A comparative needle study: EUS-FNA procedures using the HD ProCore(™) and EchoTip(®) 22-gauge needle types.
Author(s): Witt BL, Adler DG, Hilden K, Layfield LJ
Publication: Diagn Cytopathol, 2013, Vol. 41, Page 1069-74
PubMed ID: 23513000 PubMed Review Paper? No
Purpose of Paper
This paper compared the cytology, cellularity, and diagnostic accuracy of biopsies obtained with a standard 22-gauge (G) needle with those obtained using a HD ProCore 22G beveled needle.
Conclusion of Paper
Compared to specimens obtained using the standard 22G needle, biopsy specimens obtained using the HD ProCore 22G beveled needle were more likely to be satisfactory (89% versus 94%), required fewer passes to achieve adequacy (2.94 versus 2.11), and contained significantly more monolayer sheets and 3D clusters. However, there was no difference between needle types in the median number of needle passes to achieve adequacy or in the presence of thick obscuring clusters, monolayer sheets, crowded obscuring single cells, or blood nor were there differences in total cellularity or diagnostic accuracy. Cell blocks prepared from biopsies obtained using standard 22G needles were slightly more likely to contain representative diagnostic material and had higher mean cellularity score than blocks prepared from HD ProCore 22G beveled needle biopsies (77% versus 73%, and 1.7 versus 1.3, respectively).
Studies
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Study Purpose
This study compared cytological parameters, cellularity, and diagnostic accuracy of biopsies obtained with a standard 22G needle with those obtained using a HD ProCore 22G beveled needle. Biopsies were obtained with endoscopic ultrasound (EUS) guidance from 18 patients using the HD ProCore 22G beveled needle and from an additional 18 patients using a standard 22G needle by the same cytopathologist. Specimens were scored (1+, 2+, or 3+) for the presence of three-dimensional (3D) clusters, cellularity, and blood; reported as yes versus no for presence of thick obscuring clusters, monolayer sheets, crowded obscuring single cells, and sufficiency of diagnostic material; and dark versus normal for degree of nuclear staining.
Summary of Findings:
Although 2 of 18 specimens (11%) obtained using the standard 22G needle were indeterminate or unsatisfactory, only 1 of 18 (6%) specimens obtained using the HD ProCore 22G beveled needles were not satisfactory. Further, the average number of passes necessary to achieve adequacy was higher when biopsied by the standard needle than the HD ProCore 22G beveled needle (2.94 versus 2.11, P=0.03), but the median number of passes required was 3 regardless of needle type. Significantly more monolayer sheets and 3D clusters were observed in biopsies obtained using the HD ProCore 22G beveled needle than the standard 22G needle (P=0.04, both), but there were no differences in total cellularity or in the presence of thick obscuring clusters, monolayer sheets, crowded obscuring single cells, or blood. However, cell blocks prepared from biopsies obtained using standard 22G needles were slightly more likely to contain representative diagnostic material and had higher mean cellularity score than blocks prepared from HD ProCore 22G beveled needle biopsies (77% versus 73%, and 1.7 versus 1.3, respectively). The diagnostic accuracy was comparable for biopsies obtained with each of the two needle types (94%, both).
Biospecimens
Preservative Types
- Formalin
Diagnoses:
- Neoplastic - Benign
- Neoplastic - Carcinoma
Platform:
Analyte Technology Platform Morphology H-and-E microscopy Protein Immunohistochemistry Morphology Light microscopy Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Needle gauge 22G standard needle
22G beveled needle