Optimizing EUS-guided liver biopsy sampling: comprehensive assessment of needle types and tissue acquisition techniques - 20/04/17
Abstract |
Background and Aims |
EUS-guided liver biopsy sampling using FNA and, more recently, fine-needle biopsy (FNB) needles has been reported with discrepant diagnostic accuracy, in part due to differences in methodology. We aimed to compare liver histologic yields of 4 EUS-based needles and 2 percutaneous needles to identify optimal number of needle passes and suction.
Methods |
Six needle types were tested on human cadaveric tissue: one 19G FNA needle, one existing 19G FNB needle, one novel 19G FNB needle, one 22G FNB needle, and two 18G percutaneous needles (18G1 and 18G2). Two needle excursion patterns (1 vs 3 fanning passes) were performed on all EUS needles. Primary outcome was number of portal tracts. Secondary outcomes were degree of fragmentation and specimen adequacy. Pairwise comparisons were performed using t tests, with a 2-sided P < .05 considered to be significant. Multivariable regression analysis was performed.
Results |
In total, 288 liver biopsy samplings (48 per needle type) were performed. The novel 19G FNB needle had significantly increased mean portal tracts compared with all needle types. The 22G FNB needle had significantly increased portal tracts compared with the 18G1 needle (3.8 vs 2.5, P < .001) and was not statistically different from the 18G2 needle (3.8 vs 3.5, P = .68). FNB needles (P < .001) and 3 fanning passes (P ≤ .001) were independent predictors of the number of portal tracts.
Conclusions |
A novel 19G EUS-guided liver biopsy needle provides superior histologic yield compared with 18G percutaneous needles and existing 19G FNA and core needles. Moreover, the 22G FNB needle may be adequate for liver biopsy sampling. Investigations are underway to determine whether these results can be replicated in a clinical setting.
Il testo completo di questo articolo è disponibile in PDF.Abbreviation : FNB
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| DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: C. C. Thompson: Consultant for Olympus, Boston Scientific, and Covidien; research support recipient from Olympus; royalty and stock recipient from Covidien; M. Ryou: Consultant for and honorarium recipient from Covidien and Medtronic. All other authors disclosed no financial relationships relevant to this publication. Research support for this study was provided in part by the National Institute of Diabetes and Digestive and Kidney Diseases awarded to Brigham and Women’s Hospital (award number T32DK007533). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases or the National Institutes of Health. |
Vol 85 - N° 2
P. 419-426 - febbraio 2017 Ritorno al numero
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