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. 2022 Dec 11;12(12):3122.
doi: 10.3390/diagnostics12123122.

Comparison of 22G Fork-Tip and Franseen Needles and Usefulness of Contrast-Enhanced Endoscopic Ultrasound for Diagnosis of Upper Gastrointestinal Subepithelial Lesions

Yasunobu Yamashita  1 , Reiko Ashida  1 , Hirofumi Yamazaki  1 , Yuki Kawaji  1 , Toshio Shimokawa  2 , Takashi Tamura  1 , Keiichi Hatamaru  1 , Masahiro Itonaga  1 , Masayuki Kitano  1
Affiliations

Comparison of 22G Fork-Tip and Franseen Needles and Usefulness of Contrast-Enhanced Endoscopic Ultrasound for Diagnosis of Upper Gastrointestinal Subepithelial Lesions

Yasunobu Yamashita et al. Diagnostics (Basel). .

Abstract

Endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-TA) is less accurate in obtaining samples from gastrointestinal subepithelial lesions (SELs) ≤2 cm than from pancreatic cancers. The present study compared the usefulness of 22G Fork-tip and Franseen needles for EUS-TA and assessed the ability of contrast-enhanced harmonic EUS (CH-EUS) to diagnose SELs ≤2 cm. Fifty-seven patients who underwent EUS-TA for SELs ≤2 cm were evaluated. The primary endpoint was to compare the rate of acquisition of sufficient samples by these two needles. Secondary endpoints included technical success rate, adverse events, numbers of needle passes, and diagnostic ability of CH-EUS for SELs. Of the 57 included patients, 23 and 34 underwent EUS-TA with Fork-tip and Franseen needles, respectively. Technical success rates were 100% with both needles and adverse events occurred in zero (0%) and one (2.9%) patient with Fork-tip and Franseen needles, respectively. The rate of adequate sample acquisition was significantly higher using Fork-tip than Franseen needles (96% vs. 74%; p = 0.038). The hyper- or iso-vascular pattern on CH-EUS correlated significantly with a diagnosis of gastrointestinal stromal tumor (p < 0.001). EUS-TA with Fork-tip needles were superior to EUS-TA with Franseen needles in acquiring sufficient samples and CH-EUS was also useful for the diagnosis of SELs ≤2 cm.

Keywords: EUS-TA; Fork-tip needle; Franseen needle; GIST; contrast-enhanced harmonic EUS; subepithelial lesions.

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Conflict of interest statement

M.K. has received honoraria from Olympus Corporation for giving lectures at conferences. The other authors declare that they have no conflict of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Photographs of (a) a 22G Franseen needle (AcquireTM) and (b) a 22G Fork-tip needle (Shark CoreTM). (a) Franseen needles are made of cobalt–chromium and have a crown-shaped tip with three symmetric prongs. (b) Fork-tip needles are made of stainless steel and contain a nitinol stylet. The device has a multifaceted opposite bevel tip incorporating two sharp prongs of different lengths.
Figure 2
Figure 2
Receiver operating characteristics curve for diagnosis of GIST on CH-EUS. GIST, gastrointestinal stromal tumor; CH-EUS, contrast-enhanced harmonic endoscopic ultrasound.
Figure 3
Figure 3
EUS imaging between Franseen (AcquireTM) and Fork-tip (Shark CoreTM) needle in puncturing SEL. (a) Franseen needle (arrow) did not puncture SEL but pushed the surface of SEL (arrowhead). (b) Fork-tip needle (arrow) sharply punctured SEL (arrowhead). EUS, endoscopic ultrasound; SEL, subepithelial lesions.
See this image and copyright information in PMC

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