Comparison of the Diagnostic Yield of EUS Needles for Liver Biopsy: Ex Vivo Study

Woo Jung Lee, Lance T Uradomo, Yang Zhang, William Twaddell, Peter Darwin, Woo Jung Lee, Lance T Uradomo, Yang Zhang, William Twaddell, Peter Darwin

Abstract

Background and aims: EUS-guided liver biopsy is an emerging method of liver tissue acquisition which is safe and had been shown to produce excellent histological yield. There is limited data comparing the diagnostic yield of different FNA needles. We aimed to compare the diagnostic performance of four commercially available 19-gauge FNA needles.

Methods: Four FNA needles and one percutaneous needle were used to perform liver biopsies on two human cadaveric livers: Cook Echotip Procore™, Olympus EZ Shot 2™, Boston Scientific Expect Slimline™, Covidien SharkCore™, and an 18-gauge percutaneous needle (TruCore™, Argon Medical Devices). Each needle obtained biopsies by three, six, and nine complete back-and-forth motions of the needle ("throw") with a fanning technique. The combined lengths of specimen fragments and the total number of complete portal tracts (CPT) were measured by a blinded pathologist. One-way analysis of variance (ANOVA) and Bonferroni correction were used for statistical analysis.

Results: A total of 52 liver biopsies were performed. The Covidien SharkCore needle had significantly greater number of CPT compared to other FNA needles. The number of "throws" did not impact the number of CPT significantly. There was no statistically significant difference in mean total specimen length between each FNA needle type.

Conclusion: The Covidien SharkCore needle produced superior histological specimen by capturing more CPT, possibly due to its unique needle design.

Figures

Figure 1
Figure 1
Commercially available FNA needles with different needles tips. From left to right: TruCore percutaneous needles, Olympus EZ Shot 2, Covidien SharkCore, Boston Scientific Expect Slimline, and Cook Echotip Procore.
Figure 2
Figure 2
This diagram represents schema of each FNA needles biopsy; different numbers of throws were grouped separately, and biopsies were obtained from right to left lobes of liver from livers 1 and 2, totaling 12 separate specimen jars for each needle. Only 1 specimen was obtained from each lobe of liver for percutaneous reference needle, totaling 4 specimen bottles.
Figure 3
Figure 3
(a) Picture showing intact specimen and its length; (b) picture of specimen showing two complete portal tracts (CPT).
Figure 4
Figure 4
Comparison of CPT obtained from each FNA needle using one-way ANOVA analysis with Bonferroni correction.

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Source: PubMed

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