Real-world performance of the crown-cut endobronchial ultrasound guided transbronchial aspiration needle

WY. Byun^a (Mr), F. Oezkan^b (Dr), C. Loeffler^c (Mr), U. Siebolts^d (Dr), L. Diessel^d (Dr), N. Lambrecht^e (Dr), S. Eisenmann*^e (Dr)

^a The Ohio State University College of Medicine, Columbus, UNITED STATES ; ^b University Medicine Essen- Ruhrlandklinik, Department of Interventional Pulmonology, Essen, GERMANY ; ^c University Hospital Halle, Halle, GERMANY ; ^d University Hospital Halle, Institute of Pathology, Halle, GERMANY ; ^e University Hospital Halle, Department of Pulmonology, Halle, GERMANY

* stephan.eisenmann@uk-halle.de

Background: Advancements in personalized medicine have increased the demand for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples that are larger and have preserved tissue architecture. This has led to innovations such as the 3-point crown-cut SonoTip TopGain® (Medi-Globe, Rohrdorf, Germany) needle that contrasts with the standard single-bevel ViziShot 2® (Olympus, Tokyo, Japan) needle. Our objective is to compare the biopsy sample characteristics, diagnostic accuracy, and patient safety between the SonoTip TopGain® and ViziShot 2® needles.

Methods: Twenty patients with enlarged mediastinal and/or hilar lymph nodes requiring EBUS-TBNA for diagnostic workup were enrolled at the University Hospital Halle. The lymph node with the highest probability for malignant infiltration based on size and sonographic appearance was chosen for each patient. Each lymph node was targeted using both the SonoTip TopGain® and ViziShot 2® needles. The samples were then analyzed by a pathologist.

Results: Four patients could not be biopsied with the SonoTip TopGain® needle which could not penetrate cartilage in positions 11L, 11R, and 4L. The mean sample dimension of the SonoTip TopGain® was greater than that of the ViziShot 2® (0.41 cm, σ = 0.24 cm versus 0.21 cm, σ = 0.096 cm; p = 0.007). The SonoTip TopGain® yielded significantly greater high-power fields compared to the ViziShot 2® (15.88, σ = 13.04 versus 2.79 σ = 4.13; p = 0.005). There were no significant differences regarding diagnostics and safety.

Conclusion: More tissue can be sampled using the SonoTip TopGain® needle when cartilage penetration can be avoided. Thus, anatomy must be considered to maximize the benefits of the crown-cut needle design. Clinical usefulness of the SonoTip TopGain® needle for different diagnoses and how it compares to other methods such as cryobiopsy are current areas of exploration.

Disclosure of funding source(s): none