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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2020; 12(9): 266-275
Published online Sep 16, 2020. doi: 10.4253/wjge.v12.i9.266
Comparison of the reverse bevel versus Franseen type endoscopic ultrasound needle
Chi Wing Chow, Syeda Asma Haider, Krish Ragunath, Guruprasad P Aithal, Martin W James, Jacobo Ortiz-Fernandez-Sordo, Aloysious Dominic Aravinthan, Suresh Vasan Venkatachalapathy
Chi Wing Chow, Krish Ragunath, Guruprasad P Aithal, Martin W James, Jacobo Ortiz-Fernandez-Sordo, Aloysious Dominic Aravinthan, National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and University of Nottingham, Nottingham NG7 2UH, United Kingdom
Syeda Asma Haider, Department of Pathology, Nottingham University Hospitals National Health Service Trust, Nottingham NG7 2UH, United Kingdom
Krish Ragunath, Guruprasad P Aithal, Aloysious Dominic Aravinthan, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2RD, United Kingdom
Suresh Vasan Venkatachalapathy, National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and University of Nottingham, Nottingham NG2 7UH, United Kingdom
Author contributions: Venkatachalapathy SV did the conception of the study, design of the study, writing of manuscript, critical review and overall supervision of the study; Chow CW did the design of the study, data gathering, statistical analysis of data, writing of manuscript and critical review; Haider SA reviewed cytology and did critical review; Ragunath K, Aithal GP, James MW, Ortiz-Fernandez-Sordo J designed the study and did critical review; Aravinthan AD did the statistical analysis of data, writing of manuscript and critical review.
Institutional review board statement: This study was reviewed and approved by the Nottingham University Hospitals National Health Service Trust review board.
Informed consent statement: The informed consent to the study was provided.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Suresh Vasan Venkatachalapathy, MBBS, MRCP, Doctor, National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and University of Nottingham, Derby Road, Nottingham NG2 7UH, United Kingdom.
suresh.venkatachalapathy@nuh.nhs.uk
Received: May 25, 2020
Peer-review started: May 25, 2020
First decision: June 4, 2020
Revised: June 8, 2020
Accepted: August 1, 2020
Article in press: August 1, 2020
Published online: September 16, 2020
Processing time: 108 Days and 6.2 Hours
BACKGROUND
Reverse bevel (RB) needle is widely used for endoscopic ultrasound fine needle biopsy (EUS-FNB). A 3-plane symmetrical needle with Franseen geometry (FG) has recently become available.
AIM
To compare the clinical efficacy of FG to that of RB needle.
METHODS
A retrospective cohort study of all adult patients who underwent EUS-FNB for solid and mixed lesions either with 22G RB needle or 22G FG needle between January 2016 and February 2019 was undertaken. All cytology slides were reviewed by an independent gastrointestinal cytopathologist blinded to the needle used and the initial cytology report. The primary and secondary outcomes were to assess the sample adequacy using Euro-cytology criteria and the number of cell clusters, respectively.
RESULTS
Two hundred and twenty six procedures were included in the study. RB needle was used in 128 procedures and FG needle in 98 procedures. The baseline characteristics of both groups were comparable. On multivariable analysis, FG needle (P = 0.02) and location of the lesion (P < 0.01) were independently associated with adequate tissue. Further, the use of FG needle (P = 0.04) and the size of the lesion (P = 0.02) were independently associated with acquisition of increased number of cell clusters.
CONCLUSION
FG needle is superior to RB needle in acquiring adequate tissue and attaining higher number of cell clusters for solid and mixed lesions.
Core Tip: Despite retrospective, it is the first paper to try to compare the performance of reverse bevel fine needle biopsy (FNB) needle with Franseen geometry FNB needle in term of tissue acquisition and number of cell groups in specimen. Slides reviewed by an independent expert gastrointestinal cytopathologist blinded to needle type used and original cytology reports to minimize bias.
