Histologic retrieval rate of a newly designed side‐bevelled 20G needle for EUS‐guided tissue acquisition of solid pancreatic lesions

Background Innovative approaches to improve diagnostic yield of endoscopic ultrasound‐guided tissue acquisition (EUS‐TA) have focused on needle design with development of fine‐needle biopsy (FNB) needles with microcore‐acquisition technology. Recently, a 20‐gauge (20G) antegrade‐cutting‐side‐bevelled biopsy needle (ProCore®) was developed for EUS‐TA, but data about its diagnostic performance and histological capability are scant. Objectives We assessed the diagnostic performance and histologic retrieval rate of a new 20G antegrade‐cutting‐side‐bevelled biopsy needle compared with a 22G reverse‐side‐bevelled needle for EUS sampling of solid pancreatic lesions. Patients and methods A retrospective analysis of 238 consecutively collected patients who underwent EUS‐TA using a 20G or a 22G ProCore® needle, without rapid on‐site evaluation (ROSE), was conducted at two centres. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Histologic tissue retrieval was evaluated applying a scoring system for each case. Results Sensitivity and specificity were estimated as 98.4–100% in the 20G‐, and 94.9–100% in the 22G‐needle groups, respectively (p > 0.99). The 20G procured more histologic‐grade tissues (92.6% vs 49.5%, p < 0.0001) achieved by a lower number of passes (2.64 vs 3.44, p < 0.0001) compared to the 22G. Conclusions Both side‐bevelled FNB needles achieved a high diagnostic sensitivity. The 20G‐side‐bevelled needle obtained a significantly higher microcore retrieval rate.