Comprehensive review on endoscopic ultrasound-guided tissue acquisition techniques for solid pancreatic tumor

Table 1 The respective characteristics of fine-needle aspiration and fine-needle biopsy

	EUS-FNA	EUS-FNB
Recommended needle caliber	22-25G	22G or thicker
Recommended negative pressure	Suction or wet suction	Stylet retraction
Recommended puncture technique	Fanning or DKM	Fanning or torque
Recommended number of needle passes	1-3 times for histological diagnosis, depending on site and size	Three times for NGS
Diagnostic accuracy		FNB ≥ FNA
Tissue volume		FNB ≥ FNA
Suitability for NGS		FNB ≥ FNA
MOSE	Recommended for use in combination	Recommended for use in combination
Complications	Rare	Rare
Cost-effectiveness		FNB ≥ FNA

DKM: Door knocking method; G: Gauge; EUS: Endoscopic ultrasound; FNA: Fine-needle aspiration; FNB: Fine-needle biopsy; MOSE: Macroscopic on-site evaluation; NGS: Next-generation sequencing.

Table 2 Recommended negative pressure procedural technique for each endoscopic ultrasound-guided tissue acquisition needle to achieve optimal outcomes[61]

Needle type	Best cellularity	Best diagnostic accuracy	Best overall outcome (specimen)
Menghini	Stylet retraction = suction = no suction	Suction	Suction
Reverse-bevel	Stylet retraction = suction	Suction	Suction
Franseen	Stylet retraction	Stylet retraction = suction	Stylet retraction
Fork-tip	Stylet retraction = no suction	Stylet retraction = suction	Stylet retraction