Procedures: Advancements in Lung Cancer Diagnostics and Treatment |

A Novel 19g EBUS-TBNA Needle: Results of Ex Vivo Tissue Evaluations FREE TO VIEW

Sujeeth Parthiban, PhD; David Dillard, BS; Anna Sczaniecka, PhD; Xavier Gonzalez, MD
Author and Funding Information

Olympus Respiratory America, Redmond, WA

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):976A. doi:10.1016/j.chest.2016.08.1082
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SESSION TITLE: Advancements in Lung Cancer Diagnostics and Treatment

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Wednesday, October 26, 2016 at 08:45 AM - 10:00 AM

PURPOSE: Endobronchial ultrasound - guided transbronchial needle aspiration (EBUS-TBNA) is now widely used for mediastinal lymph node staging in lung cancer patients and diagnosis of other lymph node adenopathies. The commercially available needles for these procedures are currently limited to 21G, 22G and 25G sizes. A new 19G needle compatible with EBUS bronchoscopes has been developed with a goal to collect larger volumetric samples. We report the results of the bench testing performed to compare the sample collection of these 19G needles to commercially available 21G and 22G needles.

METHODS: ViziShot FLEX 19G needles (Olympus Respiratory America, Redmond, WA) and ViziShot 21G and 22G needles (Olympus, Tokyo, Japan) were evaluated under controlled conditions. Fresh pieces of bovine heart and liver were used as substrates. Heart tissue was chosen as a surrogate for hypertrophic, dense lymph node and liver served as surrogate for normal lymph node. Five devices of each kind were tested. Each needle was penetrated by hand 2cm into the tissue target at an angle resembling EBUS-TBNA. Ten agitations using 20cc of vacuum were performed consistently to collect samples. Each sample was ejected using air onto slides. The tissue core was then arranged using a fine needle to remove any overlapping and stacking. The samples were photographed using a high power microscope. The sample images were analyzed using image analysis software (ImageJ, NIH, Bethesda, MD) to calculate the tissue core area. To obtain sample volume, the sample depth was extrapolated from the needles’ inner diameter and then the tissue core area of each sample was multiplied by the sample depth. The sample volume collected by each needle was statistically compared using an unpaired t-test.

RESULTS: A total of 15 needle samples from heart and 15 samples from liver were collected. Image analysis of the samples showed that the 19G needles produced statistically larger volume tissue cores than either the 21G or 22G needles (p< 0.01). In liver only, the 21G needles collected statistically larger volume tissue cores compared to the 22G needles (p<0.01). For all evaluations and comparisons, the liver tissue provided statistically larger volumetric samples compared to the denser heart tissue (p<0.01).

CONCLUSIONS: In both ex-vivo tissue substrates, the ViziShot FLEX 19G needle provided a significantly larger amount of tissue material compared to the 21G and 22 G needles. The volume of sample collected also depends on the density of the tissue target. Evaluations in patients are warranted to confirm these results.

CLINICAL IMPLICATIONS: There is a clinical need for larger EBUS-TBNA samples with more material for histological assessment and molecular analysis. This evaluation shows that the 19G EBUS-TBNA needles collect more material which could be of clinical utility. This information could also guide bronchoscopists in needle selection for their cases.

DISCLOSURE: Sujeeth Parthiban: Employee: Receive salary from Olympus Respiratory America David Dillard: Employee: Receive salary from Olympus Respiratory America Anna Sczaniecka: Employee: Receive salary from Olympus Respiratory America Xavier Gonzalez: Employee: Receive salary from Olympus Respiratory America

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