Prospective comparative study of the EUS guided 25‐gauge FNA needle with the 19‐gauge Trucut needle and 22‐gauge FNA needle in patients with solid pancreatic masses
- 23 March 2009
- journal article
- research article
- Published by Wiley in Journal of Gastroenterology and Hepatology
- Vol. 24 (3), 384-390
- https://doi.org/10.1111/j.1440-1746.2008.05636.x
Abstract
Background and Study Aims: The aim of this prospective study was to compare fine‐needle aspiration guided by endoscopic ultrasonography (EUS‐FNA) using 25‐gauge and 22‐gauge needles with the EUS‐guided 19‐gauge Trucut needle biopsy (EUS‐TNB) in patients with solid pancreatic mass. Patients and Methods: Twenty‐four consecutive patients with pancreatic mass underwent biopsies by both EUS‐FNA and EUS‐TNB. Three needles were compared with respect to technical success rate, tissue size obtained, overall diagnostic accuracy and accuracy for histological and cytological diagnosis. Results: The 25‐gauge EUS‐FNA was technically easier and obtained superior overall diagnostic accuracy than the 22‐gauge and Trucut needles, especially in lesions of the pancreas head and uncinate process. Overall accuracy for the 25‐gauge, 22‐gauge and Trucut needle was 91.7%, 79.7% and 54.1%, respectively. Accuracy for cytological diagnosis irrespective the site of lesions with 25‐gauge, 22‐gauge and Trucut needles was 91.7%, 75.0%, and 45.8%, respectively. For uncinate masses, it was 100%, 33.3%, and 0.0%, respectively. These differences were significant. Among technically successful patients, the accuracy for histological diagnosis using the 25‐gauge was significantly inferior (P < 0.05) to 22‐gauge and Trucut needles and the rates were 45.8%, 78.9% and 83.3%. Conclusions: The 25‐gauge FNA needle was significantly superior in terms of technical success rate and overall diagnostic accuracy, especially for the head and uncinate lesions, compared to the 22‐gauge and Trucut needles and could be considered ‘the best choice needle for cytological diagnosis’ of solid pancreatic lesions. If histological diagnosis is required, the 22‐gauge FNA needle and Trucut needle may be advantageous for use in head/uncinate and body/tail lesions, respectively.Keywords
This publication has 23 references indexed in Scilit:
- Advantage of EUS Trucut biopsy combined with fine-needle aspiration without immediate on-site cytopathologic examinationGastrointestinal Endoscopy, 2006
- Cytologic diagnosis of pancreatic endocrine tumors by endoscopic ultrasound‐guided fine‐needle aspiration: A reviewDiagnostic Cytopathology, 2006
- A prospective control study of the safety and cellular yield of EUS-guided FNA or Trucut biopsy in patients taking aspirin, nonsteroidal anti-inflammatory drugs, or prophylactic low molecular weight heparinGastrointestinal Endoscopy, 2006
- Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB): past, present, and futureThe Esophagus, 2005
- Complications of endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) for pancreatic lesionsThe Esophagus, 2005
- Puncture of Solid Pancreatic Tumors Guided by Endoscopic Ultrasonography: A Pilot Study Series Comparing Trucut and 19-Gauge and 22-Gauge Aspiration NeedlesEndoscopy, 2005
- Preliminary experience with an EUS-guided trucut biopsy needle compared with EUS-guided FNAGastrointestinal Endoscopy, 2003
- Assessment of complications of EUS-guided fine-needle aspirationGastrointestinal Endoscopy, 2001
- The clinical utility of endoscopic ultrasound–guided fine-needle aspiration in the diagnosisand staging of pancreatic carcinomaGastrointestinal Endoscopy, 1997
- Fine-Needle Aspiration Cytology Guided by Endoscopic Ultrasonography: Results in 141 PatientsEndoscopy, 1995