Recent advancement in EUS-guided fine needle sampling

Abstract

EUS-guided tissue acquisition technique plays an essential role for evaluation of gastrointestinal tumors. Several components affect the yield of EUS-guided tissue acquisition outcomes such as sampling techniques, use of ROSE (rapid onsite evaluation), training and experience, and needle designs. In this review we discuss advancement in EUS-guided fine needle sampling.

Keywords: Endoscopic ultrasound; Fine needle aspiration; Fine needle biopsy.

Fig. 1

Image of EchoTip ProCore needle tip (22-gauge) showing the reverse bevel that promotes the procuring of core tissue sample from the target lesion (adapted from Dwyer et al. (2016), with permission)

Fig. 2

The 22-gauge tip of fork-tip needle with a second tip at opposite side of the lumen (adapted from Kandel et al. (2016), with permission)

Fig. 3

The tip of 22-gauge Franseen needle design with a crown-shaped containing 3 symmetric planes (adapted from Bang et al. (2018), with permission)

Fig. 4

On-site cytological evaluation of pancreatic sample obtained by EUS–FNA supporting the diagnosis of pancreatic adenocarcinoma (adapted from Iglesias-Garcia et al. (2011), with permission)

Fig. 5

Demonstrating wet suction technique preparation with saline solution (a), loading suction syringe in locked position (b) and column of saline solution moving into the suction syringe as FNA is performed (adapted from Attam et al. (2015), with permission)

Fig. 6

Needle-based confocal laser endomicroscopy (nCLE) images of benign and pancreatic ductal adenocarcinoma lesions. [Benign lesions: a showing normal acinar cells, b-showing fine white fibrous band representing a fibrotic tissue. Pancreatic ductal adenocarcinoma: c- showing dark aggregates > 40 μm, d- showing dilated vessels with fluorescein leakage] Adapted from Karstensen et al. (2018), with permission

Fig. 7

Small biopsy forceps through 19-gauge needle (adapted from Nakai et al. (2016), with permission)