019) on the first puncture, 90.3% (28/31) versus 63.6% (28/44) (x2 = 7.139, P = .028) on the second puncture, 96.8% (30/31) versus 70.5% (31/44) (x2 = 7.319, P = .026) on both the first and second punctures, and 96.8% (30/31) versus 72.7% (32/44) (x2 = 7.538, P = .023) on all three punctures. CONCLUSIONS The 19G EUS-FNA requires only two punctures to achieve better tissue core quality by MOSE and yields a higher rate of histological diagnosis than 22G ProCore needle for SETs. The bigger 19G FNA needle seems to play an important role in the evaluation of SETs.
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Affiliation(s)
- Juan Li
- Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, China
| | - Jing Feng
- Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, China
| | - Shan Gao
- Department of Gastroenterology, Xiangyang Central Hospital, Xiangyang, China
| | - Wei Wang
- Department of Gastroenterology, Xiangyang Central Hospital, Xiangyang, China
| | - Lihua Huang
- Department of Pathology, Wuhan Fourth Hospital, Wuhan, China
| | - Shanshan Yi
- Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, China
| | - Haiyan Xu
- Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, China
| | - Xiang Wu Ding
- Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, China
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Zarogoulidis P, Petridis D, Sapalidis K, Tsakiridis K, Baka S, Vagionas A, Hohenforst-Schmidt W, Freitag L, Huang H, Bai C, Drougas D, Theofilatou V, Romanidis K, Perdikouri EI, Petanidis S, Zaric B, Kovacevic T, Stojsic V, Sarcev T, Bursac D, Kukic B, Perin B, Courcoutsakis N, Athanasiou E, Hatzibougias D, Drevelegas K, Boukovinas I, Kosmidou M, Kosmidis C. Lung cancer biopsies: Comparison between simple 22G, 22G upgraded and 21G needle for EBUS-TBNA. J Cancer 2020; 11:6454-6459. [PMID: 33033529 PMCID: PMC7532516 DOI: 10.7150/jca.48691] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/25/2020] [Indexed: 02/07/2023] Open
Abstract
Introduction: Novel technologies are currently used for lung cancer diagnosis. EBUS-TBNA 22G is considered one of the most important tools. However; there are still issues with the sample size.Patients and Methods: 223 patients underwent EBUS-TBNA with a 21G Olympus needle, 22GUS Mediglobe and 22GUB Mediglobe. In order to evaluate the efficiency of 22GUB novel needle design. In order to evaluate the sample size of each needle, we constructed cell blocks and measured the different number of slices from each biopsy site. Results: The 22GUB novel needle had similar and larger number of slices from each biopsy site compared to 21G needle. Discussion: Firstly as a novel methodology we used the number of slices from the constructed cell blocks in order to evaluate the sample size. Secondly, we should seek novel needle designs and not only concentrate on the volume of the sample size.
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Affiliation(s)
- Paul Zarogoulidis
- 3rd University General Hospital, "AHEPA" University Hospital, Thessaloniki, Greece
| | - Dimitris Petridis
- Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, Thessaloniki, Greece
| | | | - Kosmas Tsakiridis
- Thoracic Surgery Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | - Sofia Baka
- Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece
| | | | - Wolfgang Hohenforst-Schmidt
- Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany
| | - Lutz Freitag
- Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich Switzerland
| | - Haidong Huang
- Department of Respiratory Medicine, Changhai Hospital of Second Military Medical University, Shanghai, China
| | - Chong Bai
- Department of Respiratory Medicine, Changhai Hospital of Second Military Medical University, Shanghai, China
| | - Dimitris Drougas
- Scientigraphy Department, "Bioclinic" Private Laboratory, Thessaloniki, Greece
| | | | - Konstantinos Romanidis
- Second Department of Surgery, General University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Savas Petanidis
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Bojan Zaric
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tomi Kovacevic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Vladimir Stojsic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Tatjana Sarcev
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Daliborka Bursac
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Biljana Kukic
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | - Branislav Perin
- Faculty of Medicine, University of Novi Sad, Institute for Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
| | | | | | | | | | | | - Maria Kosmidou
- Internal Medicine Department, University of Ioannina, Ioannina, Greece
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Fujie S, Ishiwatari H, Sasaki K, Sato J, Matsubayashi H, Yoshida M, Ito S, Kawata N, Imai K, Kakushima N, Takizawa K, Hotta K, Ono H. Comparison of the Diagnostic Yield of the Standard 22-Gauge Needle and the New 20-Gauge Forward-Bevel Core Biopsy Needle for Endoscopic Ultrasound-Guided Tissue Acquisition from Pancreatic Lesions. Gut Liver 2020; 13:349-355. [PMID: 30600677 PMCID: PMC6529169 DOI: 10.5009/gnl18189] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 08/30/2018] [Accepted: 09/24/2018] [Indexed: 01/20/2023] Open
Abstract
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 December 2016 and April 2017. At least two punctures were performed for each patient; the sample from the first pass was used for cytology with or without histology and that from the second pass was used for histology. Sample quantity was evaluated using the sample obtained from the second pass. Results There was no significant difference in the diagnostic accuracy rate between the first and second passes (20-gauge CBN: 96% [48/50]; standard 22-gauge needle: 88% [44/50]). Samples >10× power fields in length were obtained from 90% (43/48) and 60% (30/50) of patients using the 20-gauge CBN and standard 22-gauge needle, respectively (p=0.01). Technical failure occurred for two patients with the 20-gauge CBN. Conclusions Diagnostic accuracy of the 20-gauge CBN was comparable to that of the 22-gauge needle. However, two passes with the 20-gauge CBN yielded a correct diagnosis for 100% of patients when technically feasible. Moreover, the 20-gauge CBN yielded core tissue for 90% patients, which was a performance superior to that of the 22-gauge needle.
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Affiliation(s)
- Shinya Fujie
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Keiko Sasaki
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Junya Sato
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Masao Yoshida
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Sayo Ito
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Noboru Kawata
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kenichiro Imai
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Naomi Kakushima
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kohei Takizawa
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kinichi Hotta
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiroyuki Ono
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
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Grassia R, Imperatore N, Capone P, Cereatti F, Forti E, Antonini F, Tanzi GP, Martinotti M, Buffoli F, Mutignani M, Macarri G, Manes G, Vecchi M, De Nucci G. EUS-guided tissue acquisition in chronic pancreatitis: Differential diagnosis between pancreatic cancer and pseudotumoral masses using EUS-FNA or core biopsy. Endosc Ultrasound 2020; 9:122-129. [PMID: 32295970 PMCID: PMC7279087 DOI: 10.4103/eus.eus_75_19] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background and Objective: EUS-FNA sensitivity for malignancy in parenchymal masses of patients with concurrent chronic pancreatitis (CP) has been reported to be unsatisfactory. The aim of the present study was to directly compare the diagnostic accuracy of EUS-FNA and EUS-fine-needle biopsy (FNB) in differentiating between inflammatory masses and malignancies in the setting of CP. Methods: We performed a retrospective analysis of prospective, multicentric databases of all patients with pancreatic masses and clinico-radiological-endosonographic features of CP who underwent EUS-FNA or FNB. Results: Among 1124 patients with CP, 210 patients (60% males, mean age: 62.7 years) with CP and pancreatic masses met the inclusion criteria and were enrolled. In the FNA group (110 patients), a correct diagnosis was obtained in all but 18 cases (diagnostic accuracy 83.6%, sensitivity 69.5%, specificity 100%, positive predictive value [PPV] 100%, and negative predictive value [NPV] 73.9%); by contrast, among 100 patients undergoing FNB, a correct diagnosis was obtained in all but seven cases (diagnostic accuracy 93%, sensitivity 86.8%, specificity 100%, PPV 100%, and NPV 87%) (P = 0.03, 0.03, 1, 1, and 0.07, respectively). At binary logistic regression, focal pancreatitis (odds of event occurrence [OR]: 4.9; P < 0.001), higher Ca19-9 (OR: 2.3; P = 0.02), and FNB (OR: 2.5; P < 0.01) were the only independent factors associated with a correct diagnosis. Conclusion: EUS-FNB is effective in the differential diagnosis between pseudotumoral masses and solid neoplasms in CP, showing higher diagnostic accuracy and sensitivity than EUS-FNA. EUS-FNB should be considered the preferred diagnostic technique for diagnosing cancer in the setting of CP.
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Affiliation(s)
- Roberto Grassia
- Gastroenterology and Digestive Endoscopy Unit, Cremona Hospital, Cremona, Italy
| | - Nicola Imperatore
- Gastroenterology, Department of Clinical Medicine and Surgery, School of Medicine, "Federico II" of Naples, Naples, Italy
| | - Pietro Capone
- Gastroenterology and Digestive Endoscopy Unit, Hospital "A. Maresca", Torre del Greco, Naples, Italy
| | - Fabrizio Cereatti
- Gastroenterology and Digestive Endoscopy Unit, Cremona Hospital, Cremona, Italy
| | - Edoardo Forti
- Gastroenterology Unit, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Filippo Antonini
- Department of Gastroenterology, A. Murri Hospital, Polytechnic University of Marche, Fermo, Italy
| | | | | | - Federico Buffoli
- Gastroenterology and Digestive Endoscopy Unit, Cremona Hospital, Cremona, Italy
| | | | - Giampiero Macarri
- Department of Gastroenterology, A. Murri Hospital, Polytechnic University of Marche, Fermo, Italy
| | - Gianpiero Manes
- Gastroenterology and Digestive Endoscopy Unit, A.O. Salvini, Garbagnate Milanese, Milan, Italy
| | - Maurizio Vecchi
- Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Germana De Nucci
- Gastroenterology and Digestive Endoscopy Unit, A.O. Salvini, Garbagnate Milanese, Milan, Italy
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Facciorusso A, Buccino RV, Muscatiello N. How to measure quality in endoscopic ultrasound. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:266. [PMID: 30094252 DOI: 10.21037/atm.2018.03.36] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Quality is a key focus for gastrointestinal endoscopy and main international gastroenterology societies instituted specific task forces focused on this issue. Endoscopic ultrasound (EUS) represents one of the most fascinating fields to explore in gastrointestinal endoscopy due to its relatively limited availability out of high-volume centers. This leads to a particular need to define widely accepted quality indicators (QIs) and the ways to measure them. The current manuscript reviews these indicators in light of their impact on common clinical practice.
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Affiliation(s)
- Antonio Facciorusso
- Department of Medical Sciences, Gastroenterology Unit, University of Foggia, Foggia, Italy
| | | | - Nicola Muscatiello
- Department of Medical Sciences, Gastroenterology Unit, University of Foggia, Foggia, Italy
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