Endoscopy 2019; 51(04): S18-S19
DOI: 10.1055/s-0039-1681222
ESGE Days 2019 oral presentations
Friday, April 5, 2019 08:30 – 10:30: EUS diagnosis Club D
Georg Thieme Verlag KG Stuttgart · New York

HIGH DIAGNOSTIC ADEQUACY AND ACCURACY OF THE NEW 20G PROCORE NEEDLE FOR EUS-GUIDED TISSUE ACQUISITION: RESULTS OF A LARGE MULTICENTRE RETROSPECTIVE STUDY

C Fabbri
1   Gastroenterology and Endoscopy Unit, AUSL Romagna, Forlì, Italy
,
A Fornelli
2   Pathology Service, Bellaria-Maggiore Hospital, Bologna, Italy
,
L Fuccio
3   Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
,
S Giovanelli
4   Unit of Gastroenterology and Digestive Endoscopy, Bellaria-Maggiore Hospital, Bologna, Italy
,
I Tarantino
5   Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy
,
F Antonini
6   Department of Gastroenterology, A. Murri Hospital, Fermo, Italy
,
R Liotta
7   Pathology Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy
,
L Frazzoni
3   Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
,
P Gusella
8   Pathology Service, A. Murri Hospital, Polytechnic University of Marche, Fermo, Italy
,
M La Marca
3   Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
,
L Barresi
5   Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy
,
G Macarri
6   Department of Gastroenterology, A. Murri Hospital, Fermo, Italy
,
M Traina
5   Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), Palermo, Italy
,
D De Biase
2   Pathology Service, Bellaria-Maggiore Hospital, Bologna, Italy
,
S Fiorino
4   Unit of Gastroenterology and Digestive Endoscopy, Bellaria-Maggiore Hospital, Bologna, Italy
,
E Jovine
4   Unit of Gastroenterology and Digestive Endoscopy, Bellaria-Maggiore Hospital, Bologna, Italy
,
A Larghi
9   Digestive Endoscopy Unit, Gemelli University Hospital, Rome, Italy
,
V Cennamo
4   Unit of Gastroenterology and Digestive Endoscopy, Bellaria-Maggiore Hospital, Bologna, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

EUS-guided fine-needle biopsy has become the standard for tissue sampling. A new 20G ProCore needle has been developed to overcome the limitations of tissue acquisition of the smaller needles (22G, 25G) and the rigidity of the larger one (19G). Aim of the study was to assess the performance of the 20G ProCore needle.

Tab. 1:

Diagnostic performance of the 20G ProCore needle, in pancreatic and extra-pancreatic lesions.

20G ProCore needle performance

Pancreatic lesions (n = 236)

Extra-pancreatic lesions (n = 148)

Histological/cytological diagnosis drawn from tissue sample (diagnostic yield), n (%)

218 (92.4%)

141 (95.3%)

Possibility to obtain histological core, n (%)

170 (72.0%)

125 (84.5%)

Sensitivity for malignant lesions, % (95% CI)

90.8% (86.1 – 94.3%)

92.6% (85.4 – 97.0%)

Specificity for malignant lesions, % (95% CI)

100% (82.4 – 100%)

100% (93.3 – 100%)

Methods:

Patients who underwent EUS-guided tissue acquisition with the 20G ProCore needle of pancreatic and extra-pancreatic mass lesions were retrospectively identified at three Italian centers (Bologna, Fermo, Palermo). Diagnostic adequacy, accuracy and tissue core acquisition were the outcome measures. All the cases were performed without rapid on-site evaluation.

Results:

A total of 384 patients with pancreatic (62.2%) and extra-pancreatic lesions were included. For pancreatic lesions, adequacy, accuracy, sensitivity and specificity were 92.4%, 91.5%, 90.8% and 100%, respectively with a number needed to misdiagnose (NNM) of 11.8. The tissue core was obtained in 72% cases. Trans-duodenal approach was performed in 150 pancreatic lesions; adequacy, accuracy and tissue core acquisition were 88.7%, 90% and 66%, respectively (NNM 10). For extra-pancreatic lesions, adequacy, accuracy, sensitivity, specificity and tissue core sampling were 95.3%, 95.3%, 92.6%, 100% and 84.5% (NNM 21.3). Details are reported in Table 1.

Conclusions:

The 20G ProCore needle showed high diagnostic adequacy and accuracy, regardless of the access route.