Crown-tipped EUS needles nearly tripled the odds of an adequate sample

Design

Systematic review and meta-analysis

Population

30 studies, about 12,000 EUS tissue acquisitions

Primary outcome

Sample adequacy, core procurement, diagnostic accuracy, adverse events

Effect

Sample adequacy OR 2.83 (2.13–3.75); optimal core OR 5.02 (3.29–7.68)

This meta-analysis pooled 30 studies, about 12,000 observations, comparing crown-tipped (Franseen) needles with standard needles for EUS-guided tissue acquisition of solid gastrointestinal and pancreaticobiliary lesions.

Crown-tipped needles gave higher odds of sample adequacy (OR 2.83, 95% CI 2.13–3.75, I² 17%) and of an optimal histological core (OR 5.02), achieved in 89% of patients. Passes fell by about 0.36 per patient. Pooled sensitivity was 0.92 and specificity 0.98. Adverse events did not differ.

For pancreatic and other solid lesions, the needle choice affects whether one procedure gives a diagnosis, and core tissue matters increasingly for molecular testing.

• Consider crown-tipped needles for EUS sampling of solid pancreatic and GI lesions.
• Core tissue supports molecular profiling as well as diagnosis.
• Fewer passes may shorten procedures without raising complications.
• Diagnostic accuracy estimates may be inflated by small-study effects.

Why it matters

A non-diagnostic EUS means a repeat procedure and delay, especially in pancreatic cancer.

Don't overread it

Most included studies were observational, and the authors found evidence of small-study effects in accuracy estimates.

The statistics, in plain English

I² of 17% for sample adequacy means the studies agreed well, so that result is more reliable than the accuracy figures.

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