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World J Gastrointest Endosc. Oct 16, 2018; 10(10): 267-273
Published online Oct 16, 2018. doi: 10.4253/wjge.v10.i10.267
Concise review on the comparative efficacy of endoscopic ultrasound-guided fine-needle aspiration vs core biopsy in pancreatic masses, upper and lower gastrointestinal submucosal tumors
Tawfik Khoury, Wisam Sbeit, Nicholas Ludvik, Divya Nadella, Alex Wiles, Caitlin Marshall, Manoj Kumar, Gilad Shapira, Alan Schumann, Meir Mizrahi
Tawfik Khoury, Department of Gastroenterology and Liver Unit, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel
Wisam Sbeit, Institute of Gastroenterology and Liver Diseases, Galilee Medical Center Bar Ilan Faculty of Medicine, Naharia 22101, Israel
Nicholas Ludvik, Divya Nadella, Alex Wiles, Caitlin Marshall, Manoj Kumar, Gilad Shapira, Alan Schumann, Meir Mizrahi, Department of Internal Medicine, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, AL 251660, United States
Author contributions: Khoury T and Mizrahi M contributed to the conception and design; all authors contributed to the analysis and interpretation of data; Khoury T and Mizrahi M contributed to drafting the manuscript; all authors approved the final version to be published.
Conflict-of-interest statement: The authors report no conflict of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tawfik Khoury, MD, Doctor, Lecturer, Senior Researcher, Department of Gastroenterology and Liver Unit, Hebrew University-Hadassah Medical Center, POB 12000, Jerusalem 91120, Israel. tawfikkhoury1@hotmail.com
Telephone: +972-509870611
Received: May 10, 2018
Peer-review started: May 10, 2018
First decision: June 8, 2018
Revised: July 2, 2018
Accepted: July 23, 2018
Article in press: July 23, 2018
Published online: October 16, 2018
Processing time: 159 Days and 3.6 Hours
Abstract

Endoscopic ultrasound (EUS)-guided fine needle aspiration with or without biopsy (FNA/FNB) are the primary diagnostic tools for gastrointestinal submucosal tumors. EUS-guided fine needle aspiration (EUS-FNA) is considered a first line diagnostic method for the characterization of pancreatic and upper gastrointestinal lesions, since it allows for the direct visualization of the collection of specimens for cytopathologic analysis. EUS-FNA is most effective and accurate when immediate cytologic assessment is permitted by the presence of a cytopathologist on site. Unfortunately, the accuracy and thus the diagnostic yield of collected specimens suffer without this immediate analysis. Recently, a EUS-FNB needle capable of obtaining core samples (fine needle biopsy, FNB) has been developed and has shown promising results. This new tool adds a new dimension to the diagnostic and therapeutic utility of this technique. The aim of the present review is to compare the efficacy of EUS-FNA to that afforded by EUS-FNB in the characterization of pancreatic masses and of upper and lower gastrointestinal submucosal tumors.

Keywords: Efficacy; Safety; Gastrointestinal masses; Fine needle aspiration and biopsy

Core tip: Endoscopic ultrasound (EUS)-guided sampling is the first diagnostic option for gastrointestinal submucosal and pancreatic lesions. In the past, fine needle aspiration (FNA) was the main method to obtain tissue for histological examination, however, it was associated with limited diagnostic accuracy. In the last decade, fine needle biopsy (FNB) needle was introduced into clinical practice, which allows for more tissue acquisition and improvement in diagnostic yield. In this updated minireview, we provide an overview on the role of EUS-FNA and FNB in certain gastrointestinal lesions. In addition, we provide a summary on the efficacy and safety profile of each procedure with reporting the recent guidelines recommendation.