Feasibility of rapid on‐site cytological evaluation of lung cancer by a trained pulmonologist during bronchoscopy examination

Abstract

Objective Rapid on‐site cytological evaluation (ROSE) in bronchoscopy is a useful ancillary technique. ROSE is usually performed by a cytopathologist or cytotechnologist. However, because of staff shortages and reduced availability, ROSE cannot be performed in every hospital. We aimed to evaluate the accuracy of ROSE when performed by a trained pulmonologist, comparing the diagnosis results with the final diagnosis of cytopathologists. Methods We performed a retrospective cohort study on 125 patients who underwent bronchoscopy with endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) and endobronchial ultrasonography with a guide sheath (EBUS‐GS) for peripheral pulmonary lesions by conventional bronchoscopy at Sapporo Medical University Hospital between March 2012 and September 2018. ROSE was performed by a pulmonologist who was trained by a cytotechnologist for a total of 1 month. DiffQuik® staining for ROSE was used to prepare cytology slides. The results of ROSE were compared with the final diagnosis obtained using Papanicolaou staining by cytopathologists. Results In all procedures, the sensitivity, specificity and diagnostic accuracy of ROSE were 88.5%, 83.0% and 86.4%, respectively. There was no significant difference in the sensitivity, specificity, positive predictive value, negative predictive value or accuracy between EBUS‐TBNA and EBUS‐GS. Conclusions ROSE of lung cancer by a trained pulmonologist can be highly accurate and deemed as feasible and useful for not only EBUS‐TBNA but also EBUS‐GS.

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

“…In our study, ROSE was performed by a well trained pulmonologist. Our study showed that the sensitivity and speci city of ROSE in diagnosing malignant lymph nodes were 96.32% and 79.05% respectively, consistent with previous studies of 88.5% and 83.0% (Umeda et al 2019) In previous studies, ROSE was only applied as an ancillary study to evaluate the su ciency of the sampling in EBUS-TNBA (Huang et al 2017) (Gu et al 2017). To better analyze the effects of elastography or ROSE, we combined elastography and ROSE for statistical analysis.…”

“…ROSE could guide the operator for identifying the sampling site, determining the su ciency of the sample and decreasing the procedure during (Sehgal et al 2020). Meena et al showed that pulmonologists with cytopathology training could perform onsite cytological evaluation of EBUS-TBNA samples, and no signi cant difference in accuracy of the sample was identi ed when compared with cytopathologists (Meena et al 2016;Umeda et al 2019), bene ting the clinical practice. In our study, ROSE was performed by a well trained pulmonologist.…”

Application of microbiological rapid on-site evaluation in respiratory intensive care units: a retrospective study

“…ROSE is a rapid, real-time cytological interpretation technique that accompanies the sampling process. In Europe and the United States, C-ROSE is widely used in diagnostic interventional pulmonology due to its high diagnosis rate for malignant tumors, its ability to diagnose infectious and noninfectious diseases, and its low complications (13)(14)(15)(16). However, there are few studies on the diagnostic value of M-ROSE as a microbiological evaluation technique for determining the pathogenesis of pulmonary infections.…”

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

“…ROSE can also guide the operator in identifying the sampling site, determining the adequacy of the sample, and decreasing procedure duration [ 8 ]. Meena et al showed that pulmonologists with cytopathology training could perform onsite cytological evaluation of EBUS-TBNA samples, and no significant difference in accuracy of the sample was identified when compared with cytopathologists [ 42 , 43 ], benefiting clinical practice. In this study, ROSE was performed by a well-trained pulmonologist; the results demonstrate that the sensitivity and specificity of ROSE in diagnosing malignant lymph nodes were 95.73% and 79.05% respectively, consistent with findings in previous studies of 88.5% and 83.0% [ 43 ]…”