EUS-guided liver biopsy for parenchymal disease: a comparison of diagnostic yield between two core biopsy needles.
OBJECTIVE
EUS-guided biopsy of the liver has a variable diagnostic accuracy and specimen adequacy. A new core biopsy needle has been developed that may improve performance. The objective of this study was to compare the diagnostic yield of a new core biopsy needle with the previous standard needle.


METHODS
In this cross-sectional study, consecutive patients who underwent EUS-guided core liver biopsy over a 7-year period for suspected parenchymal disease were prospectively evaluated. Between 2007 and 2011, all biopsies were performed with a 19-gauge Tru-cut biopsy needle (Quick-core [QC]), whereas a novel reverse bevel needle (PC) was used exclusively from 2011 to 2014. All specimens were examined by 1 of 3 experienced, blinded pathologists for the following: presence of visible core, aggregate specimen length, number of complete portal tracts, and specimen adequacy.


RESULTS
A total of 75 patients (mean age 51 years, 51 female) underwent liver biopsy by using the QC (n = 45) or PC (n = 30) needle. The QC and PC groups had similar demographics, indications for EUS, indications for liver biopsy, and liver findings on EUS. Compared with those of the QC, biopsies with the PC required fewer passes (median 2 vs 3; P < .0001) but produced longer aggregate length (median 20 mm vs 9 mm; P < .0001) with more complete portal tracts (median 5 vs 2; P = .0003) and adequate specimens (P < .01). Two patients had abdominal pain after liver biopsy with the QC needle.


CONCLUSIONS
Compared with the QC needle, EUS-guided core liver biopsy with the PC needle produced longer aggregate length, more complete portal tracts, and more adequate specimens despite fewer passes (Clinical trial registration number: NCT00586313.).
Division of Gastroenterology and Hepatology, Western University, London, Ontario, Canada.
Michael Sai Lai
MS
Sey
Digestive Disease Institute, Division of Gastroenterology and Hepatology, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Mohammad
M
Al-Haddad
Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana, USA; Center for Innovation at Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA.
Thomas F
TF
Imperiale
Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana, USA.
Kathleen
K
McGreevy
Department of Pathology and Laboratory Medicine, Indiana University Medical Center, Indianapolis, Indiana, USA.
Jingmei
J
Lin
Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana, USA.
John M
JM
DeWitt
D003430:Cross-Sectional Studies; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009339:Needles; D011446:Prospective Studies; D015203:Reproducibility of Results; D013997:Time Factors