Endoscopic ultrasound-guided fine-needle aspiration biopsy - Recent topics and technical tips

Table 1 List of endoscopic ultrasound-guided fine-needle aspiration biopsy needles

Release year1	Endoscopic ultrasound-guided fine-needle aspiration biopsy needles
2000	Echo Tip Ultra (Cook)
2001	NA-11J-KB (OLYMPUS)
2003	EZ Shot (OLYMPUS)
2004	Quick-Core (Cook)
2011	Expect (Boston)
2011	EZ Shot (OLYMPUS)
2012	Echo Tip Procore (Cook)
2012	SONO tip Pro Control (Medi-Globe)
2012	Expect 19 G Flex Needle (Boston)
2013	EUS Sonopsy CY (HAKKO)
2016	EZ Shot 3 Plus (OLYMPUS)
2016	Echo Tip Procore 20 G (Cook)
2016	Acquire (Boston)

¹Year of release in Japan.

Table 2 Factors affecting diagnostic power of endoscopic ultrasound-guided fine-needle aspiration biopsy and evidence

Factors influencing diagnostic ability	Result
Scope	A forward-viewing echoendoscope is useful[5]
Stylet	The presence or absence of a stylet has no impact on the diagnostic power of EUS-FNA[6]
Needle diameter	A 22-G needle and 25-G needle have equivalent diagnostic power[7]. A 25-G needle has significantly better sensitivity for pancreatic tumors than a 22-G needle[8] A 19-G needle has a significantly better correct diagnostic rate for pancreatic tumors than a 22-G needle[9]
The shape of the needle tip	The number of punctures is reduced using puncture needles with a side hole[10] EUS-guided through-the-needle forceps biopsy is useful[11]
Suction	Wet suction[12] and a high negative pressure provided improved cellularity compared to the typical methods[13]. There is no difference between the stylet slow-pull and standard suction in diagnostic power[14]
Puncture	Fanning lowers the number of punctures[15] The door-knock technique improved cellularity in transgastric punctures when compared to the typical methods[16]
Post puncture-treatment	FNA combined with ROSE and fine-needle biopsy have equivalent diagnostic power[17] Macroscopic on-site quality evaluation is useful[18] The ROSE was useful[19] Cellvizio[20] and TSCI[21] are useful devices to assist with post-puncture treatment

EUS-FNA: Endoscopic ultrasound-guided fine-needle aspiration biopsy; ROSE: Rapid on-site evaluation.