A medical team at the University of California (UC) Davis Health recently performed what it’s calling the world’s first endoscopic, ultrasound-guided core biopsy of a pancreatic tumor with a drilling method.
The team, led by Antonio Mendoza-Ladd, MD, said that this method successfully collected a larger-than-normal core of tumor tissue in an efficient manner. It highlighted that this can make way for better diagnostic workup.
“It is done in an easier-to-control way. We only need to do one puncture,” Mendoza-Ladd told AuntMinnie.com. “The cores we obtain with this device are better than regular needles.”
The medical team performed the procedure by using an instrument called EndoDrill GI (BiBB Instruments) to biopsy a gastrointestinal stromal tumor and two pancreatic tumors. The team highlighted that it could better access deep tissues in the upper gastrointestinal tract.
The technology uses electric high-speed drilling to take core tissue samples. An endoscopist operates a flexible rotating cylinder to remove fine samples while maintaining tissue architecture. The technology also enables sampling for deep-lying tumors. The rotating needle also removes fragments.
“It’s like a drill that you use at home for work you need to do around the house,” Mendoza-Ladd said, talking about the motion of the drill.
He added that this method avoids the need for a stabbing motion to be used to create the initial puncture in conventional biopsies.
Mendoza-Ladd said that the patients who underwent the procedure have not experienced post-procedure complications. He also highlighted that the samples from the procedure make way for more accurate diagnosis and ergo, better treatment strategies for gastrointestinal cancers.
“The hope is that we will reduce the number of punctures that we need to do,” Mendoza-Ladd told AuntMinnie.com. “We will have a single pass that will give us enough tissue we can run on special analysis.”
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
