Endoscopic ultrasound fine needle aspiration vs fine needle biopsy for pancreatic masses, subepithelial lesions, and lymph nodes

Table 1 Prospective comparative trials of endoscopic ultrasound fine needle aspiration vs fine needle biopsy for solid pancreatic mass lesions

Ref.	Study design	Number of subjects	Needle size (FNA, FNB)	Diagnostic yield/specimen adequacy (EUS-FNA vs EUS-FNB)	Diagnostic accuracy (EUS-FNA vs EUS-FNB)	Number of passes needed (EUS-FNA vs EUS-FNB)	Comments
Bang et al[9], 2012	RCT	56	22 G, 22 G Procore	66.7% vs 80% (NS)	N/A	1.61 vs 1.28 (NS)
Aadam et al[30], 2015	RCT	73	Variable, variable	78.4% vs 91.7% (NS)	67.5% vs 83.3% (NS)	N/A
Tian et al[31], 2018	RCT	36	22 G, 22 G ProCore	83.3% vs 83.3%	N/A	1.83 vs 1.11 (P = 0.049)
Hedenstrom et al[33], 2018	RCT, crossover	68	25G, 22G reverse bevel Wilson Cook	N/A	78% vs 69% (NS)	N/A	In a subset of non-pancreatic adenocarcinoma, combined modality (EUS-FNA + FNB) was significantly higher compared to EUS-FNA alone
Oppong et al[34], 2020	RCT, crossover	108	Variable, variable Sharkcore	71% vs 82% (OR 3.23, sig)	64% vs 79% (OR 4.79, sig)	N/A	Shorter sampling time and pathology viewing time with EUS-FNB. Equivalent cost analysis.
Kandel et al[35], 2020	RCT, crossover	50	25 G, variable Sharkcore	100% vs 86% (NS)	100% vs 100%	N/A	Primary outcome of DNA concentration, significantly higher in EUS-FNB than in EUS-FNA
Wang et al[26], 2017	Meta-analysis	921	Variable, variable	81.4% vs 88.3% (OR 0.57, sig)	84.0% vs 87.8% (NS)	Fewer in EUS-FNB
Li et al[27], 2018	Meta-analysis	1382	Variable, variable	82.3% vs 89.4% (OR 1.83, sig)	84.3% vs 89.6% (OR 1.62, sig)	Fewer in EUS-FNB

EUS-FNA: Endoscopic ultrasound fine needle aspiration; EUS-FNB: Endoscopic ultrasound fine needle biopsy; RCT: Randomized controlled trial; N/A: Not applicable; NS: Not significant.

Table 2 Prospective comparative trials of endoscopic ultrasound fine needle aspiration vs fine needle biopsy for subepithelial lesions

Ref.	Study design	Number of subjects	Needle size (FNA, FNB)	Lesions sampled	Diagnostic yield/specimen adequacy (EUS-FNA vs EUS-FNB)	Diagnostic accuracy (EUS-FNA vs EUS-FNB)	Number of needle passes needed (EUS-FNA vs EUS-FNB)	Comments
Kim et al[47], 2014	RCT	22	22 G, 22 G Procore	All SELs	20% vs 75% (P = 0.01)	N/A	4 vs 2 (P = 0.025)
Iwai et al[43], 2017	RCT, crossover	23	Variable, variable Procore	Gastric SELs	73.9% vs 91.3% (P = 0.12)	N/A	N/A	Histology positive significantly higher in EUS-FNB for 21 mm-30 mm lesions
Hedenstrom et al[48], 2018	RCT, crossover	70	Variable, variable reverse-bevel Wilson-Cook	All SELs	N/A	49% vs 83% (P < 0.001)	N/A	Extramural lesions lower sensitivity for EUS-FNA but not EUS-FNB)
Nagula et al[49], 2018	RCT	18	Variable, variable Procore	All SELs	83.3% vs 75% (NS)	N/A	2 vs 2 (NS)

EUS-FNA: Endoscopic ultrasound fine needle aspiration; EUS-FNB: Endoscopic ultrasound fine needle biopsy; RCT: Randomized controlled trial; N/A: Not applicable; NS: Not significant; SELs: Subepithelial lesions.

Table 3 Prospective comparative trials of endoscopic ultrasound fine needle aspiration vs fine needle biopsy for lymph node biopsy

Ref.	Study design	Number of subjects	Needle size (FNA, FNB)	Lymph nodes sampled	Diagnostic yield/specimen adequacy (EUS-FNA vs EUS-FNB)	Diagnostic accuracy (EUS-FNA vs EUS-FNB)	Number of needle passes needed (EUS-FNA vs EUS-FNB)	Comments
Nagula et al[49], 2018)	RCT	46	Variable, variable Procore	All lymph nodes	92.9% vs 94.4% (NS)	N/A	2 vs 2 (NS)
de Moura et al[52], 2020)	Retrospective study of prospectively collected data	209	Variable, variable	All lymph nodes	N/A	78.8% vs 83.2% (NS)	N/A	For peri-hepatic lesions, EUS-FNB was significantly more accurate

EUS-FNA: Endoscopic ultrasound fine needle aspiration; EUS-FNB: Endoscopic ultrasound fine needle biopsy; RCT: Randomized controlled trial; N/A: Not applicable; NS: Not significant.