S2026 A Novel Endoscopic Ultrasound-Guided Motorized Needle Biopsy

Abstract

Introduction: Endoscopic ultrasound (EUS with fine needle aspiration (FNA) is often used to evaluate solid tumors of the pancreas. However, fine needle biopsy (FNB) offers a histologic sample versus a disaggregated sample seen in FNA. Even with FNB technique can limit sample quality. All current needles are manually operated. However, there is a novel motorized FNB needle offering a rotational axial motion resulting in an intact core. This case demonstrates the use of a motorized FNB needle for tissue sampling during EUS. Case Description/Methods: A 87 F presents for the work up of abdominal pain and weight loss. She has no significant medical problems. A cat scan of the abdomen and pelvis was ordered revealing a 3.5 cm mass in the body of the pancreas, concerning for neoplasm. The patient was sent for EUS with biopsy for tissue diagnosis. During the EUS exam a 19g motorized FNB needle was used. After the needle is passed into the tumor a button on the needle shaft is pressed. The needle begins to rotate using an electro mechanical axial motion cutting into the tumor to obtain a specimen. A single pass was required, which confirmed a ductal adenocarcinoma of the pancreas. Due to the vascular invasion the patient was sent to oncology for further management. Discussion: Cancer management continuous to move in the direction of precision medicine. A tissue biopsy is needed to have intact histology sample for diagnosis of a malignant tumor. Furthermore, biopsy is needed to allow molecular analysis of the tumor to offer a personalized treatment plan. This is the first reported case of a motorized EUS needle for tissue acquisition. Future studies are needed to assess performance against traditional manual EUS needles. Watch video at https://bit.ly/3kNpL7R.