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Endoscopy 2009; 41(5): 445-448
DOI: 10.1055/s-0029-1214643
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Retrospective analysis of the utility of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in pancreatic masses, using a 22-gauge or 25-gauge needle system: a multicenter experience

T.  E.  Yusuf1 , S.  Ho2 , D.  A.  Pavey3 , H.  Michael4 , F.  G.  Gress1
  • 1Division of Gastroenterology and Hepatology
    SUNY Downstate Medical Center, Brooklyn, New York, USA
  • 2Division of Gastroenterology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA
  • 3Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina, USA
  • 4Division of Gastroenterology, Hepatology, and Nutrition, Winthrop University Hospital, Mineola, New York, USA
Further Information

Publication History

submitted 5 July 2008

accepted after revision 4 March 2009

Publication Date:
05 May 2009 (online)

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Retrospective analysis of the utility of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in pancreatic masses, using a 22-gauge or 25-gauge needle system: a multicenter experienceEndoscopy 2009; 41(06): 509-509
DOI: 10.1055/s-0029-1214805

Background and study aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is now performed routinely in many advanced endoscopy centers and has enhanced the ability to diagnose pancreatic masses. However, there is uncertainty about which needle size is optimal for EUS-FNA of pancreatic masses. We aimed to evaluate the performance of the 22-gauge and 25-gauge needles in obtaining cytologic diagnosis of pancreatic masses.

Methods: All cases that were referred for EUS-FNA for pancreatic masses between February 2001 and June 2007 were reviewed, and patients who underwent EUS-FNA using the 22-gauge and 25-gauge needle system were identified. In patients who underwent surgery, operative histopathological findings were compared with the cytopathological findings from EUS-FNA.

Results: A total of 842 patients with pancreatic masses detected on computed tomography (CT) and/or magnetic resonance imaging (MRI) and confirmed by EUS underwent EUS-FNA with the 22-gauge needle (n = 540) or the 25-gauge needle (n = 302). Results of EUS-FNA cytology findings were compared with the gold standard of surgical histopathological findings or long-term clinical follow-up. The sensitivity, specificity, PPV, and NPV of FNA were respectively 84 %, 100 %, 100 %, and 49 % for the 22-gauge needle compared with 92 %, 97 %, 98 %, and 89 %, respectively for the 25-gauge needle. No complications were noted in the 25-gauge needle group, compared with pancreatitis in 2 % of the 22-gauge needle group.

Conclusions: This retrospective comparative study shows that EUS-FNA with a 25-gauge needle system is a safe and reliable method for tissue sampling in pancreatic masses. The system is more sensitive and has a higher NPV than the standard 22-gauge needle. Our study suggests that perhaps the smaller caliber FNA needle causes less trauma during EUS-FNA and hence less complications. Further studies including randomized trials are needed.

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T. E. YusufMD 

GI Endoscopy and Pancreato-Biliary Center of Excellence
Division of Gastroenterology and Hepatology
SUNY Downstate Medical Center

450 Clarkson Avenue, Box 1196
Brooklyn, New York 11203-2098

Fax: (718)270-7201

Email: tyusuf@yahoo.com