Evaluation of Needles in Endoscopic Ultrasound-Guided Tissue Acquisition of Pancreatic Cancer for Genetic Yield and Quality

Background: Endoscopic ultrasound-guided fine needle biopsy (FNB) is the gold standard in tissue acquisition of pancreatic ductal adenocarcinoma (PDAC). There is a paucity of evidence of the impact of needle type or size on the genetic yield and quality. Methods: Patients 18 years and older with PDAC who underwent FNB were retrospectively identified from a single database from 2016 to 2021. Genetic quantity is measured in micrograms (mu g) and quality defined by RNA or DNA integrity number (RIN and DIN). FNB needles examined were Acquire 22 gauge (Boston Scientific, Marlborough, MA, USA) and ProCore 22 and 20 gauges (Cook Medical, Bloomington, IN, USA). Results: Two hundred seventy-seven patients were identified. ProCore 20G needle procured higher RNA quantity (4125.8 mu g, IQR: 2003.8, 5954.8, p = 0.012) compared to ProCore 22G (2050 mu g IQR: 966.4, 3181.6) and Acquire 22G (2310.6 mu g, IQR: 1439.3, 4312). Median DNA quantity was 3340.5 mu g (Acquire 22G), 2610.4 mu g (ProCore 22G) and 3499.7 mu g (ProCore 20G) (p = 0.763). Median DIN was 7.3 (Acquire 22G and ProCore 22G) and 7.4 (ProCore 20G) (p = 0.449). Median RIN was 3.0 (Acquire 22G and ProCore 22G) and 2.7 (ProCore 20G) (p = 0.886). Conclusion: ProCore 20G was associated with higher quantity of RNA. There were no differences in the quality acquired by different needles.