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Application of a novel endoscopic ultrasound–guided motorized fine needle for liver and pancreatic lesion biopsy

Abstract:

Background and Aims: The motorized fine-needle biopsy (mFNB) device (Precision-GI; Limaca Medical, Ein Ha Emeq, Israel) is a novel electromechanical tool designed to optimize EUS-guided tissue acquisition through controlled axial advancement and high-speed rotational coring. This study presents 2 clinical cases demonstrating the safety and effectiveness of the second-generation mFNB in obtaining liver and pancreatic biopsy samples. Methods: Two female patients underwent EUS-guided biopsies using a 20-gauge mFNB device. One patient had suspected liver disease and the other a pancreatic mass, respectively. The device was used to perform targeted tissue sampling, with emphasis on tissue adequacy, integrity, and absence of blood contamination. Results: In both cases, the mFNB allowed successful tissue acquisition without adverse events. The liver biopsy yielded a 0.5 × 0.5 × 0.2-cm specimen with 6 portal triads, confirming micronodular cirrhosis with steatosis and fibrosis. The pancreatic biopsy produced a 0.8 × 0.5 × 0.2-cm core, leading to a diagnosis of acinar cell carcinoma. Both specimens were deemed adequate and intact with no blood contamination. Conclusions: The mFNB device is safe for EUS-guided liver and pancreatic biopsies, providing high-quality tissue samples. The motorized design may reduce procedure time and improve diagnostic yield. Further comparative studies with manual fine-needle biopsy are required to validate these findings.