Effectiveness of Menghini-Type Needles for Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Masses

Dig Dis Sci. 2021 Sep;66(9):3171-3178. doi: 10.1007/s10620-020-06628-1. Epub 2020 Oct 19.

Abstract

Background: Cutting needles are thought to be effective as biopsy needles. A few types of cutting needles are available for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), and the Menghini-type needle is an end-type cutting needle.

Aims: A prospective randomized controlled trial was conducted to compare the results of EUS-FNA using a Menghini-type needle (needle M) versus a conventional needle (needle S).

Methods: The main eligibility criteria were as follows: patients with a pancreatic mass referred for EUS-FNA, ≥ 20 years old, and a performance status < 4. The primary outcome was the sample quality. The secondary outcomes were factors associated with the sample quality, diagnostic accuracy, and adverse events.

Results: A total of 97 patients were enrolled in this study. The sample quality for total puncture with needle M (92.8%) was significantly higher than that with needle S (81.4%) (p = 0.0305). The tumor size (p = 0.033) and type of needle (p = 0.031) were significant factors associated with adequate tissue collection in univariate and multivariate analyses (odds ratio [OR] 2.71; 95% confidence interval [CI] 1.12-6.54; p = 0.027 for tumor size, and OR 2.93; 95% CI 1.23-8.21; p = 0.0153 for type of needle). The diagnostic accuracy of each needle was 88.7% (86/97) with needle M and 73.2% (71/97) with needle S. Adverse events occurred in 2 of the 97 patients (0.02%).

Conclusion: A Menghini-type needle was able to obtain core tissue for histology more effectively than a conventional aspiration needle.

Trial registration numbers: UMIN registration number of 000020668.

Keywords: Endoscopic ultrasound-guided fine-needle aspiration; Fine needle biopsy; Pancreatic cancer; Pancreatic neoplasms.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cross-Over Studies
  • Diagnosis, Differential
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / adverse effects
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / instrumentation*
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods
  • Equipment Design
  • Female
  • Humans
  • Male
  • Materials Testing / methods
  • Needles / adverse effects*
  • Outcome and Process Assessment, Health Care / methods
  • Pancreatic Neoplasms* / diagnostic imaging
  • Pancreatic Neoplasms* / pathology
  • Specimen Handling* / methods
  • Specimen Handling* / standards

Associated data

  • UMIN-CTR/UMIN000020668