Does needle-type increase the diagnostic yield of malignancies in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)?—a prospective comparative study

BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a commonly performed minimally invasive technique for diagnosing mediastinal pathologies. Currently, many needle types are being developed to improve the accuracy of the final diagnosis. Our study aimed to assess the possible advantages and disadvantages between the 22-gauge ProCore(®) needle and the standard 22-gauge needles. METHODS: In this prospective study, we enrolled a group of 363 EBUS-TBNA patients. For each patient, we used either the ProCore(®) needle or the standard one. We used the ProCore(®) needle in 51 patients and the standard needle in 312 patients. When a diagnosis could not be made, it was subsequently established with a surgical biopsy. We calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the biopsy for both needle types. RESULTS: By using EBUS-TBNA, a diagnosis was established in 306 patients (84.3%). The rates of the final diagnoses in ProCore(®) and standard needle groups were 92.2% and 83.0% (P=0.14), respectively. The sensitivity, specificity, PPV, and NPV for ProCore(®) vs. standard needles did not differ and were 89.2% vs. 79.3%, 100.0% vs. 95.7%, 100.0% vs. 98.5%, and 77.8% vs. 57.3%, respectively. A total of 57 patients required mediastinoscopy or surgical biopsy to obtain a final pathology. However, this number was not significantly different between the needles [ProCore(®) (7.8%) vs. standard (17%), P=0.26]. CONCLUSIONS: Both types of needles demonstrated very high diagnostic efficiency for malignancy, and there was no significant advantage of the ProCore(®) over the standard needle.