GIE Senior Associate Editor Mohamed O. Othman, MD, highlights this article from the June issue: “Comparing a 19-gauge fine-needle biopsy needle with a 22-gauge fine-needle biopsy needle for EUS-guided liver biopsy sampling: a prospective randomized study” by David L. Diehl, MD, FASGE, AGAF, et al.

EUS-guided liver biopsy is gaining traction and is frequently requested by referring specialists. Unlike pancreatic fine-needle biopsy (FNB), there are variations in quality and consistency of liver tissue acquired by FNB needles.

This study showed that a 19-gauge needle acquired longer tissue core (21.5 ± 6.3 mm) than a 22-gauge needle (9.4 ± 5.5 mm, P < .01). The 22-gauge needle was inadequate in obtaining adequate liver biopsy in one-fifth of included patients. No adverse events were noted in both groups, and the pain score was similar.

This is a well-executed randomized trial comparing 22-gauge and 19-gauge needles. The research measured preprocessing length of tissue core and postprocessing aggregate length and showed superiority of the 19-gauge needle.

In conclusion, 19-gauge core FNB should be the first choice for obtaining EUS-guided liver biopsy.

Macroscopic appearance of liver biopsy samples from (A) a 19-gauge fine-needle biopsy needle and (B) a 22-gauge fine-needle biopsy needle before histologic processing.

Read the full article online.

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