A multicenter evaluation of a new EUS core biopsy needle: Experience in 200 patients

Abstract

Background and objectives: We present a multicenter study of a new endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needle (Acquire, Boston Scientific, Natick, MA). The aim of the study was to analyze the needle's clinical performance when sampling solid lesions and to assess the safety of this device.

Methods: We performed a multicenter retrospective study of patients undergoing EUS-FNB during July 1-November 15, 2016.

Results: Two hundred patients (121 males and 79 females) underwent EUS-FNB of solid lesions with the Acquire needle. Lesions included solid pancreatic masses (n = 109), adenopathy (n = 45), submucosal lesions (n = 34), cholangiocarcinoma (n = 8), liver lesions (n = 6), and other (n = 8). Mean lesion size was 30.6 mm (range: 3-100 mm). The mean number of passes per target lesion was 3 (range: 1-7). Rapid onsite cytologic evaluation (ROSE) by a cytologist was performed in all cases. Tissue obtained by EUS-FNB was adequate for evaluation and diagnosis by ROSE in 197/200 cases (98.5%). Data regarding the presence or absence of a core of tissue obtained after EUS-FNB were available in 145/200 procedures. In 131/145 (90%) of cases, a core of tissue was obtained. Thirteen out of 200 patients (6.5%) underwent some form of repeat EUS-based tissue acquisition after EUS-FNB with the Acquire needle. There were no adverse events.

Conclusion: Overall, this study showed a high rate of tissue adequacy and production of a tissue core with this device with no adverse events seen in 200 patients. Comparative studies of different FNB needles are warranted in the future to help identify which needle type and size is ideal in different clinical settings.

Keywords: Acquire; EUS; fine-needle biopsy; lesions; tissue core.

Figure 1

Cell block from an Acquire needle biopsy showing intact cores with infiltrating malignant glands and single cells, consistent with adenocarcinoma (H and E, ×10)

Figure 2

Cell block from an Acquire needle biopsy showing an intact core harboring malignant cells with scant cytoplasm and heavy crush artifact within a fibrous background. The morphology is suggestive of small cell (poorly differentiated) neuroendocrine carcinoma (H and E)

Figure 3

Photomicrograph of the same patient as Figure 2 cells showing diffuse cytoplasmic staining for synaptophysin, supporting the diagnosis of small cell carcinoma (×10)