PMID- 33771557
OWN - NLM
STAT- MEDLINE
DCOM- 20210831
LR  - 20210831
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 94
IP  - 3
DP  - 2021 Sep
TI  - Single-pass 1-needle actuation versus single-pass 3-needle actuation technique 
      for EUS-guided liver biopsy sampling: a randomized prospective trial (with 
      video).
PG  - 551-558
LID - S0016-5107(21)00262-5 [pii]
LID - 10.1016/j.gie.2021.03.023 [doi]
AB  - BACKGROUND AND AIMS: Several reports have validated EUS-guided liver biopsy 
      sampling (EUS-LB) as safe and effective. Nineteen-gauge EUS aspiration (FNA) or 
      core (fine-needle biopsy [FNB]) needles are used, but different needle techniques 
      can yield variable outcomes. Some data show that 1 pass (single liver puncture) 
      with 1 actuation (1 to-and-fro needle movement) may be enough to obtain a 
      satisfactory specimen. However, there has not been a head-to-head comparison of 
      single versus multiple needle actuations for EUS-LB. METHODS: This was a 
      prospective randomized trial of EUS-LB in 40 patients comparing tissue yields and 
      adequacy using 1 pass, 1 actuation (1:1) versus 1 pass 3 actuations (1:3) of an 
      FNB needle. The primary outcome was number of complete portal triads (CPTs). 
      Secondary outcomes were length of the longest piece, aggregate specimen length, 
      number of cores >9 mm, and adverse events (AEs). Computerized randomization 
      determined selection (either 1:1 or 1:3 with fanning technique). Sample lengths 
      were measured before pathologic processing. RESULTS: Both groups had similar 
      demographics and indications for EUS-LB. All biopsy samples were adequate for 
      pathologic interpretation. Compared with 1:1, biopsy sampling with 1:3 yielded 
      more CPTs (mean [standard deviation], 17.25 [6.2] vs 24.5 [9.88]; P < .008) and 
      longer aggregate specimen length (6.89 cm [1.86] vs 12.85 cm [4.02]; P < .001). 
      AEs were not statistically different between the techniques. No severe AEs were 
      noted. CONCLUSIONS: EUS-LB using the 1:3 technique produced longer liver cores 
      with more CPTs than the 1:1 technique with an equivalent safety profile. Two 
      needle passes are more likely to provide tissue adequacy according to the 
      American Association for the Study of Liver Diseases guidelines. (Clinical trial 
      registration number: UMIN 000040101.).
CI  - Copyright (c) 2021 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Ching-Companioni, Rafael A
AU  - Ching-Companioni RA
AD  - Department of Gastroenterology, Digestive Diseases Center, Panama City, Florida, 
      USA; Department of Medicine, Gulf Coast Regional Medical Center, Panama City, 
      Florida, USA.
FAU - Johal, Amitpal S
AU  - Johal AS
AD  - Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, 
      Pennsylvania, USA.
FAU - Confer, Bradley D
AU  - Confer BD
AD  - Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, 
      Pennsylvania, USA.
FAU - Forster, Erin
AU  - Forster E
AD  - Division of Gastroenterology & Hepatology, Medical University of South Carolina, 
      Charleston, South Carolina, USA.
FAU - Khara, Harshit S
AU  - Khara HS
AD  - Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, 
      Pennsylvania, USA.
FAU - Diehl, David L
AU  - Diehl DL
AD  - Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, 
      Pennsylvania, USA.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Video-Audio Media
DEP - 20210323
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2021 Sep;94(3):559-561. PMID: 34412827
MH  - Endoscopic Ultrasound-Guided Fine Needle Aspiration
MH  - Humans
MH  - *Liver Diseases
MH  - *Needles
MH  - Prospective Studies
EDAT- 2021/03/28 06:00
MHDA- 2021/09/01 06:00
CRDT- 2021/03/27 05:47
PHST- 2021/01/10 00:00 [received]
PHST- 2021/03/14 00:00 [accepted]
PHST- 2021/03/28 06:00 [pubmed]
PHST- 2021/09/01 06:00 [medline]
PHST- 2021/03/27 05:47 [entrez]
AID - S0016-5107(21)00262-5 [pii]
AID - 10.1016/j.gie.2021.03.023 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2021 Sep;94(3):551-558. doi: 10.1016/j.gie.2021.03.023. Epub 
      2021 Mar 23.