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Published in: BMC Gastroenterology 1/2018

Open Access 01-12-2018 | Research article

Feasibility of a 20-gauge ProCore needle in EUS-guided subepithelial tumor sampling: a prospective multicenter study

Authors: Do Hoon Kim, Gwang Ha Kim, Chang Min Cho, Chang Hwan Park, Soo-Young Na, Tae Hyeon Kim, Yu Kyung Cho, Ji Hyun Kim, Dong-Wan Seo, Korean EUS Study Group

Published in: BMC Gastroenterology | Issue 1/2018

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Abstract

Background

Endoscopic ultrasonography-guided fine-needle biopsy (EUS-FNB) may facilitate tissue acquisition for a definitive diagnosis of gastrointestinal subepithelial tumors (SETs). This study aimed to determine the diagnostic yield of EUS-FNB using a novel 20-gauge ProCore needle with a coiled sheath in tissue sampling of gastrointestinal SETs.

Methods

Between July 2016 and February 2017, 39 patients with gastrointestinal SETs were prospectively recruited from six university hospitals in Korea. Hypoechoic SETs ≥2 cm in size and originating from the submucosal and/or muscularis propria layer under EUS were eligible. This study was registered on ClinicalTrials.​gov (NCT02884154).

Results

A total of 36 patients were included in the final analyses. EUS-FNB was diagnostic in 88.9% of SETs. Tissue adequacy was judged as optimal in 97.2% of FNB specimens according to on-site visual evaluation by endosonographers, and in 88.9% of specimens according to pathologists. A macroscopically optimal core sample was obtained with two needle passes in 94.4% of cases. Technical failure rate was encountered in two cases (5.6%) after two needle passes. There were two cases (5.6%) of bleeding, which was managed endoscopically.

Conclusions

EUS-FNB using a 20-gauge ProCore needle is a technically feasible and effective modality for histopathologic diagnosis of gastrointestinal SETs, providing adequate core samples with fewer needle passes;ClinicalTrials.​gov number, NCT02884154.
Literature
1.
go back to reference Hwang JH, Saunders MD, Rulyak SJ, Shaw S, Nietsch H, Kimmey MB. A prospective study comparing endoscopy and EUS in the evaluation of GI subepithelial masses. Gastrointest Endosc. 2005;62:202–8.CrossRef Hwang JH, Saunders MD, Rulyak SJ, Shaw S, Nietsch H, Kimmey MB. A prospective study comparing endoscopy and EUS in the evaluation of GI subepithelial masses. Gastrointest Endosc. 2005;62:202–8.CrossRef
2.
go back to reference Moon JS. Role of endoscopic ultrasonography in guiding treatment plans for upper gastrointestinal subepithelial tumors. Clin Endosc. 2016;49:220–5.CrossRef Moon JS. Role of endoscopic ultrasonography in guiding treatment plans for upper gastrointestinal subepithelial tumors. Clin Endosc. 2016;49:220–5.CrossRef
3.
go back to reference Polkowski M, Bergman JJ. Endoscopic ultrasonography-guided biopsy for submucosal tumors: needless needling? Endoscopy. 2010;42:324–6.CrossRef Polkowski M, Bergman JJ. Endoscopic ultrasonography-guided biopsy for submucosal tumors: needless needling? Endoscopy. 2010;42:324–6.CrossRef
4.
go back to reference Philipper M, Hollerbach S, Gabbert HE, Heikaus S, Bocking A, Pomjanski N, et al. Prospective comparison of endoscopic ultrasound-guided fine-needle aspiration and surgical histology in upper gastrointestinal submucosal tumors. Endoscopy. 2010;42:300–5.CrossRef Philipper M, Hollerbach S, Gabbert HE, Heikaus S, Bocking A, Pomjanski N, et al. Prospective comparison of endoscopic ultrasound-guided fine-needle aspiration and surgical histology in upper gastrointestinal submucosal tumors. Endoscopy. 2010;42:300–5.CrossRef
5.
go back to reference Fernandez-Esparrach G, Sendino O, Sole M, Pellise M, Colomo L, Pardo A, et al. Endoscopic ultrasound-guided fine-needle aspiration and trucut biopsy in the diagnosis of gastric stromal tumors: a randomized crossover study. Endoscopy. 2010;42:292–9.CrossRef Fernandez-Esparrach G, Sendino O, Sole M, Pellise M, Colomo L, Pardo A, et al. Endoscopic ultrasound-guided fine-needle aspiration and trucut biopsy in the diagnosis of gastric stromal tumors: a randomized crossover study. Endoscopy. 2010;42:292–9.CrossRef
6.
go back to reference Levy MJ, Wiersema MJ. EUS-guided Trucut biopsy. Gastrointest Endosc. 2005;62:417–26.CrossRef Levy MJ, Wiersema MJ. EUS-guided Trucut biopsy. Gastrointest Endosc. 2005;62:417–26.CrossRef
7.
go back to reference Polkowski M, Gerke W, Jarosz D, Nasierowska-Guttmejer A, Rutkowski P, Nowecki ZI, et al. Diagnostic yield and safety of endoscopic ultrasound-guided trucut [corrected] biopsy in patients with gastric submucosal tumors: a prospective study. Endoscopy. 2009;41:329–34.CrossRef Polkowski M, Gerke W, Jarosz D, Nasierowska-Guttmejer A, Rutkowski P, Nowecki ZI, et al. Diagnostic yield and safety of endoscopic ultrasound-guided trucut [corrected] biopsy in patients with gastric submucosal tumors: a prospective study. Endoscopy. 2009;41:329–34.CrossRef
8.
go back to reference Varadarajulu S, Fraig M, Schmulewitz N, Roberts S, Wildi S, Hawes RH, et al. Comparison of EUS-guided 19-gauge Trucut needle biopsy with EUS-guided fine-needle aspiration. Endoscopy. 2004;36:397–401.CrossRef Varadarajulu S, Fraig M, Schmulewitz N, Roberts S, Wildi S, Hawes RH, et al. Comparison of EUS-guided 19-gauge Trucut needle biopsy with EUS-guided fine-needle aspiration. Endoscopy. 2004;36:397–401.CrossRef
9.
go back to reference Iglesias-Garcia J, Poley JW, Larghi A, Giovannini M, Petrone MC, Abdulkader I, et al. Feasibility and yield of a new EUS histology needle: results from a multicenter, pooled, cohort study. Gastrointest Endosc. 2011;73:1189–96.CrossRef Iglesias-Garcia J, Poley JW, Larghi A, Giovannini M, Petrone MC, Abdulkader I, et al. Feasibility and yield of a new EUS histology needle: results from a multicenter, pooled, cohort study. Gastrointest Endosc. 2011;73:1189–96.CrossRef
10.
go back to reference Lee JH, Cho CJ, Park YS, Ahn JY, Kim DH, Na HK, et al. EUS-guided 22-gauge fine needle biopsy for the diagnosis of gastric subepithelial tumors larger than 2 cm. Scand J Gastroenterol. 2016;51:486–93.CrossRef Lee JH, Cho CJ, Park YS, Ahn JY, Kim DH, Na HK, et al. EUS-guided 22-gauge fine needle biopsy for the diagnosis of gastric subepithelial tumors larger than 2 cm. Scand J Gastroenterol. 2016;51:486–93.CrossRef
11.
go back to reference Han JP, Lee TH, Hong SJ, Kim HK, Noh HM, Lee YN, et al. EUS-guided FNA and FNB after on-site cytological evaluation in gastric subepithelial tumors. J Dig Dis. 2016;17:582–7.CrossRef Han JP, Lee TH, Hong SJ, Kim HK, Noh HM, Lee YN, et al. EUS-guided FNA and FNB after on-site cytological evaluation in gastric subepithelial tumors. J Dig Dis. 2016;17:582–7.CrossRef
12.
go back to reference Lee M, Min BH, Lee H, Ahn S, Lee JH, Rhee PL, et al. Feasibility and diagnostic yield of endoscopic ultrasonography-guided fine needle biopsy with a new core biopsy needle device in patients with gastric subepithelial tumors. Medicine (Baltimore). 2015;94:e1622.CrossRef Lee M, Min BH, Lee H, Ahn S, Lee JH, Rhee PL, et al. Feasibility and diagnostic yield of endoscopic ultrasonography-guided fine needle biopsy with a new core biopsy needle device in patients with gastric subepithelial tumors. Medicine (Baltimore). 2015;94:e1622.CrossRef
13.
go back to reference Na HK, Lee JH, Park YS, Ahn JY, Choi KS, Kim DH, et al. Yields and utility of endoscopic ultrasonography-guided 19-gauge trucut biopsy versus 22-gauge fine needle aspiration for diagnosing gastric subepithelial tumors. Clin Endosc. 2015;48:152–7.CrossRef Na HK, Lee JH, Park YS, Ahn JY, Choi KS, Kim DH, et al. Yields and utility of endoscopic ultrasonography-guided 19-gauge trucut biopsy versus 22-gauge fine needle aspiration for diagnosing gastric subepithelial tumors. Clin Endosc. 2015;48:152–7.CrossRef
14.
go back to reference Witt BL, Adler DG, Hilden K, Layfield LJ. A comparative needle study: EUS-FNA procedures using the HD ProCore(™) and EchoTip(®) 22-gauge needle types. Diagn Cytopathol. 2013;41:1069–74.CrossRef Witt BL, Adler DG, Hilden K, Layfield LJ. A comparative needle study: EUS-FNA procedures using the HD ProCore(™) and EchoTip(®) 22-gauge needle types. Diagn Cytopathol. 2013;41:1069–74.CrossRef
15.
go back to reference Lee BS, Cho CM, Jung MK, Jang JS, Bae HI. Comparison of histologic core portions acquired from a core biopsy needle and a conventional needle in solid mass lesions: a prospective randomized trial. Gut Liver. 2017;11:559–66.CrossRef Lee BS, Cho CM, Jung MK, Jang JS, Bae HI. Comparison of histologic core portions acquired from a core biopsy needle and a conventional needle in solid mass lesions: a prospective randomized trial. Gut Liver. 2017;11:559–66.CrossRef
16.
go back to reference Bang JY, Hawes R, Varadarajulu S. A meta-analysis comparing ProCore and standard fine-needle aspiration needles for endoscopic ultrasound-guided tissue acquisition. Endoscopy. 2016;48:339–49.PubMed Bang JY, Hawes R, Varadarajulu S. A meta-analysis comparing ProCore and standard fine-needle aspiration needles for endoscopic ultrasound-guided tissue acquisition. Endoscopy. 2016;48:339–49.PubMed
17.
go back to reference Hamada T, Yasunaga H, Nakai Y, Isayama H, Horiguchi H, Matsuda S, et al. Rarity of severe bleeding and perforation in endoscopic ultrasound-guided fine needle aspiration for submucosal tumors. Dig Dis Sci. 2013;58:2634–8.CrossRef Hamada T, Yasunaga H, Nakai Y, Isayama H, Horiguchi H, Matsuda S, et al. Rarity of severe bleeding and perforation in endoscopic ultrasound-guided fine needle aspiration for submucosal tumors. Dig Dis Sci. 2013;58:2634–8.CrossRef
18.
go back to reference Zhang XC, Li QL, Yu YF, Yao LQ, Xu MD, Zhang YQ, et al. Diagnostic efficacy of endoscopic ultrasound-guided needle sampling for upper gastrointestinal subepithelial lesions: a meta-analysis. Surg Endosc. 2016;30:2431–41.CrossRef Zhang XC, Li QL, Yu YF, Yao LQ, Xu MD, Zhang YQ, et al. Diagnostic efficacy of endoscopic ultrasound-guided needle sampling for upper gastrointestinal subepithelial lesions: a meta-analysis. Surg Endosc. 2016;30:2431–41.CrossRef
19.
go back to reference Eckardt AJ, Adler A, Gomes EM, Jenssen C, Siebert C, Gottschalk U, et al. Endosonographic large-bore biopsy of gastric subepithelial tumors: a prospective multicenter study. Eur J Gastroenterol Hepatol. 2012;24:1135–44.CrossRef Eckardt AJ, Adler A, Gomes EM, Jenssen C, Siebert C, Gottschalk U, et al. Endosonographic large-bore biopsy of gastric subepithelial tumors: a prospective multicenter study. Eur J Gastroenterol Hepatol. 2012;24:1135–44.CrossRef
20.
go back to reference Kim GH, Cho YK, Kim EY, Kim HK, Cho JW, Lee TH, et al. Comparison of 22-gauge aspiration needle with 22-gauge biopsy needle in endoscopic ultrasonography-guided subepithelial tumor sampling. Scand J Gastroenterol. 2014;49:347–54.CrossRef Kim GH, Cho YK, Kim EY, Kim HK, Cho JW, Lee TH, et al. Comparison of 22-gauge aspiration needle with 22-gauge biopsy needle in endoscopic ultrasonography-guided subepithelial tumor sampling. Scand J Gastroenterol. 2014;49:347–54.CrossRef
21.
go back to reference Nishida T, Kawai N, Yamaguchi S, Nishida Y. Submucosal tumors: comprehensive guide for the diagnosis and therapy of gastrointestinal submucosal tumors. Dig Endosc. 2013;25:479–89.CrossRef Nishida T, Kawai N, Yamaguchi S, Nishida Y. Submucosal tumors: comprehensive guide for the diagnosis and therapy of gastrointestinal submucosal tumors. Dig Endosc. 2013;25:479–89.CrossRef
Metadata
Title
Feasibility of a 20-gauge ProCore needle in EUS-guided subepithelial tumor sampling: a prospective multicenter study
Authors
Do Hoon Kim
Gwang Ha Kim
Chang Min Cho
Chang Hwan Park
Soo-Young Na
Tae Hyeon Kim
Yu Kyung Cho
Ji Hyun Kim
Dong-Wan Seo
Korean EUS Study Group
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2018
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-018-0880-1

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