Wet-suction technique in EUS-FNB yields higher tissue core rate than slow-pull method

Italy: Researchers have found in a new research that wet-suction technique in endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using new-generation needles may result in a higher tissue core procurement rate compared to the slow-pull method in patients with solid lesions of ≥ 1 cm.

A recent clinical trial published in Thieme: Endoscopy compared the performance of two techniques - wet-suction and slow-pull-during endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using new-generation needles.

The study aimed to evaluate the histological yield, sample quality, diagnostic accuracy, and adequate tumor fraction of the two techniques in patients with solid lesions of ≥ 1 cm.

The study included 210 patients with 146 pancreatic and 64 nonpancreatic lesions. Four needle passes with either a 22 G fork-tip or Franseen-type needle were performed, alternating between the wet-suction and slow-pull techniques in a randomized order. The primary outcome was the histological yield, defined as samples containing an intact piece of tissue of at least 550 μm.

The study revealed the following clinical findings:

1. Wet-suction technique resulted in a higher tissue core procurement rate (71.4%) compared to the slow-pull technique (61.4%).
2. Mean tissue integrity score was higher with wet suction, but blood contamination of samples was also higher.
3. Tissue core rate and tissue integrity score were not statistically different between the two techniques in subgroups of pancreatic and nonpancreatic lesions.
4. Diagnostic accuracy and tumor fraction were similar between the two techniques.

The findings of this study suggest that the wet-suction technique in EUS-FNB using new-generation needles may result in a higher tissue core procurement rate compared to the slow-pull method. However, it also indicates that there are trade-offs, with wet suction showing higher tissue integrity but also increased blood contamination.

“Clinicians may need to consider these factors when choosing between the two techniques based on the specific clinical scenario and patient characteristics. Further research and clinical trials may be needed to validate these findings and determine the optimal technique for EUS-FNB with new-generation needles.” added the researchers of the study.

Reference:

Crinò, S. F., Conti Bellocchi, M. C., Mitri, R. D., Inzani, F., Rimbaș, M., Lisotti, A., Manfredi, G., B. Teoh, A. Y., Mangiavillano, B., Sendino, O., Bernardoni, L., Manfrin, E., Scimeca, D., Unti, E., Carlino, A., Voiosu, T., Mateescu, R. B., Fusaroli, P., Lega, S., . . . Larghi, A. (2022, September 27). Wet-suction versus slow-pull technique for endoscopic ultrasound-guided fine-needle biopsy: a multicenter, randomized, crossover trial. Thieme E-Journals - Endoscopy / Abstract. https://doi.org/10.1055/a-1915-1812