title: A prospective randomized study comparing 25-G and 22-G needles of a new platform for endoscopic ultrasound-guided fine needle aspiration of solid masses.
abstract: BACKGROUND
  A new needle platform for endoscopic ultrasound-guided fine-needle aspiration biopsy has been developed that allows interchangeability of all needle sizes.
  
  
  OBJECTIVE
  To prospectively compare the efficacy of the new 25-G needles and 22-G needles for obtaining an adequate aspirate of solid masses.
  
  
  METHODS
  Randomized controlled trial of 144 patients referred for endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses, intraparietal tumours, or lymph-nodes, randomized to the 25-G or 22-G needle arms.
  
  
  RESULTS
  An adequate specimen was obtained from 74.3% of cases. The sample tended to be more adequate in the 25-G compared to the 22-G group (81% vs. 68%; p=0.09). Crossover was required in 14 (19%) and 12 (17%) cases in the 22-G and in the 25-G groups, respectively (p=0.7). The overall rate of adequacy improved from 74% before crossover to 90% after crossover (p<0.01). When comparing the two groups after crossover, the rate of obtaining adequate samples was significantly higher in the 25-G arm than in the 22-G arm (95.8% vs. 86.1%; p=0.03).
  
  
  CONCLUSIONS
  The 25-G needle was superior to the 22-G needle for endoscopic ultrasound-guided fine-needle aspiration biopsy. The adequacy and diagnostic accuracy improved after crossover, reaching 90%.
authors.affiliation: Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy. Electronic address: silvia.carrara@humanitas.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Carrara
authors.affiliation: Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Anderloni
authors.affiliation: Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy.
authors.forename: Manol
authors.initials: M
authors.lastname: Jovani
authors.affiliation: Department of Pathology, Humanitas Research Hospital, Rozzano, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Di Tommaso
authors.affiliation: Department of Pathology, Humanitas Research Hospital, Rozzano, Milan, Italy.
authors.forename: Daoud
authors.initials: D
authors.lastname: Rahal
authors.affiliation: Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Hassan
authors.affiliation: Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ridola
authors.affiliation: Department of Pathology, Humanitas Research Hospital, Rozzano, Milan, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Federico
authors.affiliation: Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Loriga
authors.affiliation: Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Repici
mesh_terms: D000368:Aged; D018592:Cross-Over Studies; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009339:Needles; D010190:Pancreatic Neoplasms / Q000473:pathology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
keywords: 22-Gauge needle; 25-Gauge needle; Endoscopic ultrasound; Fine needle aspiration