Establishment of an endobronchial ultrasound‐guided transbronchial fine needle aspiration service with rapid on‐site evaluation: 2 years experience of a single UK centre

Abstract

In our experience, ROSE provides a clear advantage in providing a patient-centred EBUS service by facilitating specimen triage, ensuring adequate sampling and providing a rapid provisional diagnosis, however, there is a learning curve for both the clinicians and cytopathologists involved.

Evolution of a rapid onsite evaluation (ROSE) service for endobronchial ultrasound guided (EBUS) fine needle aspiration (FNA) cytology in a UK Hospital: A 7 year audit

“…Following the departure of the pathologists from Exeter in mid-2012, the cytology department was then funded for a trained BMS to attend this clinic on a weekly basis.Since 2014 all EBUS procedures have had an onsite BMS.The practicalities and pitfalls of ROSE in an EBUS setting and algorithms for reporting the adequacy of material have been widely documented elsewhere. 5,6 However, there is an important distinction between adequacy and diagnostic yield. 7In the EBUS setting, it is important to recognize the material aspirated as this determines the subsequent handling of the material.…”

Molecular testing on endobronchial ultrasound (EBUS) fine needle aspirates (FNA): Impact of triage

“…15,20 In the current analysis, 22 and more recent studies. 20,[23][24][25][26][27][28] However, the reported impact of ROSE varies. In a meta-analysis, ROSE increased specimen adequacy rate by 12% overall.…”

Committee II: Guidelines for cytologic sampling techniques of lung and mediastinal lymph nodes

“…One study of the role of ROSE for CT‐guided FNAs of lung nodules mentioned that a smear was considered inadequate if it contained poorly preserved cells or the cellularity was scanty and not compatible with the clinical and/or radiologic impressions . Similarly, another study defined a specimen as inadequate when no malignant cells or sufficient site‐specific tissue is present . A retrospective study including 64 FNA specimens of lung lesions defined samples as non‐diagnostic and benign depending on the absence and presence of bronchial epithelial cells or pigmented macrophages, respectively.…”

“…66 Similarly, another study defined a specimen as inadequate when no malignant cells or sufficient site-specific tissue is present. 68 limited, and the best example is evaluation of HER2 expression in breast cancer. 70 There is great variation among laboratories for processing non-gynecological cytology.…”