Abstract
Endoscopic ultrasound (EUS) with fine needle aspiration (FNA) or biopsy (FNB) to diagnose lesions in the gastrointestinal tract is common. Demand for histology sampling to identify treatment-specific targets is increasing. Various core biopsy FNB needles to obtain tissue for histology are currently available, however, with variable (37–97%) histology yields. In this multicenter study, we evaluated performance, safety, and user experience of a novel device (the puncture biopsy forceps (PBF) needle). Twenty-four procedures with the PBF needle were performed in 24 patients with a suspected pancreatic lesion (n = 10), subepithelial lesion (n = 10), lymph node (n = 3), or pararectal mass (n = 1). In 20/24 (83%) procedures, the PBF needle yielded sufficient material for interpretation (sample adequacy). In 17/24 (71%), a correct diagnosis was made with the material from the PBF needle (diagnostic accuracy). All participating endoscopists experienced a learning curve. (Per)procedural technical issues occurred in four cases (17%), but there were no adverse events. The PBF needle is a safe and potentially useful device to obtain an EUS-guided biopsy specimen. As the design of the PBF needle is different to core biopsy FNB needles, specific training will likely further improve the performance of the PBF needle. Furthermore, the design of the needle needs further improvement to make it more robust in clinical practice.
Highlights
Endoscopic ultrasound (EUS) is nowadays increasingly used for the evaluation of lesions in the gastrointestinal tract [1]
Biopsies were performed on 10 pancreatic lesions (41.7%), 10 subepithelial lesions (41.7%; esophageal n = 1, gastroesophageal junction n = 3, gastric n = 4, duodenal n = 1, and small bowel n = 1), three lymph nodes (12.5%; mediastinal n = 2 and peripancreatic n = 1), and one pararectal mass (4.2%)
In 22 cases (92%) another needle was used during the same EUS procedure: fine needle aspiration (FNA) (n = 14), fine needle biopsy (FNB) (n= 7), or both FNA and FNB (n= 1)
Summary
Endoscopic ultrasound (EUS) is nowadays increasingly used for the evaluation of lesions in the gastrointestinal tract [1]. The histology instead of cytology, for in additional andwith analyrapid development of precision medicine in oncology there an increasing diagnosing demand for sis of molecular biomarkers to identify treatment targets [3,4].is tissue histology sampling instead of cytology, for additional immunohistochemistry and non-pancreatic lesions often requires samples with a high cellularity and assessment of analysis of molecular biomarkers to identify treatment targets [3,4]. For subepithelial masses and lymph nodes, ing non-pancreatic lesions often requires samples with a high cellularity and assessment of FNA performance varies with a diagnostic accuracy of 46–98% and 65–100%, respectively lesion architecture and morphology [5,6]. For subepithelial masses and lymph nodes, FNA [2]
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