Comparison of EUS-guided 19-gauge Trucut needle biopsy with EUS-guided fine-needle aspiration

S. Varadarajulu, M. Fraig, N. Schmulewitz, S. Roberts, S. Wildi, R. H. Hawes, B. J. Hoffman, M. B. Wallace

Research output: Contribution to journalArticle

208 Scopus citations

Abstract

Background and Study Aims: The accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) depends on immediate specimen review by a cytopathologist. Stromal tumors, lymphoma, and well-differentiated pancreatic cancer are difficult to diagnose on the basis of cytology alone. To overcome these limitations, a 19-gauge Trucut needle has been developed to obtain histological samples at EUS. This pilot study compares the specimen adequacy and diagnostic accuracy of EUS-guided Trucut needle biopsy (EUS-TNB) with EUS-FNA. Patients and Methods: A total of 18 patients underwent EUS-TNB and EUS-FNA. The specimen adequacy and diagnostic accuracy of the two techniques was compared. The technical performance and safety profile of the Trucut needle were also evaluated. Results: The EUS-TNB specimen was adequate for evaluation in 15/18 patients compared with 18/18 with EUS-FNA (83% vs. 100%, not significant). The diagnostic accuracy of EUS-TNB was not significantly different from EUS-FNA (78% vs. 89%). Two complications were encountered: one patient developed mediastinitis and required surgery; another had immediate bleeding that was managed conservatively. One technical problem was encountered: the Trucut needle failed to deploy after two passes when a gastric stromal cell tumor was being biopsied. Conclusion: The diagnostic accuracy of the new EUS-TNB is comparable to that of EUS-FNA. In our experience, the overall efficacy and safety profile of the Trucut needle appears modest.

Original languageEnglish (US)
Pages (from-to)397-401
Number of pages5
JournalEndoscopy
Volume36
Issue number5
DOIs
StatePublished - May 1 2004

ASJC Scopus subject areas

  • Gastroenterology

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    Varadarajulu, S., Fraig, M., Schmulewitz, N., Roberts, S., Wildi, S., Hawes, R. H., Hoffman, B. J., & Wallace, M. B. (2004). Comparison of EUS-guided 19-gauge Trucut needle biopsy with EUS-guided fine-needle aspiration. Endoscopy, 36(5), 397-401. https://doi.org/10.1055/s-2004-814316