Accuracy of Cytotechnologist Evaluation of Specimen Adequacy and Screening Interpretation of Malignancy in Fine-Needle Aspiration of the Liver

Abstract

Objective: To evaluate the performance of cytotechnologists in assessing the adequacy and accuracy of the preliminary diagnosis for fine-needle aspirates of the liver. Study Design: We retrospectively analyzed 10 years of data and found 589 cases of ultrasound-guided fine-needle aspiration (FNA) of the liver with on-site evaluation of adequacy (OSEA). All the OSEA were performed by the cytopathologist because OSEA of liver FNA is not performed by cytotechnologists at our institution at present. After OSEA, the material was seen by cytotechnologists who rendered an adequacy assessment and preliminary diagnosis. We calculated the adequacy and accuracy statistics and compared the performance of the cytotechnologists with the OSEA and final interpretation. Results: There was no statistically significant difference in adequacy downgrade rate for cytotechnologist versus cytopathologist assessment during the study period (5 vs. 3%, p = 0.06). A total agreement of 88% was noted in overall diagnosis with 97% agreement in malignant cases. Conclusion: Cytotechnologists assess the adequacy of liver FNA accurately and there is therefore potential for them to perform OSEA for liver FNA.

Endobronchial ultrasound‐guided transbronchial needle aspiration: performance of biomedical scientists on rapid on‐site evaluation and preliminary diagnosis

“…We found an excellent correlation between both adequacy assessments both by ROSE (Diff‐Quik) and preliminary assessments (Diff‐Quik, MGG and HE), and diagnostic properties between BMS and cytopathologists. These findings are supported by previous studies of BMS adequacy assessments and preliminary diagnosis, although these studies were performed on FNA from a variety of tissues rather than EBUS‐TBNA.…”

“…suggests that BMS performing ROSE of EBUS‐TBNA may be cost effective and the way forward in interventional cytology. In addition, the BMS may play an important role in offering a preliminary diagnosis to the cytopathologist signing out the specimen, as has been shown for fine needle aspiration (FNA) of the liver …”

Rapid on‐site evaluation with the Hemacolor rapid staining method of medical thoracoscopy biopsy specimens for the management of pleural disease

“…Rapid on‐site evaluation is commonly used during transthoracic or ultrasound guided fine needle aspirations . During bronchoscopy and EBUS‐TBNA, a diagnostic ROSE result spared the need for additional sampling without reducing the overall diagnostic yield .…”

Rapid On-Site Evaluation of Fine-Needle Aspiration by Non-Cytopathologists: A Systematic Review and Meta-Analysis of Diagnostic Accuracy Studies for Adequacy Assessment

“…The concordance rate for the screening process was 98%. Thirteen studies were included after full-text review of the 57 potentially relevant studies [9-21]. …”