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REVIEW ARTICLE
Year : 2020  |  Volume : 9  |  Issue : 4  |  Page : 225-231

EUS tissue acquisition: From A to B


Gastro Unit, Division of Endoscopy, Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark

Correspondence Address:
Dr. Bojan Kovacevic
Gastro Unit, Division of Endoscopy, Borgmester Ib Juuls Vej 1, 2730 Herlev
Denmark
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/eus.eus_21_20

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EUS-guided tissue acquisition (EUS-TA) has made rapid development since its introduction in the early 1990s. The technique is widely accepted and invaluable for staging and diagnosis of a variety of upper gastrointestinal and mediastinal lesions. Fine-needle aspiration (FNA) has long been the gold standard, but due to its limitations such as the inability to retain stroma and associated cellular architecture, novel biopsy needles (FNB) were designed. Overall, FNA and FNB needles perform seemingly equally in terms of diagnostic accuracy, however, the second-generation FNB needles require less passes. The third-generation FNB needles (crown-cut needle types) seem to be preferable to FNA needles as well as to the second-generation FNB needles, when larger histological specimens and preserved tissue architecture are required. EUS-TA is constantly under development, and new applications of this technique include tumor risk stratification according to its genetic profile as well as minimally invasive creation of patient-derived organoids, hallmarks of personized medicine. It remains yet to be shown, whether these applications will lead to a decisive shift from aspiration to biopsy, i.e., from A to B.


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