title: Drill needle aspiration biopsy for submucosal tumors in an experimental study.
abstract: OBJECTIVE
  EUS-guided FNA biopsy has been widely performed to aid in the diagnosis of submucosal tumors (SMTs). However, in cases of small tumors, the diagnostic yield of EUS-FNA is poor. Therefore, it is necessary to develop a new needle for the diagnosis. We developed a device with a new mechanism that we refer to as a drill needle aspiration biopsy (DNAB). The aim of this study was to evaluate the use of DNAB in resected gastric SMT specimens.
  
  
  METHODS
  A drill needle with a sharp tip and wide ditch was inserted into a catheter for angiography. Continuous suction is enabled through the catheter at the tip. DNAB was performed with one pass and one stroke in 13 gastric SMTs resected by operation. Similarly, FNA was performed by one pass and ten strokes. These gastric tumors included nine diagnosed gastrointestinal stromal tumors and four undiagnosed SMTs by preoperative examinations. The tissue quantity between DNAB and FNA was macroscopically and microscopically examined.
  
  
  RESULTS
  All 13 drill biopsy specimens were obtained. Additionally, all 13 gastric SMTs, including 4 undiagnosed tumors, could be diagnosed by DNAB. The quantity of each specimen obtained by DNAB was macroscopically and microscopically much greater than that by FNA. In particular, for tumors <25 mm in the longer axis, the ratio of microscopic diagnosable cases was 100 % (7/7) for DNAB and 42.9 % (3/7) for FNA.
  
  
  CONCLUSIONS
  DNAB is a novel method that can obtain more tissue than FNA for small gastric SMT.
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan. uesato@faculty.chiba-u.jp.
authors.forename: Masaya
authors.identifier: http://orcid.org/0000-0002-6766-5600
authors.initials: M
authors.lastname: Uesato
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan.
authors.forename: Tomohide
authors.initials: T
authors.lastname: Tamachi
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hanari
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan.
authors.forename: Yorihiko
authors.initials: Y
authors.lastname: Muto
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kagaya
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan.
authors.forename: Ryuma
authors.initials: R
authors.lastname: Urahama
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Ogura
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Suito
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Nakano
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan.
authors.forename: Mizuho
authors.initials: M
authors.lastname: Aikawa
authors.affiliation: Department of Diagnostic Pathology, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Oide
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba-shi, 260-8670, Japan.
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D013274:Stomach Neoplasms / Q000473:pathology*
keywords: Aspiration; Drill needle; FNA; GIST; SMT