Eastern Cardiothoracic Surgical Society

Fine Needle Aspiration Versus Gencut Core: Is One Biopsy MethodSuperior in Terms of Tissue Volume?
Tiffanie Aiken, Allyson L. Hale, Joseph A. Ewing, William D. Bolton, James E. Stephenson, Sharon Ben-Or, Greenville Health System, Greenville, SC

OBJECTIVE: Though multiple tools are used for biopsy via navigational bronchoscopy (ENB), the increase in genetic testing has created a need for biopsying additional tissue volume. Tissue volumes biopsied via fine needle aspiration and Gencut Core were compared.

METHODS: Between May 2016 and May 2017, we retrospectively reviewed 17 consecutive patients who underwent ENB and had biopsies via FNA and Gencut. Obtained specimens were prepared for cell block and/or slides. Data collection included lesion size, lobe location, tissue volume, and number of cell blocks and slides per biopsy. Primary endpoint was difference in total tissue volume biopsied. Impact on tissue volume according to number of cell blocks or slides per biopsy was also compared. Secondary endpoint was diagnostic accuracy.

RESULTS: During the study period, a total of 20 lesions were biopsied. Lesion characteristics are described in Table 1. Overall, the Gencut Core biopsies were significantly larger in mean tissue volume than FNA (Gencut, 0.47 0.34 mL vs. FNA, 0.19 0.12 mL; p<0.001). A total of 7 biopsies in each group (FNA vs. Gencut) underwent both 3 slides and 3 cell blocks. From these, the Gencut mean tissue volume (0.643mL, CI: 0.338, 0.948) was larger than the FNA (0.214mL, CI: 0.115, 0.314) with no overlap in confidence intervals. No differences in diagnostic accuracy were seen between biopsy methods, as both reported an accuracy rate of 90%.

CONCLUSIONS: Our findings suggest that Gencut Core may be a better biopsy tool than FNA in terms of providing increased tissue volume.

Table 1. Lesion Characteristics.

N 20
Lesion size (cm), mean SD 3.2 1.4
Lesion location, no. (%)
Left upper lobe 9 (45)
Left lower lobe 1 (5)
Right upper lobe 3 (15)
Right lower lobe 6 (30)
Lingula 1 (5)
Tissue volume (mL), mean SD
Gencut Core 0.47 0.34
FNA 0.19 0.12
Diagnostic accuracy, no. (%)
Gencut Core 18 (90)
FNA 18 (90)