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Comparison of Franseen Versus Forward Bevel Needle for EUS-Guided Fine-Needle Biopsy of Subepithelial Lesions: A
Eyad Gadour1,2, Germana De Nucci3, Stefano Francesco Crinò4
1Multi-Organ Transplant Centre of Excellence, Liver Transplantation Unit, King Fahad Specialist Hospital, 32253, Dammam, Saudi Arabia.
Background:
There is lack of direct comparison between different endoscopic ultrasound (EUS)-guided fine-needle biopsy (FNB) needles for tissue sampling of subepithelial lesions (SELs).
Aims:
We aimed to compare Franseen vs forward bevel needle in patients with SELs.
Methods:
Out of 483 patients undergoing endoscopic sampling of SELs, after propensity score matching two groups were compared: 145 undergoing EUS-FNB with 22G Franseen and 145 with 20G forward bevel needle. The primary outcome was diagnostic accuracy. Secondary outcomes were sample adequacy, quality of the sample, sensitivity, specificity, and adverse event rate.
Results:
Sample adequacy and diagnostic accuracy rates were significantly higher with the Franseen needle (98.6 vs 89.6% and 96.5 vs 88.9%; p = 0.01). The scores concerning the integrity of the sample were significantly higher with the Franseen needle (p = 0.02). Diagnostic sensitivity was higher with the Franseen needle (97.9 vs 88.5%, p = 0.02), whereas specificity was 100% with both needles. These findings were confirmed in subgroup analyses according to lesion location and final diagnosis. No adverse events were observed in both groups.
Conclusion:
The 22G Franseen needle determines significantly higher adequacy and accuracy rates and the quality of the sample is higher as compared to the 20G forward bevel needle.
