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Endosc Ultrasound. 2019 Jun 20. doi: 10.4103/eus.eus_27_19. [Epub ahead of print]

Comparison of Franseen and fork-tip needles for EUS-guided fine-needle biopsy of solid mass lesions: A systematic review and meta-analysis.

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University of Arizona, Banner University Medical Center, Tucson, Arizona, USA.
Rapides Regional Medical Center, Alexandria, Louisiana, USA.
Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Division of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
Division of Gastroenterology/Hepatology, University of Nevada, Las Vegas, Nevada, USA.
Department of Hospital Medicine, Carilion Roanoke Memorial Hospital, Roanoke, Virginia, USA.
Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA.
Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA.


Franseen-tip and Fork-tip needles have been widely used in EUS guided fine-needle biopsy (FNB) of solid organs. There is conflicting data on the performance of these needles and unanswered questions on the ideal number of needle-passes and the requirement of an onsite cytopathologist (ROSE). We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed, EMBASE, and Web of Science databases (from inception through July 2018) to identify studies that reported on the use of Forktip and Franseen-tip needles in EUS-FNB of solid organs. The primary outcome was to estimate and compare the pooled rates of diagnostic-yield. A subgroup analysis compared the outcomes based on the number of needle-passes and the availability of ROSE. A total of 23 study-arms were available for analysis. The pooled rate of diagnostic yield with Fork-tip needle was 92.8% (95% CI 85.3 - 96.6, I2 = 73.1) and the pooled rate of diagnostic yield with Franseen-tip needle was 92.7% (95% CI 86.4 - 96.2, I2 = 88.4).


Fine-needle biopsy; Franseen-tip needle; fork-tip needle; rapid onsite evaluation


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