Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar-Apr;12(2):251-258.
doi: 10.4103/EUS-D-22-00059.

Objective evaluation of the resistance forces of 22-gauge EUS-FNA and fine-needle biopsy needles

Yukitoshi Matsunami  1 , Takao Itoi  1 , Takayoshi Tsuchiya  1 , Kentaro Ishii  1 , Reina Tanaka  1 , Ryosuke Tonozuka  1 , Shuntaro Mukai  1 , Kazumasa Nagai  1 , Kenjiro Yamamoto  1 , Yasutsugu Asai  1 , Takashi Kurosawa  1 , Hiroyuki Kojima  1 , Hirohito Minami  1 , Toshihiro Homma  1 , Eri Joyama  2 , Atsushi Sofuni  1
Affiliations

Objective evaluation of the resistance forces of 22-gauge EUS-FNA and fine-needle biopsy needles

Yukitoshi Matsunami et al. Endosc Ultrasound. 2023 Mar-Apr.

Abstract

Background and objectives: EUS-guided tissue acquisition is routinely performed for the diagnosis of gastrointestinal tract and adjacent organ lesions. Recently, various types of needles have been developed. However, how the shape of the needle tip and echoendoscope tip angle affect puncturability, has not been clarified. The aim of this experimental study was to compare the puncturability of several 22-gauge EUS-FNA and EUS-guided fine-needle biopsy (EUS-FNB) needles, and to evaluate the effects of the needle tip shape and echoendoscope tip angle on tissue puncturability.

Materials and methods: The following six major FNA and FNB needles were evaluated: SonoTip® ProControl, EZ Shot 3 Plus, Expect™ Standard Handle, SonoTip® TopGain, Acquire™, and SharkCore™. The mean maximum resistance force against needle advancement was evaluated and compared under several conditions using an echoendoscope.

Results: The mean maximum resistance force of the needle alone was higher for the FNB needles than for the FNA needles. The mean maximum resistance force of the needle in the echoendoscope with free angle demonstrated that the resistance forces were between 2.10 and 2.34 Newton (N). The mean maximum resistance force increased upon increases in angle of the tip of echoendoscope, particularly in the FNA needles. Among the FNB needles, SharkCore™ had the lowest resistance force (2.23 N). The mean maximum resistance force of the needle alone, the needle in the echoendoscope with free angle, and the needle in the echoendoscope with full-up angle for SonoTip® TopGain were all similar to that of Acquire™.

Conclusion: SonoTip® TopGain had similar puncturability to Acquire™ in all tested situations. Regarding the puncturability, SharkCore™ is most suitable for insertion into target lesions, when tight echoendoscope tip angle is necessary.

Keywords: EUS guided tissue acquisition; EUS-FNA; EUS-guided fine-needle biopsy; Franseen type needle; Lancet type needle; fork tip type needle; puncturability; resistance force of the needle; twenty two gauge.

PubMed Disclaimer

Conflict of interest statement

Takao Itoi is an Associate Editor of the journal, and Shuntaro Mukai is an Editorial Board Member. This article was subject to the journal’s standard procedures, with peer review handled independently of the editors and their research groups.

Figures

Figure 1
Figure 1
Images of the tip of each type of needles. (a) Top view of SonoTip® ProControl, (b) Side view of SonoTip® ProControl, (c) Top view of EZshot3, (d) Side view of EZshot3, (e) Top view of Expect™, (f) Side view of Expect™, (g) Top view of SonoTip® TopGain, (h) Side view of SonoTip® TopGain, (i) Top view of Acquire™, (j) Side view of Acquire™, (k) Top view of SharkCore™, (l) Side view of SharkCore™
Figure 2
Figure 2
Images of the bench simulator of puncturability test of the needle alone. (a) The Autograph and the tested needle. The needle tip is fixed to the Autograph, (b) The Autograph, needle tip, and the natural rubber sheet, (c) Measuring the resistance force when the needle tip pierces the natural rubber sheet
Figure 3
Figure 3
Images of the bench simulator of puncturability test of the needle in the echoendoscope. (a) The Autograph, the echoendoscope, and the tested needle, (b) The Autograph and the handle of needle, (c) Measuring the resistance force when the needle tip pierces the natural rubber sheet. The tip of echoendoscope is straight, (d) The tip of echoendoscope is fully-up angled
Figure 4
Figure 4
Resistance forces of the needles alone
Figure 5
Figure 5
Resistance forces of the needles in the echoendoscope with free angle
Figure 6
Figure 6
Resistance forces of the needles in the echoendoscope with full-up angle
Figure 7
Figure 7
Resistance forces of the needles alone, the needles in the echoendoscope with free angle, and the needles in the echoendoscope with full-up angle
See this image and copyright information in PMC

References

    1. Vilmann P, Jacobsen GK, Henriksen FW, et al. Endoscopic ultrasonography with guided fine needle aspiration biopsy in pancreatic disease. Gastrointest Endosc. 1992;38:172–3. - PubMed
    1. Wiersema MJ, Vilmann P, Giovannini M, et al. Endosonography-guided fine-needle aspiration biopsy:Diagnostic accuracy and complication assessment. Gastroenterology. 1997;112:1087–95. - PubMed
    1. Polkowski M, Jenssen C, Kaye P, et al. Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology:European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline –March 2017. Endoscopy. 2017;49:989–1006. - PubMed
    1. Vilmann P. Endoscopic ultrasonography-guided fine-needle aspiration biopsy of lymph nodes. Gastrointest Endosc. 1996;43:S24–9. - PubMed
    1. Itoi T, Itokawa F, Sofuni A, et al. Puncture of solid pancreatic tumors guided by endoscopic ultrasonography:A pilot study series comparing Trucut and 19-gauge and 22-gauge aspiration needles. Endoscopy. 2005;37:362–6. - PubMed

LinkOut - more resources