22G Acquire vs. 20G Procore needle for endoscopic ultrasound-guided biopsy of pancreatic
masses: a randomized study comparing histologic sample quantity and diagnostic accuracy
David Karsenti
1
Digestive Endoscopy Unit, Pôle Digestif Paris Bercy, Clinique de Paris-Bercy, Charenton-le-Pont,
France
,
Laurent Palazzo
2
Digestive Endoscopy Unit, Clinique du Trocadéro, Paris, France
,
Bastien Perrot
3
UMR1246_SPHERE Methods for Patient-Centered Outcomes and Health Research, Nantes University,
France
,
Jacqueline Zago
4
Pathology Department, 29 rue du Colisée, Paris, France
,
Anne-Isabelle Lemaistre
5
Department of Pathology, Eurofins Biomnis, Lyon, France
,
Jérôme Cros
6
Beaujon Hospital, Pathology Department, Université de Paris, INSERM U1149, Clichy,
France
,
Bertrand Napoléon
7
Digestive Endoscopy Unit, Hôpital Privé Jean Mermoz, Ramsay Générale de Santé, Lyon,
France
› Author AffiliationsTrial Registration: ClinicalTrials.gov Registration number (trial ID): NCT03567863
Type of study: Multicenter randomized crossover trial
Background Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) has been suggested for obtaining
high quality tissue samples from pancreatic tumors. We performed a multicenter randomized
crossover trial comparing EUS-FNB with a 20G Procore needle vs. a 22G Acquire needle.
The aims were to compare the quantity of targeted tissue (pancreas) and diagnostic
accuracy for the two needles.
Methods 60 patients admitted for EUS-FNB in three endoscopy units were included. One pass
was performed consecutively with each needle, in a randomized order. Histologic material
was studied in a blinded manner with respect to the needle. The primary end point
was mean cumulative length of tissue core biopsies per needle pass.
Results Final diagnosis was adenocarcinoma (n = 46; 77 %), neuroendocrine neoplasm (n = 11;
18 %), autoimmune pancreatitis (n = 2), and mass-forming chronic pancreatitis (n = 1).
The mean cumulative length of tissue core biopsies per needle pass was significantly
higher with the 22G Acquire needle at 11.4 mm (95 % confidence interval [CI] 9.0 – 13.8]
vs. 5.4 mm (95 %CI 3.8 – 7.0) for the 20G Procore needle (P < 0.001), as was the mean surface area (3.5 mm2 [95 %CI 2.7 – 4.3] vs. 1.8 mm2 [95 %CI 1.2 – 2.3]; P < 0.001). Diagnostic adequacy and accuracy were 100 % and 87 % with the 22G Acquire
needle, and 82 % and 67 % with the 20G Procore needle (P = 0.001 and P = 0.02, respectively).
Conclusions EUS-guided biopsy of pancreatic masses with the 22G Acquire needle provided more tissue
for histologic evaluation and better diagnostic accuracy than the 20G Procore needle.
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