CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(01): E62-E71
DOI: 10.1055/a-0655-7462
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Endoscopic ultrasound-guided biopsy in chronic liver disease: a randomized comparison of 19-G FNA and 22-G FNB needles

Shaffer R. S. Mok
Geisinger Medical Center, Department of Gastroenterology and Hepatology, Division of Interventional Endoscopy, Danville, Pennsylvania, United States
,
David L. Diehl
Geisinger Medical Center, Department of Gastroenterology and Hepatology, Division of Interventional Endoscopy, Danville, Pennsylvania, United States
,
Amitpal S. Johal
Geisinger Medical Center, Department of Gastroenterology and Hepatology, Division of Interventional Endoscopy, Danville, Pennsylvania, United States
,
Harshit S. Khara
Geisinger Medical Center, Department of Gastroenterology and Hepatology, Division of Interventional Endoscopy, Danville, Pennsylvania, United States
,
Bradley D. Confer
Geisinger Medical Center, Department of Gastroenterology and Hepatology, Division of Interventional Endoscopy, Danville, Pennsylvania, United States
,
Prashant R. Mudireddy
Geisinger Medical Center, Department of Gastroenterology and Hepatology, Division of Interventional Endoscopy, Danville, Pennsylvania, United States
,
Alicia H. Kovach
Geisinger Medical Center, Department of Gastroenterology and Hepatology, Division of Interventional Endoscopy, Danville, Pennsylvania, United States
,
Mia M. Diehl
Geisinger Medical Center, Department of Gastroenterology and Hepatology, Division of Interventional Endoscopy, Danville, Pennsylvania, United States
,
H. Lester Kirchner
Geisinger Medical Center, Department of Gastroenterology and Hepatology, Division of Interventional Endoscopy, Danville, Pennsylvania, United States
,
Zong-Ming E. Chen
Geisinger Medical Center, Department of Gastroenterology and Hepatology, Division of Interventional Endoscopy, Danville, Pennsylvania, United States
› Institutsangaben
TRIAL REGISTRATION: Randomized, single-center, prospective cross-over study with a single-blinded outcome assessor NCT02967991 at clinicaltrials.gov
Weitere Informationen

Publikationsverlauf

submitted 23. März 2018

accepted after revision 11. Juni 2018

Publikationsdatum:
04. Januar 2019 (online)

Abstract

Background and study aims Endoscopic ultrasound-guided liver biopsy uses a 19-gauge (G) needle for parenchymal liver biopsies. We evaluated tissue yields with a 22G fine-needle biopsy (FNB) versus 19G FNA fine-needle aspirate (FNA) device.

Patients and methods Biopsies were obtained from 20 patients using the 19G FNA and 22G FNB randomizing each in a cross-over fashion with a blinded outcome assessor. Tissue adequacy for histologic evaluation was the primary outcome, or the proportion of specimens obtaining pathologic diagnosis (portal structures ≥ 5 or length of the longest piece ≥ 15 mm). Additional secondary outcomes included portal and centrilobular inflammation/fibrosis, length of the longest piece, aggregate specimen length, and small (< 5 mm), medium (5 – 8 mm) and large (> 8 mm) fragments. Results were compared in a per needle basis. Patients with cirrhosis were excluded.

Results Eighty biopsies (40 each 19G FNA and 22G FNB) were obtained. Tissue adequacy was greater for the 19G FNA (88 %) versus 22G FNB (68 %), (P = 0.03). There was no difference in total portal structures for the 19G FNA (7.4) and 22G FNB (6.1), (P = 0.28).

There was no difference in pre-processing outcomes. After processing, length of the longest piece was higher for the 19G FNA (9.1 mm) versus 22G FNB (6.6 mm), (P = 0.02). More total post-processing small fragments 29.9 versus 20.7, (P = 0.01) and fewer large fragments 1.0 versus 0.4 for the 22G FNB (P = 0.01) were detected.

Conclusions Tissue adequacy was higher for the 19G FNA versus 22G FNB needle. The 22G FNB needle produced samples more prone to fragmentation during specimen processing.

 
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