Abstract 528P
Background
Endoscopic ultrasound-guided liver biopsy (EUS-LB) has recently garnered increasing attention. While reports suggest fine-needle biopsy (FNB) needles have a higher yield compared to fine-needle aspiration (FNA) needles, controversy remains regarding the superior diagnostic performance among different types of FNB needles. This study aims to evaluate the performance and safety of two commonly used FNB needles for diagnosing pancreatic lesions, specifically when applied to liver lesions.
Methods
We retrospectively analyzed patients who underwent EUS-LB for solid liver lesions between November 2014 and September 2023. The study evaluated two different needles: a Menghini needle, which has a core trap with a lateral reverse bevel, and a Franseen needle.
Results
Among 66 patients evaluated, the technical success rate was 100%. The combined diagnostic rate from cell block and histology was 89.4%, with an overall adverse event rate of 3.0%. Tissue retrieval rates were 67.5% for the Reverse-bevel needle and 96.2% for the Franseen needle (p=0.006). Adverse event rates were 2.5% and 3.8%, respectively (p=0.674). The FNAB accuracy of the Reverse-bevel needle group was 89.7%, with a sensitivity of 89.5% and specificity of 100.0%. In contrast, the Franseen needle group exhibited an FNAB accuracy of 92.6%, a sensitivity of 92.3%, and specificity of 100.0%. Table: 528P
Diagnostic yield between Reverse-bevel needle group and Franseen needle group
| Reverse-bevel needle (n=40) | Franseen needle (n=26) | p-value | |
| Biopsy specimen retrieval success, n (%) | 27 (67.5) | 25 (96.2) | 0.006 |
| Technical success, n (%) | 40 (100.0) | 26 (100.0) | |
| Adverse events, n (%) | 0.674 | ||
| Immediate bleeding | 1 (2.5) | 1 (3.8) | |
| Delated bleeding | 0 (0.0) | 0 (0.0) | |
| Pancreatitis | 0 (0.0) | 0 (0.0) | |
| Other | 0 (0.0) | 0 (0.0) | |
| FNAB diagnostic yield, % (cell block + histology) | |||
| Accuracy | 89.74 (76.42 - 95.94) | 92.59 (76.63 - 97.94) | 0.692 |
| Sensitivity | 89.47 (75.87 - 95.83) | 92.31 (75.86 - 97.86) | 0.698 |
| Specificity | 100.00 (20.65 - 100.00) | 100.00 (20.65 - 100.00) | N/A |
| PPV | 100.00 (89.85 - 100.00) | 100.00 (86.20 - 100.00) | N/A |
| NPV | 20.00 (3.62 - 62.45) | 33.33 (6.15 - 79.23) | 0.221 |
FNAB: Fine-needle aspiration biopsy; NPV: Negative predictive value; PPV: Positive predictive value
Conclusions
The Franseen needle demonstrated better tissue specimen retrieval than the Reverse-bevel needle for solid liver lesions. No other significant performance differences were observed between the two needles. This suggests that while both needles are effective, the choice may depend on specific biopsy requirements.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.