A new Japanese study shows that fewer to-and-fro movements during an endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) are equally effective when performing a pancreatic tumor biopsy. Gastrointestinal Endoscopy published the results in late January.
Researchers led by Dr. Kosuke Takahashi of Nagasaki University postulated that far fewer movements are required to acquire the needed sample. The team undertook a multicenter, randomized control trial to compare the biopsy outcomes of EUS-FNB when using 3 to-and-fro movements compared to 12 to-and-fro movements for pancreatic tumors.
Researchers also utilized an innovative new needle — the Franseen needle, an ultrasound-guided needle with three symmetrical heels, which uses a 22-gauge needle to acquire histopathological samples. The Franseen needle is experiencing increased usage among clinicians.
Of the 110 patients, 105 patients had a history of malignancy. The 100 patients included 220 punctures, evenly divided between 3-and-12 movement EUS-FNB ultrasound procedures, translating into 210 punctures on patients with malignant histology.
The results revealed similar diagnostic accuracy and sensitivity for the 3 and 12 to-and-fro movement methods.
Side-by-Side Comparisons of EUS-FNB Using 3 and 12 to-and-fro Movements
| Measure | 3-movement | 12-movement |
| Sensitivity | 88.6% | 89.5% |
| Accuracy | 92.7% | 94.6 % |
| Median macroscopically visible core length | 13.5 mm | 13.5 mm |
The study team also compared the macroscopic visual quality for each group. Using a 5-point scale, they assessed the samples — with 1 representing 50% or more of the sample loaded onto the slide containing red blood components and 5 representing white tissue only, which pathologists prefer. Almost 75% of the 3-movement samples scored 3 or above, while only a little over 50% of the 12-movement samples scored 3 or above.
The authors concluded that “less blood contamination owing to fewer to-and-fro movements offers advantages, such as less burden on pathologists. Furthermore, fewer to-and-fro [movements] can reduce the procedure time and the risk of blood leakage from the puncture site.”