Telecytology rapid on‐site evaluation: Diagnostic challenges, technical issues and lessons learned

Xing, Juan; Cuda, Jacqueline; Pantanowitz, Liron

doi:10.1111/cyt.12801

Cited by 16 publications

(3 citation statements)

References 18 publications

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“…30 Finally, some institutions have successfully implemented ROSE by telepathology and this is an exciting area for development which may alleviate some of the staffing issues. 42,43 The effect of ROSE on diagnostic yield at EBUS is controversial; however, the weight of opinion is that there is no significant improvement. 25,26,44,45 In addition, unlike in head and neck FNAs, there is no evidence, in controlled studies, for a significant improvement in adequacy.…”

Section: Ebus or Eus Are As Followsmentioning

confidence: 99%

“…Studies from the USA in centres offering ROSE have shown an overall reduction in time and volume of work, though this is dependent on individual laboratory practices 30 . Finally, some institutions have successfully implemented ROSE by telepathology and this is an exciting area for development which may alleviate some of the staffing issues 42,43 …”

Section: Specimen Acquisitionmentioning

confidence: 99%

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Technical aspects of the use of cytopathological specimens for diagnosis and predictive testing in malignant epithelial neoplasms of the lung

Maddox

Smart

2021

Cytopathology

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Lung cancer is a leading cause of cancer mortality worldwide, 1 and for at least 50 years, primary pathological diagnosis has been based on small biopsies and cytopathological specimens. Until approximately 20 years ago, a simple binary categorisation of small cell and non-small cell lung carcinoma (NSCLC) was, in most cases, sufficient for diagnosis and treatment.However, recent years have seen a rapidly rising proportion of cases of NSCLC amenable to increasingly targeted therapy, initially based on the differential response to systemic treatment of tumours of squamous or glandular differentiation 2 then on the presence of particular mutations in the EGFR gene. [3][4][5] Subsequently, further "driver mutations" have been identified with an increasing percentage having associated treatments. Finally, there is an expanding therapeutic repertoire of immune checkpoint inhibitors with eligibility determined, at least in part, by the expression of immune modulators such as Programmed Death Ligand-1 (PD-L1). 6 In the USA, it is now mandatory to test for EGFR mutations, ALK and ROS1 translocations, and expression of PD-L1. In addition, it is recommended to test for BRAF and MET mutations and RET and NTRK fusions. 7,8 In the UK, for patients with NSCLC of stage IIIB and above, treatments that target genomic abnormalities in EGFR, ALK, ROS1, and quantified expression of PD-L1 are standard-of-care 9 ; those targeting NTRK fusions are approved under certain circumstances 10,11 and those applied to RET and MET abnormalities are currently being assessed by the National Institute for Health and Care Excellence. 12,13 Treatments for a wide variety of other genomic abnormalities are being studied in clinical trials [14][15][16] and adjuvant treatments for

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Section: Ebus or Eus Are As Followsmentioning

confidence: 99%

Section: Specimen Acquisitionmentioning

confidence: 99%

Technical aspects of the use of cytopathological specimens for diagnosis and predictive testing in malignant epithelial neoplasms of the lung

Maddox

Smart

2021

Cytopathology

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“…In this context, rapid staining allows both an assessment of the quality and suitability of biopsy-derived samples for the further diagnostic and/or therapeutic measures required [1][2][3][4]. Different biopsy and processing methods are suitable for cytological rapid staining procedures [1,[5][6][7][8][9][10][11]. Typically, rapid cytology examinations are performed as rapid on-site evaluations (ROSEs) [8,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Rapid Remote Online Evaluation in Endoscopic Diagnostics: An Analysis of Biopsy-Proven Respiratory Cytopathology

Elmas,

Önal,

Steurer

et al. 2023

Diagnostics

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Background: This prospective study assesses the use of rapid remote online cytological evaluation for diagnosing endoscopical achieved biopsies. It focuses on its effectiveness in identifying benign and malignant conditions using digital image processing. Methods: The study was conducted between April 2021 and September 2022 and involved analyses of 314 Rapid Remote Online Cytological Evaluations in total (154 imprint cytologies, 143 fine needle aspirations and 17 brush cytologies) performed on 239 patients at the LungenClinic Grosshansdorf. During on-site evaluation via telecytology, the time requirement was recorded and the findings were compared with the cyto-/histological and final diagnoses. Results: By means of rapid remote online evaluation, findings of 86 cytological benign, 190 malignant and 38 unclear diagnoses were recorded (Ø assessment time, 100 s; range, 11–370 s). In 27 of the 37 specimens with unclear diagnoses, the final findings were malignant tumours and only 6 were benign changes. The diagnosis of another 4 of these 37 findings remained unclear. Excluding these 37 specimens, rapid remote online evaluation achieved a sensitivity of 90.5% with a specificity of 98.5% and a correct classification rate of 92.4% with regard to the final diagnosis of all cases. As expected, an increase in the sensitivity rate for the cytological detection of malignant tumours (76.1% vs. 92.5%) was found especially in fine-needle aspirations. Conclusions: Rapid remote online analysis allows the fast quantitative and qualitative evaluation of clinically obtained cytological specimens. With a correct classification rate of more than 93%, sampling deficiencies can be corrected promptly and diagnostic and therapeutic approaches can be derived.

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Rapid on‐site evaluation using telecytology: Quality assurance study at a high‐volume cancer center

Alhamar,

Rudomina,

Wang

et al. 2025

Cancer Cytopathology

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BackgroundTelecytology‐assisted rapid on‐site evaluation (ROSE) offers a cost‐effective method to enhance minimally invasive biopsies like fine needle aspiration and core biopsies with touch preparation. By reducing nondiagnostic sampling and the need for repeat procedures, ROSE via telecytology facilitates prompt triage for ancillary tests, improving patient management. This study examines cases initially deemed adequate for diagnosis during telecytology‐assisted ROSE but later categorized as nondiagnostic at final evaluation (NDIS).DesignWe performed a retrospective analysis of telecytology‐assisted ROSE cases over 7 years at a major cancer center, focusing on fine needle aspiration and touch preparation of core biopsies. Each case was thoroughly reviewed, correlating with clinical data and concurrent core biopsies or subsequent excisions. The study identified leading factors contributing to NDIS.ResultsThe average NDIS rate was 0.06% (42/70,612). Misinterpretation of benign or reactive cells as neoplastic was the leading cause (76.2%) of discrepancies between original ROSE and final diagnosis. Kidney biopsies had the highest NDIS rate (0.90%), primarily because of misinterpreting nonneoplastic cells. Thyroid biopsies were linked to quantitative threshold issues (0.10%). NDIS events were most associated with misinterpretation in kidney, pancreas, gastrointestinal tract, and lung biopsies.ConclusionIn conclusion, the NDIS rate in telecytology‐assisted ROSE is low, but quality assurance identified areas for improvement. Recognizing site‐specific pitfalls during telecytology‐assisted ROSE can enhance diagnostic accuracy and optimize patient care.

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Telecytology rapid on‐site evaluation: Diagnostic challenges, technical issues and lessons learned

Cited by 16 publications

References 18 publications

Technical aspects of the use of cytopathological specimens for diagnosis and predictive testing in malignant epithelial neoplasms of the lung

Technical aspects of the use of cytopathological specimens for diagnosis and predictive testing in malignant epithelial neoplasms of the lung

Rapid Remote Online Evaluation in Endoscopic Diagnostics: An Analysis of Biopsy-Proven Respiratory Cytopathology

Rapid on‐site evaluation using telecytology: Quality assurance study at a high‐volume cancer center

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