Reviewer’s report
Title: 
Utility of a 21-gauge Menghini-type biopsy needle with rolling method for an endoscopic
ultrasound-guided histological diagnosis of autoimmune pancreatitis: a retrospective study
Version: 
0 
Date: 
16 Oct 2020
Reviewer: 
Takeshi Hisa
Reviewer's report:
The authors describes that the 21-gauge Menghini-type biopsy needle was useful for endoscopic
ultrasound-guided histological diagnosis of autoimmune pancreatitis compared with the conventional 22-
gauge or 19-gauge needles. This article is interesting; however, there are several problems.
Major: 
1. What enable abundant acquisition of tissue by the 21-gauge Menghini-type needle compared with the
conventional 22-gauge needles? 
The rolling method seems to have considerable effect rather than the
needle shape and system.
2. In the historical control, the 19-gauge needle should be excluded due to the use only in 2 procedures.
3. In this study, the histological diagnostic rate of AIP by the conventional 22-gauge needles is very low
compared with that in the previous reports. You should state the reasons in detail.
4. Ease of puncture depends on the scope position. Amount of acquired tissue seems to depend on the
funning method and the stroke length of needle. These factors should be mentioned.
5. In four patients who improved before steroid treatment in the conventional needle group, AIP could
have resolved at the time of FNA. If it is so, the histological diagnostic rate should become lower.
Minor:
1. Did you use the EUS Sonopsy CY (HAKKO Medical)? If it is so, you should state it in the materials
and methods.
2. Figure 3 is similar to Figure 4. One figure contains different information of the 21-gauge Menghini-
type needle and the conventional 22-gauge needle. It is difficult for the audience to understand. You
should show the figures simply. 
Example) Fig. 3. Case of using the 21-gauge Menghini-type needle, Fig. 4. Case of using the conventional
22-gauge needle
3. In this study, you emphasize the acquisition of good-quality tissue to diagnose as AIP definitely. You
should show histopathological images of the storiform fibrosis and the obliterative phlebitis also.
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reviewers. Please find the details of processing in Publons’ privacy policy
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No
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this manuscript,
either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an organization that holds or has
applied for patents relating to the content of the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If your
reply is yes to any, please give details below.
I declare that I have no competing interests.
Reviewer Publication Consent.
 I agree for my report to be made available under an Open Access
Creative Commons CC-BY License (
 http://creativecommons.org/licenses/by/4.0
) if this manuscript is
accepted for publication. Any comments that I do not wish to be included in the published report have
been included as confidential comments to the editor, which will not be published.
If you are not happy for us to publish this report, please contact the editorial office before completing
the review.
If you wish, you can include your name in your published report. Please note you must decide whether
to include your name at the start of the process and confirm this decision whenever prompted. If you
change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my report.
Is the study design appropriate to answer the research question (including the use of appropriate controls),
and are the conclusions supported by the evidence presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free from apparent
manipulation?
Yes
Reviewer’s report
Title: 
Utility of a 21-gauge Menghini-type biopsy needle with rolling method for an endoscopic
ultrasound-guided histological diagnosis of autoimmune pancreatitis: a retrospective study
Version: 
0 
Date: 
16 Oct 2020
Reviewer: 
Takeshi Hisa
Reviewer's report:
The authors describes that the 21-gauge Menghini-type biopsy needle was useful for endoscopic
ultrasound-guided histological diagnosis of autoimmune pancreatitis compared with the conventional 22-
gauge or 19-gauge needles. This article is interesting; however, there are several problems.
Major: 
1. What enable abundant acquisition of tissue by the 21-gauge Menghini-type needle compared with the
conventional 22-gauge needles? 
The rolling method seems to have considerable effect rather than the
needle shape and system.
2. In the historical control, the 19-gauge needle should be excluded due to the use only in 2 procedures.
3. In this study, the histological diagnostic rate of AIP by the conventional 22-gauge needles is very low
compared with that in the previous reports. You should state the reasons in detail.
4. Ease of puncture depends on the scope position. Amount of acquired tissue seems to depend on the
funning method and the stroke length of needle. These factors should be mentioned.
5. In four patients who improved before steroid treatment in the conventional needle group, AIP could
have resolved at the time of FNA. If it is so, the histological diagnostic rate should become lower.
Minor:
1. Did you use the EUS Sonopsy CY (HAKKO Medical)? If it is so, you should state it in the materials
and methods.
2. Figure 3 is similar to Figure 4. One figure contains different information of the 21-gauge Menghini-
type needle and the conventional 22-gauge needle. It is difficult for the audience to understand. You
should show the figures simply. 
Example) Fig. 3. Case of using the 21-gauge Menghini-type needle, Fig. 4. Case of using the conventional
22-gauge needle
3. In this study, you emphasize the acquisition of good-quality tissue to diagnose as AIP definitely. You
should show histopathological images of the storiform fibrosis and the obliterative phlebitis also.
Publons Reviewer Recognition
. Springer Nature can send verification of this review directly to Publons
(a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on
the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted to Publons upon
publication of the manuscript. If you have already registered at Publons, they will notify you of the receipt
of this review and update your profile 
as per your settings and their policy. If you are not registered with
Publons, you will receive an email from them asking you to register in order for them to be able to
recognize your review on your new profile page. Publons may use the Review Data to generate derivative
metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such
information. For example, Publons may verify your record as a reviewer by updating your profile
published on its webservice if you have registered for such service or help editors to identify candidate
reviewers. Please find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
No
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this manuscript,
either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an organization that holds or has
applied for patents relating to the content of the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If your
reply is yes to any, please give details below.
I declare that I have no competing interests.
Reviewer Publication Consent.
 I agree for my report to be made available under an Open Access
Creative Commons CC-BY License (
 http://creativecommons.org/licenses/by/4.0
) if this manuscript is
accepted for publication. Any comments that I do not wish to be included in the published report have
been included as confidential comments to the editor, which will not be published.
If you are not happy for us to publish this report, please contact the editorial office before completing
the review.
If you wish, you can include your name in your published report. Please note you must decide whether
to include your name at the start of the process and confirm this decision whenever prompted. If you
change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my report.
Is the study design appropriate to answer the research question (including the use of appropriate controls),
and are the conclusions supported by the evidence presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free from apparent
manipulation?
Yes
Please review this paper.
user
Reviewer’s report
Title: 
Utility of a 21-gauge Menghini-type biopsy needle with rolling method for an endoscopic
ultrasound-guided histological diagnosis of autoimmune pancreatitis: a retrospective study
Version: 
0 
Date: 
16 Oct 2020
Reviewer: 
Takeshi Hisa
Reviewer's report:
The authors describes that the 21-gauge Menghini-type biopsy needle was useful for endoscopic
ultrasound-guided histological diagnosis of autoimmune pancreatitis compared with the conventional 22-
gauge or 19-gauge needles. This article is interesting; however, there are several problems.
Major: 
1. What enable abundant acquisition of tissue by the 21-gauge Menghini-type needle compared with the
conventional 22-gauge needles? 
The rolling method seems to have considerable effect rather than the
needle shape and system.
2. In the historical control, the 19-gauge needle should be excluded due to the use only in 2 procedures.
3. In this study, the histological diagnostic rate of AIP by the conventional 22-gauge needles is very low
compared with that in the previous reports. You should state the reasons in detail.
4. Ease of puncture depends on the scope position. Amount of acquired tissue seems to depend on the
funning method and the stroke length of needle. These factors should be mentioned.
5. In four patients who improved before steroid treatment in the conventional needle group, AIP could
have resolved at the time of FNA. If it is so, the histological diagnostic rate should become lower.
Minor:
1. Did you use the EUS Sonopsy CY (HAKKO Medical)? If it is so, you should state it in the materials
and methods.
2. Figure 3 is similar to Figure 4. One figure contains different information of the 21-gauge Menghini-
type needle and the conventional 22-gauge needle. It is difficult for the audience to understand. You
should show the figures simply. 
Example) Fig. 3. Case of using the 21-gauge Menghini-type needle, Fig. 4. Case of using the conventional
22-gauge needle
3. In this study, you emphasize the acquisition of good-quality tissue to diagnose as AIP definitely. You
should show histopathological images of the storiform fibrosis and the obliterative phlebitis also.
Publons Reviewer Recognition
. Springer Nature can send verification of this review directly to Publons
(a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on
the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted to Publons upon
publication of the manuscript. If you have already registered at Publons, they will notify you of the receipt
of this review and update your profile 
as per your settings and their policy. If you are not registered with
Publons, you will receive an email from them asking you to register in order for them to be able to
recognize your review on your new profile page. Publons may use the Review Data to generate derivative
metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such
information. For example, Publons may verify your record as a reviewer by updating your profile
published on its webservice if you have registered for such service or help editors to identify candidate
reviewers. Please find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
No
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this manuscript,
either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an organization that holds or has
applied for patents relating to the content of the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If your
reply is yes to any, please give details below.
I declare that I have no competing interests.
Reviewer Publication Consent.
 I agree for my report to be made available under an Open Access
Creative Commons CC-BY License (
 http://creativecommons.org/licenses/by/4.0
) if this manuscript is
accepted for publication. Any comments that I do not wish to be included in the published report have
been included as confidential comments to the editor, which will not be published.
If you are not happy for us to publish this report, please contact the editorial office before completing
the review.
If you wish, you can include your name in your published report. Please note you must decide whether
to include your name at the start of the process and confirm this decision whenever prompted. If you
change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my report.
Is the study design appropriate to answer the research question (including the use of appropriate controls),
and are the conclusions supported by the evidence presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free from apparent
manipulation?
Yes
assistant