ArticleEndoscopic ultrasound
Optimal number of needle passes during EUS-guided fine-needle biopsy of solid pancreatic lesions with 22G ProCore needles and different suction techniques: A randomized controlled trial.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Diagnostic Performance of Endoscopic Ultrasound-Guided Fine Needle Biopsy with Histological Analysis Versus Combined Cytohistological Analysis in Solid Pancreatic Lesions: A Systematic Review and Meta-Analysis.Digestive diseases and sciences · 2025Pooled it
- Comparing needle types and aspiration techniques in EUS-TA to optimize diagnostic efficacy and specimen quality in patients with pancreatic lesions.Frontiers in medicine · 2024Article
- Role of Endoscopic Ultrasound in Diagnosis of Pancreatic Ductal Adenocarcinoma.Diagnostics (Basel, Switzerland) · 2023Review
- Current status and issues in genomic analysis using EUS-FNA/FNB specimens in hepatobiliary-pancreatic cancers.Journal of gastroenterology · 2023Review
- Comparison of suction techniques for EUS-guided tissue acquisition: Systematic review and network meta-analysis of randomized controlled trials.Endoscopy international open · 2023Article
- Recent Developments in the Field of Endoscopic Ultrasound for Diagnosis, Staging, and Treatment of Pancreatic Lesions.Cancers · 2023Review
- Endoscopic Ultrasound Advanced Techniques for Diagnosis of Gastrointestinal Stromal Tumours.Cancers · 2023Review
- Exploring KRAS-mutant pancreatic ductal adenocarcinoma: a model validation study.Frontiers in immunology · 2023Article
- Review
- Optimal sampling technique for EUS-guided fine-needle biopsy of solid pancreatic lesions using a 25-gauge ProCore needle: A multicenter randomized crossover superiority study.Endoscopic ultrasoundArticle
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesThe sensitivity of EUS-guided fine-needle biopsy (EUS-FNB) varies considerably. The optimal number of passes through a solid pancreatic lesion with a 22G FNB needle during EUS-FNB is controversial. This prospective randomized controlled study aimed to determine the optimal number of needle passes during EUS-FNB of solid pancreatic lesions, with 22G FNB needles and different sampling techniques.
methodsPancreatic masses were sampled using 22G FNB needles with either the stylet slow-pull (SP) technique or the standard-suction (SS) technique. We determined the number of needle passes required to obtain a diagnostic accuracy of >90%. Differences between the two techniques in terms of technical success rate, cytological acquisition, core tissue acquisition, sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and complications were analyzed.
resultsA total of 120 patients were randomly assigned to either SP or SS group. Three patients who were lost to follow-up and one who did not complete 5 passes due to bent needle head were excluded from the study. Fifty-six cases in the SP group and 60 cases in the SS group were included in the analysis. For SP technique, the cumulative accuracy of passes 1, 2, 3, 4, and 5 was 44.83%, 76.79%, 87.50%, 92.86%, and 94.64%, respectively. For SS technique, the cumulative accuracy of passes 1, 2, 3, 4, and 5 was 71.67%, 85.0%, 90.0%, 93.33%, and 95.0%, respectively. For each group, there was no statistically significant difference in accuracy after 3 and 4 passes. After 4 passes, the pooled sensitivity (92.59% vs. 93.10%), accuracy (92.86% vs. 93.10%), and specificity (100% vs. 100%) were similar (P > 0.05) in the SP and SS groups, respectively. In addition, positive cytological diagnoses (83.9% vs. 85.0%) and positive histological diagnoses (71.4% vs. 78.3%) were comparable (P > 0.05) in the SP and SS groups, respectively. No statistically significant factor was found associated with diagnostic sensitivity for each group.
conclusionWhen on-site cytological evaluation is unavailable, we recommend that at least 3 passes with 22G ProCore needles be performed during EUS-FNB using the SS technique, at least 4 passes when using SP technique. The SS technique showed potential advantages over SP technique in tissue acquisition and diagnostic capabilities.
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