EUS-FNA using 22G nitinol or ProCore needles without on-site cytopathology.

Area of Science:

• Gastroenterology
• Endoscopic Ultrasound (EUS)
• Oncology

Background:

• Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is crucial for diagnosing gastrointestinal lesions.
• Optimizing tissue acquisition and diagnostic accuracy in EUS-FNA is an ongoing area of research.
• Novel needle designs aim to improve tissue sampling and diagnostic yield.

Purpose of the Study:

• To compare the tissue sampling rate and diagnostic accuracy of a 22G nitinol needle versus a 22G reverse bevel-tipped (ProCore) needle for EUS-FNA.
• To evaluate the performance of these needles in lesions greater than 2 cm.
• To assess needle efficacy in the absence of an on-site cytopathologist.

Main Methods:

• Prospective, randomized, crossover study conducted in a tertiary academic hospital.
• Adult patients undergoing EUS-guided FNA for lesions > 2 cm were recruited.
• Patients received EUS-FNA sequentially with both 22G nitinol and 22G ProCore needles, with blinding for patients and pathologists.

Main Results:

• No significant differences were observed in diagnostic yield, accuracy, sensitivity, specificity, positive predictive value, or negative predictive value between the two needles.
• The percentage of tissue obtained for histological assessment was similar between the nitinol and ProCore needles.
• A larger proportion of patients in the nitinol group obtained more tissue for assessment (P = 0.003).

Conclusions:

• The 22G ProCore needle offers comparable tissue sampling rates and diagnostic accuracy to the conventional 22G FNA needle.
• These findings are relevant for EUS-FNA procedures performed without an on-site cytopathologist.
• The ProCore needle is a viable option for EUS-FNA, demonstrating similar efficacy to conventional needles.