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Endosc Ultrasound. 2019 Apr 26. doi: 10.4103/eus.eus_4_19. [Epub ahead of print]

Comparison between 22G aspiration and 22G biopsy needles for EUS-guided sampling of pancreatic lesions: A meta-analysis.

Author information

Department of Medical Sciences, Gastroenterology Unit, University of Foggia, Foggia, Italy.
Department of Community Medicine, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
Department of Public Health, Sardar Patel Institute Campus, Ahmedabad, Gujarat, India.


Background and Objective:

Robust data in favor of clear superiority of 22G fine-needle biopsy (FNB) over 22G FNA for an echoendoscopic-guided sampling of pancreatic masses are lacking. The objective of this study is to compare the diagnostic outcomes and sample adequacy of these two needles.

Materials and Methods:

Computerized bibliographic search on the main databases was performed and restricted to only randomized controlled trials. Summary estimates were expressed regarding risk ratio (RR) and 95% confidence interval.


A total of 11 trials with 833 patients were analyzed. The two needles resulted comparable in terms of diagnostic accuracy (RR 1.02, 0.97-1.08; P = 0.46), sample adequacy (RR 1.01, 0.96-1.06; P = 0.61), and histological core procurement (RR 1.01, 0.89-1.15; P = 0.86). Pooled sensitivity in the diagnosis of pancreatic cancer was 93.1% (87.9%-98.4%) and 90.4% (86.3%-94.5%) with biopsy and aspirate, respectively, whereas specificity for detecting pancreatic cancer was 100% with both needles. Analysis of the number of needle passes showed a nonsignificantly positive trend in favor of FNB (mean difference: -0.32, -0.66-0.02; P = 0.07).


Our meta-analysis stands for a nonsuperiority of 22G FNB over 22G FNA; hence, no definitive recommendations on the use of a particular device can be made.


Accuracy; EUS; FNA; fine-needle biopsy; pancreas; sensitivity


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