Skip to main content
SpringerLink
Log in

Prospective histological evaluation of a 20G core trap with a forward-cutting bevel needle for EUS-FNA of pancreatic lesions

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been established as a method to obtain tissues of various organs. To obtain sufficient tissue has clinical impact to facilitate the diagnosis by clinical pathologists, the assessment and subtyping of various neoplasms, and for further immunohistochemical investigations of tumor type. Recently, a novel 20G core trap with a forward-cutting beveled FNA needle (ProC-F) has become available. The aim of this prospective study was to evaluate the feasibility and diagnostic yield of EUS-FNA for pancreatic lesions using this needle.

Patients and Method

In this study, the first puncture was performed using the ProC-F. Only tissue obtained with the first puncture using the ProC-F was used to evaluate diagnostic yield of ProC-F. The second puncture was performed using a 22G standard FNA needle using the same technique as for the first puncture. Second puncture was performed if the endosonographer did not feel that sufficient tissue had not been obtained by first puncture.

Results

Fifty-three consecutive patients who underwent EUS-FNA for pancreatic lesions were prospectively enrolled. The technical success rate of EUS-FNA using the ProC-F was 98.1% (52/53). The rate of adequate tissue obtained by ProC-F was 96.2% (50/52). On the other hand, the rate of adequate tissue obtained by the standard needle was 71.1%. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of the ProC-F and the standard needle were 92.5, 100, 100, 76.9, and 94.0%, and 85.2, 100, 100, 55.6, and 87.5%, respectively. Diagnostic yield of ProC-F about sensitivity (P = 0.027), NPV (P = 0.035), and accuracy (P = 0.004) was significantly higher than of standard needle. Adverse events were not seen in any patients.

Conclusions

Although only tissue obtained by the first puncture was evaluated, the rate of adequate tissue and the histologic diagnostic yield for pancreatic lesions were extremely high using the ProC-F.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Onda S, Ogura T, Kurisu Y et al (2016) EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence. Therap Adv Gastroenterol 9:302–312

    Article  Google Scholar 

  2. Soh JS, Lee HS, Lee S et al (2015) The clinical usefulness of endoscopic ultrasound-guided fine needle aspiration and biopsy for rectal and perirectal lesions. Intest Res 13:135–144

    Article  Google Scholar 

  3. Kurita A, Kodama Y, Nakamoto Y et al (2016) Impact of EUS-FNA for preoperative para-aortic lymph node staging in patients with pancreatobiliary cancer. Gastrointest Endosc 84:467–475

    Article  Google Scholar 

  4. Lopes RI, Moura RN, Artifon E (2015) Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of kidney lesions: a review. World J Gastrointest Endosc 16:253–257

    Article  Google Scholar 

  5. Pineda JJ, Diehl DL, Miao CL et al (2016) EUS-guided liver biopsy provides diagnostic samples comparable with those via the percutaneous or transjugular route. Gastrointest Endosc 83:360–365

    Article  Google Scholar 

  6. Itoi T, Sofuni A, Itokawa F et al (2011) Current status of diagnostic endoscopic ultrasonography in the evaluation of pancreatic mass lesions. Dig Endosc 23:17–21

    Article  Google Scholar 

  7. Chen G, Liu S, Zhao Y et al (2013) Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer: a meta-analysis. Pancreatology 13:298–304

    Article  Google Scholar 

  8. Hewitt MJ, McPhail MJ, Possamai L et al (2012) EUS-guided FNA for diagnosis of solid pancreatic neoplasms: a meta-analysis. Gastrointest Endosc 75:319–331

    Article  Google Scholar 

  9. Nakai Y, Isayama H, Chang KJ et al (2014) Slow pull versus suction in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid masses. Dig Dis Sci 59:1578–1585

    Article  Google Scholar 

  10. Attam R, Arain MA, Bloechl SJ et al (2015) “Wet suction technique (WEST)”: a novel way to enhance the quality of EUS-FNA aspirate. Results of a prospective, single-blind, randomized, controlled trial using 22-gauge needle for EUS-FNA of solid lesions. Gastrointest Endosc 81:1401–1407

    Article  Google Scholar 

  11. Ramesh J, Bang JY, Mebert-Magee S et al (2015) Randomized trial comparing the flexible 19G and 25G needles for endoscopic ultrasound-guided fine needle aspiration for solid pancreatic mass lesions. Pancreas 44:128–133

    Article  Google Scholar 

  12. Affolter KE, Schmidt RL, Matynia AP et al (2013) Needle size has only a limited effect on outcomes in EUS-guided fine needle aspiration: a systematic review and meta-analysis. Dig Dis Sci 58:1026–1034

    Article  Google Scholar 

  13. Varadarajulu S, Fraig M, Schmulewitz N et al (2004) Comparison of EUS-guided 19-gauge trucut needle biopsy with EUS-guided fine-needle aspiration. Endoscopy 36:397–401

    Article  CAS  Google Scholar 

  14. Levy MJ, Jondal ML, Clain J et al (2003) Preliminary experience with EUS-guided trucut biopsy needle compared with EUS-guided FNA. Gastrointest Endosc 57:101–106

    Article  Google Scholar 

  15. Alatawi A, Beuvon F, Grabar S et al (2015) Comparison of 22G reverse-beveled versus standard needle for endoscopic ultrasound-guided sampling of solid pancreatic lesions. United Eur Gastroenterol J 3:343–352

    Article  Google Scholar 

  16. Kamata K, Kitano M, Yasukawa S et al (2016) Histologic diagnosis of pancreatic masses using 25-gauge endoscopic ultrasound needles with and without a core trap: a multicenter randomized trial. Endoscopy 48:632–638

    Article  Google Scholar 

  17. Rodrigues-Pinto E, Jalaji S, Grimm IS et al (2016) Impact of EUS-guided fine-needle biopsy sampling with a new core needle on the need for onsite cytopathologic assessment: a preliminary study. Gastrointest Endosc 84:1040–1046

    Article  Google Scholar 

  18. Kandel P, Tranesh G, Nassar A et al (2016) EUS-guided fine needle biopsy sampling using a novel fork-tip needle: a case-control study. Gastrointest Endosc 84:1034–1039

    Article  Google Scholar 

  19. Ishiwatari H, Hayashi T, Kawakami H et al (2016) Randomized trial comparing a side-port needle and standard needle for EUS-guided histology of pancreatic lesions. Gastrointest Endosc 84:670–678

    Article  Google Scholar 

  20. Cotton PB, Eisen GM, Aabakken L et al (2010) A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 71:746–754

    Article  Google Scholar 

  21. Paik WH, Park Y, Park DH et al (2015) Prospective evaluation of new 22 gauge endoscopic ultrasound core needle using capillary sampling with stylet slow-pull technique for intra-abdominal solid masses. J Clin Gastroentrol 49:199–205

    Article  Google Scholar 

  22. Matynia AP, Schmidt RL, Barraza G et al (2014) Impact of rapid on-site evaluation on the adequacy of endoscopic-ultrasound guided fine-needle aspiration of solid pancreatic lesions: a systematic review and meta-analysis. J Gastroenterol Hepatol 29:697–705

    Article  Google Scholar 

  23. Fabbri C, Fuccio L, Fornelli A et al (2017) The presence of rapid on-site evaluation did not increase the adequacy and diagnostic accuracy of endoscopic ultrasound-guided tissue acquisition of solid pancreatic lesions with core needle. Surg Endosc 31:225–230

    Article  Google Scholar 

  24. Ogura T, Yamao K, Sawaki A et al (2012) Clinical impact of K-ras mutation analysis in EUS-guided FNA specimens from pancreatic masses. Gastrointest Endosc 75:769–774

    Article  Google Scholar 

  25. Wani S, Shah RJ (2016) EUS-guided tissue acquisition: do we need to shoot for a “core” to score? Gastrointest Endosc 84:1047–1049

    Article  Google Scholar 

  26. Paquin SC, Gariepy G, Lepanto L et al (2005) A first report of tumor seeding because of EUS-guided FNA of a pancreatic adenocarcinoma. Gastrointest Endosc 61:610–611

    Article  Google Scholar 

  27. Katanuma A, Maguchi H, Hashigo S et al (2012) Tumor seeding after endoscopic ultrasound-guided fine-needle aspiration of cancer in the body of the pancreas. Endoscopy 44:E160–E161

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 2nd Department of Internal Medicine, Osaka Medical College, 2-7 Daigakuchou, Takatsukishi, Osaka, 569-8686, Japan

    Nobu Nishioka, Takeshi Ogura, Miyuki Imanishi, Saori Onda, Wataru Takagi, Tatsushi Sano, Atsushi Okuda, Akira Miyano, Mio Amano & Kazuhide Higuchi

  2. Department of Pathology, Osaka Medical College, Osaka, Japan

    Yoshitaka Kurisu

Authors
  1. Nobu Nishioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takeshi Ogura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshitaka Kurisu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Miyuki Imanishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Saori Onda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wataru Takagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tatsushi Sano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Atsushi Okuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Akira Miyano
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mio Amano
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Kazuhide Higuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takeshi Ogura.

Ethics declarations

Disclosures

Nobu Nishiok, Takeshi Ogura, Yoshitaka Kurisu, Miyuki Imanishi, Saori Onda, Wataru Takagi, Tatsushi Sano, Atsushi Okuda, Akira Miyano, Mio Amano, and Kazuhide Higuchi declare that there are no conflict of interest or financial ties to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nishioka, N., Ogura, T., Kurisu, Y. et al. Prospective histological evaluation of a 20G core trap with a forward-cutting bevel needle for EUS-FNA of pancreatic lesions. Surg Endosc 32, 4125–4131 (2018). https://doi.org/10.1007/s00464-018-6155-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-018-6155-7

Keywords

Search

Navigation