DIAGNOSTIC YIELD OF NEW 20-GAUGE FORWARD-BEVEL CORE BIOPSY NEEDLE FOR EUS-GUIDED TISSUE ACQUISITION FROM PANCREATIC LESIONS IN COMPARISON WITH STANDARD 22G NEEDLE

Aims:

A 20G forward-bevel core biopsy needle (CBN) characterized by an antegrade core trap has been developed to obtain histological core tissue during endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). We evaluated diagnostic yield of the needle for EUS-FNA of a solid pancreatic mass ≥10 mm in comparison with standard 22G needle.

Methods:

20G CBN were prospectively evaluated in 50 patients who underwent EUS-FNA from June 2016-December 2016. Those data were compared with data obtained by retrospectively studying 50 consecutive patients who underwent EUS-FNA using standard 22G needle between December 2016-April 2017. Two punctures were performed in all patients; sample with 1^st pass was used for cytology with/without histology, while sample with 2^nd pass was used for histology. Quantity of sample was evaluated in sample obtained by 2^nd pass.

Results:

There was no significant difference in the rate of diagnostic accuracy of 1^st pass, 2^nd pass, and both 1^st and 2^nd passes (20G CBN, 92% [46/50], 90% [45/50], 96% [48/50] vs. standard 22G, 86% [43/50], 84% [42/50], 94% [47/50]). Regarding quantity of sample, sample with > 10 × power field in length were obtained in 90% (43/48) and 62% (31/50) of patients from 20G CBN and standard 22G, respectively (P= 0.01). Technical failure occurred in 2 patients in 20G CBN.

Conclusions:

Diagnostic accuracy of 20G CBN is comparable with that of standard 22G needle, although 2 passes of 20G CBN yields correct diagnosis in 100% of patients if technically feasible. In addition, 20G CBN yields core tissue in 90% of patients, which is superior to standard 22G needle.