Vacuum Fine-Needle Aspiration Biopsy: Efficiency of the Method from the Perspective of Cytological Assessment — an Experimental Study on Porcine Liver

Introduction: Morphological veriĮcation remains the cornerstone of tumor diagnosis, providing an objective basis for treatment planning. Among instrumental diagnostic methods, Įne-needle aspiration biopsy (FNA) occupies a leading position due to its minimal invasiveness and high diagnostic yield. However, traditional aspiration techniques are limited by unstable negative pressure and frequent cellular damage, which may compromise smear quality. The development of vacuum Įne-needle aspiration biopsy (v-FNA) introduces the potential for procedural standardization and improved cytological specimen quality.

Objective: To experimentally evaluate the eĸciency and diagnostic value of v-FNA for obtaining cytological material from porcine liver tissue, to assess the feasibility of using small-diameter needles (including 25G), and to compare the results with conventional FNA.

Materials and Methods: The study was conducted on porcine liver specimens, which closely resemble human liver in structure and density. Biopsies were performed using Chiba needles of 18G, 20G, 22G, and 25G diameters. Each puncture was carried out both with traditional syringe aspiration and with vacuum aspiration under a stable negative pressure of -0.8 bar. All procedures were performed under ultrasound guidance to ensure precise needle positioning and controlled advancement through the parenchyma. Cytological smears were prepared using the standard technique and stained by the May–Grunwald method for microscopic evaluation.

Results: The quality and quantity of aspirated material strongly depended on the needle diameter. Conventional FNA using 18G and 20G needles yielded excessive cell masses, often accompanied by hemorrhagic contamination and cellular destruction. Needles of 22G produced more homogeneous and diagnostically suitable smears. The application of vacuum-assisted aspiration signiĮcantly improved cell preservation and smear uniformity. Notably, even 25G needles, traditionally considered ineffective for cytological sampling, provided limited but diagnostically valuable material when used with v-FNA.

Conclusions: Vacuum-assisted fine-needle aspiration biopsy represents a promising direction in cytological diagnostics, improving the quality and informativeness of aspirated material while maintaining minimal invasiveness. The method expands the range of usable needle diameters, supports procedural standardization, and has strong potential for clinical implementation in liver, pancreatic, and lymph node lesion diagnostics.

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