22-gauge corevs22-gauge aspiration needle for endoscopic ultrasound-guided sampling of abdominal masses.
OBJECTIVE
To compare the aspiration needle (AN) and core biopsy needle (PC) in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of abdominal masses.


METHODS
Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge (G) AN (Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22G PC (EchoTip ProCore; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and complications.


RESULTS
Fifty six consecutive patients (29 men; mean age 68 years) with pancreatic lesions (n= 38), lymphadenopathy (n= 13), submucosal tumors (n= 4), or others lesions (n= 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy (AN: 88.9vsPC: 96.1,P= 0.25), specimen adequacy (AN: 96.4%vsPC: 91.1%,P= 0.38), mean number of passes (AN: 1.5vsPC: 1.7,P= 0.14), mean cellularity score (AN: 1.7vsPC: 1.1,P= 0.058), and complications (none). A diagnosis on the basis of histology was achieved in the PC group in 36 (64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN (AN: 1.7vsPC: 1.0,P= 0.034); no other differences were of statistical significance.


CONCLUSIONS
Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
William
W
Sterlacci
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Athanasios D
AD
Sioulas
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Lothar
L
Veits
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Pervin
P
Gönüllü
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Guido
G
Schachschal
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Stefan
S
Groth
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Mario
M
Anders
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Christos K
CK
Kontos
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Theodoros
T
Topalidis
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Andrea
A
Hinsch
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Michael
M
Vieth
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Thomas
T
Rösch
William Sterlacci, Lothar Veits, Michael Vieth, Institute of Pathology, Clinic of Bayreuth, 95445 Bayreuth, Germany.
Ulrike W
UW
Denzer
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000295:instrumentation / Q000379:methods*; D019160:Endosonography / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D011446:Prospective Studies; D013048:Specimen Handling / Q000379:methods; D055815:Young Adult
Abdominal tumors; Core biopsy needle; Cytology; Endoscopic ultrasound; Fine needle aspiration