title: Diagnostic accuracy of 22/25-gauge core needle in endoscopic ultrasound-guided sampling: systematic review and meta-analysis.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of endoscopic ultrasound-guided core needle aspiration with that of standard fine-needle aspiration by systematic review and meta-analysis.
  
  
  METHODS
  Studies using 22/25-gauge core needles, irrespective of comparison with standard fine needles, were comprehensively reviewed. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic curves for the diagnosis of malignancy were used to estimate the overall diagnostic efficiency.
  
  
  RESULTS
  The pooled sensitivity, specificity, and DOR of the core needle for the diagnosis of malignancy were 0.88 (95% confidence interval [CI], 0.84 to 0.90), 0.99 (95% CI, 0.96 to 1), and 167.37 (95% CI, 65.77 to 425.91), respectively. The pooled sensitivity, specificity, and DOR of the standard needle were 0.84 (95% CI, 0.79 to 0.88), 1 (95% CI, 0.97 to 1), and 130.14 (95% CI, 34.00 to 495.35), respectively. The area under the curve of core and standard needle in the diagnosis of malignancy was 0.974 and 0.955, respectively. The core and standard needle were comparable in terms of pancreatic malignancy diagnosis. There was no significant difference in procurement of optimal histologic cores between core and standard needles (risk ratio [RR], 0.545; 95% CI, 0.187 to 1.589). The number of needle passes for diagnosis was significantly lower with the core needle (standardized mean difference, -0.72; 95% CI, -1.02 to -0.41). There were no significant differences in overall complications (RR, 1.26; 95% CI, 0.34 to 4.62) and technical failure (RR, 5.07; 95% CI, 0.68 to 37.64).
  
  
  CONCLUSIONS
  Core and standard needles were comparable in terms of diagnostic accuracy, technical performance, and safety profile.
authors: Division of Gastroenterology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
authors: Hyoung-Chul
authors: HC
authors: Oh
authors: Department of Anesthesiology, Chung-Ang University College of Medicine, Seoul, Korea.
authors: Hyun
authors: H
authors: Kang
authors: Division of Gastroenterology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
authors: Jae Young
authors: JY
authors: Lee
authors: Department of Anesthesiology, Chung-Ang University College of Medicine, Seoul, Korea.
authors: Geun Joo
authors: GJ
authors: Choi
authors: Division of Gastroenterology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
authors: Jung Sik
authors: JS
authors: Choi
mesh_terms: D019540:Area Under Curve; D016009:Chi-Square Distribution; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D009339:Needles; D009369:Neoplasms / Q000473:pathology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors
keywords: Core needle; Endoscopic ultrasound; Fine needle aspiration