Endoscopic ultrasound-guided sampling of solid pancreatic masses: the fine needle aspiration or fine needle biopsy dilemma. Is the best needle yet to come?

Table 1 Published comparative studies regarding fine needle aspiration versus fine needle biopsy needles performance in terms of diagnostic yields

Ref	Study design	N°Lesions,pan-creatic	Rose	Needles (G),FNA vs FNB	Overall diagnostic yield	Sample adequacy	Comments
[4]	RCT	(56)	Yes	22 vs 22 Procore	Equivalent	Equivalent
[29]	Meta-analysis (11 observational study and 4 RCTs)	1024 (mainly pancreatic and lymph nodes)	#6 NO #9 Yes	19 (only one study); 22 and 25 G vs 22	Equivalent	Equivalent	in the absence of ROSE, FNB was associated with better diagnostic adequacy (P  =  0.02) and FNB required less passes
[50]	RCT	194 (100)	No	22 vs 22 Procore	84 vs 90	Equivalent	Lower n° of passes for FNB vs FNA needle (2 vs 3)
[51]	RCT	377 (249)	Yes	22 vs 22 Procore	Equivalent	81.7 vs 92.6
[52]	RCT	(36)	No	22 vs 22 Procore	Equivalent	Equivalent	1.1 passes needed for FNB vs 1.83 passes for FNA (P < 0.05)
[53]	Meta-analysis (8 RCT)	921	No	22, 25, and 19 (only one study) G vs 22	Equivalent	Equivalent	Few passes for FNB
[54]	Retrospective	42 (12)	Yes	22 or 25	Equivalent	Equivalent
[55]	Retrospective	(87)	No	22 vs 22 Franseen	Equivalent	Equivalent
[56]	Retrospective	(76)	No	22 vs 25	32.4 vs 60	Equivalent
[57]	RCT	(214)	No	25 vs 25 Procore	Equivalent	69.4 vs 81
[58]	RCT	(116)	Yes	22, 25 vs 22, 25 Procore	Equivalent	Equivalent	Few passes for FNB
[59]	Meta-analysis (7 comparative studies and 4 single cohort studies)	896 (pancreatic and lymph nodes)	Only in 4 studies	22 and 25	Equivalent	Equivalent
[60]	RCT	140 (73)	YES	19, 22, 25	67 vs 90	Equivalent	Diagnostic yield only for pancreatic masses was equivalent
[61]	Prospective comparative	145 (69)	No	22 vs 22 Procore	Equivalent	Equivalent	Few passes for FNB
[62]	RCT	58 (16)	No	22 vs 22 Procore	Equivalent	Equivalent	Few passes for FNB
[63]	RCT (13 centers)	608 (312)	In 7 centers	25 vs 20 Procore	44 vs 77	Equivalent

RCT: Randomized clinical trial; FNB: Fine needle biopsy; FNA: Fine needle aspiration; ROSE: Rapid on site evaluation

Table 2 Published comparative studies regarding fine needle biopsy needles performance in terms of diagnostic yield

Ref	Study design	N°Lesions,pan-creatic	Rose	Needles	Gauge	Diagnostic yield, %	Sample adequacy, %	Comments
[64]	Cohort	(201)	No	Opposing bevel vs reverse bevel	22-25 vs 20-22-25	71 vs 90	87 vs 99	Opposing bevel needle resulted superior
[65]	Cohort	194 (100)	Only in 12% of cases	Franseen vs fork tip	22	64 vs 85	The use of ROSE is a confounding factor	Fork tip seems superior, but the study lack of methodology
[66]	RCT	(50)	Yes	Franseen vs fork tip	22	> 90%, equivalent	94 vs 98	Equivalent
[67]	Cohort	(66)		Procore	22 vs 25	87.5 vs 82.1	98 vs 95	Equivalent

RCT: Randomized clinical trial; ROSE: Rapid on site evaluation.