• Ji Young Bang, Sachin Kirtane, Konrad Krall, Udayakumar Navaneethan, Muhammad Hasan, Robert Hawes, and Shyam Varadarajulu.
• Center for Interventional Endoscopy, Florida Hospital, Orlando, USA.
• Dig Endosc. 2019 Mar 1; 31 (2): 197-202.

Background And AimFine-needle aspiration (FNA) cytology has been the preferred technique for procuring tissue at endoscopic ultrasound (EUS) procedures for the past 25 years. To overcome some of the limitations of FNA cytology, fine-needle biopsy (FNB) has been recently developed to yield histological tissue. Main objective was to compare the diagnostic yield of FNB compared to FNA for both onsite and offsite specimen assessment.MethodsA retrospective study was conducted at a single tertiary referral center to evaluate the outcomes of FNA and FNB over a 4-year period. EUS-guided tissue sampling was carried out using 22- or 25-G FNA needles from 2014 to 2015, and 22-G FNB needle was used from 2016 to 2017.ResultsOf 3020 patients undergoing EUS-guided sampling of solid mass lesions (pancreatic masses 71.3%, other lesions 28.7%), FNA was carried out in 68.9% and FNB in 31.1%. Median number of passes required for diagnostic adequacy on rapid onsite evaluation was significantly lower for FNB compared to FNA (1 [IQR: 1-2] vs 2 [IQR 1-3], P < 0.001). Diagnostic yield on cell block was also significantly superior with FNB compared to FNA (92.3 vs 71.1%, P < 0.001). The superior performance of FNB over FNA was observed for both pancreatic (P < 0.001) and non-pancreatic lesions (P < 0.001).ConclusionGiven these promising findings, in the future, EUS-guided FNB will likely be the preferred technique for sampling of solid mass lesions.© 2018 Japan Gastroenterological Endoscopy Society.

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