Background and Aims
EUS-guided FNA or biopsy sampling is widely practiced. Optimal sonographic visualization
of the needle is critical for image-guided interventions. Of the several commercially
available needles, bench-top testing and direct comparison of these needles have not
been done to reveal their inherent echogenicity. The aims are to provide bench-top
data that can be used to guide clinical applications and to promote future device
research and development.
Methods
Descriptive bench-top testing and comparison of 8 commonly used EUS-FNA needles (all
size 22 gauge): SonoTip Pro Control (Medi-Globe); Expect Slimline (Boston Scientific);
EchoTip, EchoTip Ultra, EchoTip ProCore High Definition (Cook Medical); ClearView
(Conmed); EZ Shot 2 (Olympus); and BNX (Beacon Endoscopic), and 2 new prototype needles,
SonoCoat (Medi-Globe), coated by echogenic polymers made by Encapson. Blinded evaluation
of standardized and unedited videos by 43 EUS endoscopists and 17 radiologists specialized
in GI US examination who were unfamiliar with EUS needle devices.
Results
There was no significant difference in the ratings and rankings of these needles between
endosonographers and radiologists. Overall, 1 prototype needle was rated as the best,
ranking 10% to 40% higher than all other needles (P < .01). Among the commercially available needles, the EchoTip Ultra needle and the
ClearView needle were top choices. The EZ Shot 2 needle was ranked statistically lower
than other needles (30%-75% worse, P < .001).
Conclusions
All FNA needles have their inherent and different echogenicities, and these differences
are similarly recognized by EUS endoscopists and radiologists. Needles with polymeric
coating from the entire shaft to the needle tip may offer better echogenicity.
Abbreviations:
NICE (Needle Identification Comparison and Evaluation), NICE-E (NICE endosonographers), NICE-R (NICE radiologists), SED (shaft echo-definition), TED (tip echo-definition)To read this article in full you will need to make a payment
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References
- Endoscopic ultrasonography with guided fine needle aspiration biopsy in pancreatic disease.Gastrointest Endosc. 1992; 38: 172-173
- Endosonographically-guided fine needle aspiration biopsy of malignant lesions in the upper gastrointestinal tract.Endoscopy. 1993; 25: 523-527
- A new biopsy handle instrument for endoscopic ultrasound-guided fine-needle aspiration biopsy.Gastrointest Endosc. 1996; 43: 238-242
- EUS accessories.Gastrointest Endosc. 2007; 66: 1076-1081
- EUS-guided tissue acquisition: an evidence-based approach (with videos).Gastrointest Endosc. 2014; 80: 939-959
- Interventional EUS.Gastrointest Endosc. 2010; 72: 1-4
- In-vitro visualization of biopsy needles with ultrasound: a comparative study of standard and echogenic needles using an ultrasound phantom.Clin Radiol. 2001; 56: 499-502
- Needle echogenicity in sonographically guided regional anesthesia: blinded comparison of 4 enhanced needles and validation of visual criteria for evaluation.J Ultrasound Med. 2013; 32: 143-148
- Ultrasound visibility of needles used for regional nerve block: an in vitro study.Reg Anesth Pain Med. 2004; 29: 480-488
- Relative ultrasonographic echogenicity of standard, dimpled, and polymeric-coated needles.J Vasc Interv Radiol. 2000; 11: 351-358
- Changes in ultrasonographic echogenicity and visibility of needles with changes in angles of insonation.J Vasc Interv Radiol. 2003; 14: 1553-1557
- Compound imaging technology and echogenic needle design: effects on needle visibility and tissue imaging.Reg Anesth Pain Med. 2013; 38: 452-455
- A review of the benefits and pitfalls of phantoms in ultrasound-guided regional anesthesia.Reg Anesth Pain Med. 2011; 36: 162-170
- A review of tissue substitutes for ultrasound imaging.Ultrasound Med Biol. 2010; 36: 861-873
- Tissue harmonic imaging, frequency compound imaging, and conventional imaging: use and benefit in breast sonography.J Ultrasound Med. 2007; 26: 1041-1051
- Contribution of tissue harmonic imaging and frequency compound imaging in interventional breast sonography.J Ultrasound Med. 2006; 25: 845-855
- Needle-related ultrasound artifacts and their importance in anaesthetic practice.Br J Anaesth. 2014; 112: 794-802
Article info
Publication history
Published online: February 09, 2016
Accepted:
January 29,
2016
Received:
November 24,
2015
Footnotes
DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: P. Vilmann, A. Saftoiu: Advisory board members for Medi-Globe; P. Fink: Employee of Medi-Globe. All other authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
Copyright © 2016 by the American Society for Gastrointestinal Endoscopy
