Initial experience with transmural use of a new endoscopic ultrasound electric core needle biopsy device: Case series

Abstract

Background and study aims Endoscopic ultrasound-guided biopsy via fine-needle biopsy/fine-needle aspiration (FNB/FNA) is currently the standard method to sample tumors in the mediastinum and abdomen. Although specimens obtained with these needles are acceptable, a histological diagnosis is not always possible. Recently, a new EUS-guided core needle biopsy (EUS-CNB) device became available. Herein, we describe the first experience with its use in a transmural fashion.

Patients and methods This was a case series of patients who underwent EUS-CNB at an academic center. All patients provided written informed consent and were observed in the hospital ≥ 48 hours after the procedure.

Results A total of 8 patients underwent EUSC-CNB: five in the pancreas, two in the retroperitoneum, and one in the mediastinum. The diagnostic accuracy of EUS-CNB was 100% after one actuation. In four patients, same-session FNB and EUS-CNB were obtained from the same lesion with superior tissue sample in the latter. No adverse events were documented.

Conclusions To our knowledge this is the first report on transmural use of EUS-CNB in gastroenterology. Our findings suggest that the device is effective and safe. Larger studies comparing it with FNA/FNB needles will be required to further assess performance and safety.

Keywords

Endoscopic ultrasonography - Pancreas - Tissue diagnosis - Fine-needle aspiration/biopsy - Endoscopy Upper GI Tract - Precancerous conditions & cancerous lesions (displasia and cancer) stomach

Publication History

Received: 29 June 2024

Accepted after revision: 26 September 2024

Accepted Manuscript online:
30 September 2024

Article published online:
28 October 2024

• References

• 1 Mendoza Ladd A, Casner N, Cherukuri SV. et al. Fine needle biopsies of solid pancreatic lesions: tissue acquisition technique and needle design do not impact specimen adequacy. Dig Dis Sci 2022; 67: 4549-4556
• 2 Swahn F, Glavas R, Hultin L. et al. The advent of the first electric driven EUS-guided 17 gauge core needle biopsy - A pilot study on subepithelial lesions. Scand J Gastroenterol 2024; 1-7
• 3 Vilmann P, Jacobsen GK, Henriksen FW. et al. Endoscopic ultrasonography with guided fine needle aspiration biopsy in pancreatic disease. Gastrointest Endosc 1992; 38: 172-173
• 4 Wiersema MJ, Chak A, Wiersema LM. Mediastinal histoplasmosis: evaluation with endosonography and endoscopic fine-needle aspiration biopsy. Gastrointest Endosc 1994; 40: 78-81
• 5 Vilmann P, Hancke S, Henriksen FW. et al. Endosonographically-guided fine needle aspiration biopsy of malignant lesions in the upper gastrointestinal tract. Endoscopy 1993; 25: 523-527
• 6 Wong T, Pattarapuntakul T, Netinatsunton N. et al. Diagnostic performance of endoscopic ultrasound-guided tissue acquisition by EUS-FNA versus EUS-FNB for solid pancreatic mass without ROSE: a retrospective study. World J Surg Oncol 2022; 20: 215
• 7 Iglesias-Garcia J, Poley JW, Larghi A. et al. Feasibility and yield of a new EUS histology needle: results from a multicenter, pooled, cohort study. Gastrointest Endosc 2011; 73: 1189-1196
• 8 Karstensen JG, Vilmann P. Historical perspective on needle development: From the past to the future. Best Pract Res Clin Gastroenterol 2022; 60–61: 101814
• 9 Itonaga M, Yasukawa S, Fukutake N. et al. Comparison of 22-gauge standard and Franseen needles in EUS-guided tissue acquisition for diagnosing solid pancreatic lesions: a multicenter randomized controlled trial. Gastrointest Endosc 2022; 96: 57-66.e52
• 10 Li Z, Liu W, Xu X. et al. A meta-analysis comparing endoscopic ultrasound-guided fine-needle aspiration with endoscopic ultrasound-guided fine-needle biopsy. J Clin Gastroenterol 2022; 56: 668-678