Comparison of EUS-guided tissue acquisition using two different 19-gauge core biopsy needles: a multicenter, prospective, randomized, and blinded study.

ABSTRACT: BACKGROUND AND STUDY AIMS:The optimal core biopsy needle for endoscopic ultrasound (EUS) is unknown. The principle aim of this study is to compare outcomes of EUS-fine-needle biopsy (EUS-FNB) with a new 19-gauge EUS histology needle (ProCore, Cook Medical Inc., Winston-Salem, North Carolina, United States) to a conventional 19-gauge Tru-Cut biopsy (EUS-TCB) needle (19G, Quick-Core, Cook Medical Inc.). PATIENTS AND METHODS:Patients referred for EUS who require possible histologic biopsy were prospectively randomized to EUS-FNB or EUS-TCB. With the initial needle, ??3 biopsies were obtained until either technical failure or an adequate core was obtained. Patients with suspected inadequate biopsies were crossed over to the other needle and similarly ??3 passes were obtained until adequate cores or technical failure occurred. Technical success, diagnostic histology, accuracy and complication rates were evaluated. RESULTS:Eighty-five patients (mean 58 years; 43 male) were randomized to FNB (n?=?44) and TCB (n?=?41) with seven patients excluded. Procedure indication, biopsy site, mass size, number of passes, puncture site, overall technical success and adverse events were similar between the two groups. FNB specimens had a higher prevalence of diagnostic histology (85?% vs. 57?%; P?=?0.006), accuracy (88?% vs. 62?%; P?=?0.02), mean total length (19.4 vs. 4.3 mm; P?=?0.001), mean complete portal triads from liver biopsies (10.4 vs. 1.3; P?=?0.0004) and required fewer crossover biopsies compared to those of TCB (2?% vs. 65?%; P?=?0.0001). Overall technical success and complication rates were comparable. CONCLUSION:EUS-FNB using a 19-gauge FNB needle is superior to 19-gauge EUS-TCB needle.

SUBMITTER: DeWitt J 

PROVIDER: S-EPMC4612231 | biostudies-literature | 2015 Oct

REPOSITORIES: biostudies-literature