You would have to switch to a 4 bolt TB (which will be pretty expensive in cable style) or run an adapter, which pretty much defeats the purpose of the swap.

I think it was worth the swap on my truck, but since mine is a DBW 2001 I didn't have to buy the module to convert to the newer TB, so it really didn't cost me much.

If you change to a 87/90mm TB you will definately need a tune.