The optimal approach of EBUS-FNA rapid on-site evaluation (ROSE): a five-year experience from a large academic medical center

Elzamly, Shaimaa; Al-Habib, Ali; Toraih, Eman A.; Jani, Pushan; Thomas-Ogunniyi, Jaiyeola; Sun, Hongxia; Liu, Jing; Zhu, Hai‐Liang; Buryanek, Jamie; Guo, Tianhua; Zhang, Songlin

doi:10.1016/j.jasc.2022.06.002

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…Here, ROSE may reduce the passes for molecular tests and the number of further invasive procedures 18 . A retrospective review of 516 EBUS‐FNA procedures revealed that ROSE assessment of the first 5 passes during the EBUS‐FNA could provide similar adequacies compared to total ROSE judgment of all punctures 19 . According to a review on 618 subjects, the employment of ROSE during EBUS‐TBNA necessitated significantly fewer needle passes 20 …”

Section: Discussionmentioning

confidence: 99%

EBUS ROSE‐guided cytological evaluations of intrathoracic lesions. Assessments of the pathological material adequacy and the diagnostic efficacy

Silav

Çıkrıkçıoğlu²,

Aydemir

et al. 2023

Diagnostic Cytopathology

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Background Several clinical groups consider cytological assessment under EBUS (Endobronchial Ultrasonography)‐ROSE (Rapid Onsite Evaluation) as the golden standard for diagnosis and staging of intrathoracic lesions. On the other hand, some investigators proposed that EBUS‐TBNA (Transbronchial Needle Aspiration) has considerably high false‐negative rates for diagnosis. In this study, we analyzed our patient cohort (n = 152) with intrathoracic lesions and suspected malignancies evaluated by EBUS‐ROSE. Our specific aims were: (i) to determine whether EBUS‐ROSE could provide sufficient pathologic material for diagnosis and staging; (ii) to determine the fidelity of EBUS‐ROSE‐guided initial diagnoses in comparison to paraffin block diagnoses; (iii) to evaluate whether anatomical localization of sampled lymph nodes associate with material adequacy and final diagnoses. Methods NCSS (Number Cruncher Statistical System) 2020 Statistical Software (Utah, USA) was used for statistical analysis. Results In EBUS‐ROSE cytological assessment, material adequacy was determined in 50,7% (n = 77) of the cases. Considering the paraffin block pathology as the golden standart, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates of EBUS‐ROSE were 90,2%, 93,1%, 94,8%, 87,1%, and 91,4%, respectively. There was no statistically significant difference between the final pathology and EBUS cytology results (p > .05) with a non‐random Kappa agreement rate as 82.9%. There were differences in material adequacy and diagnoses according to the localization of sampled lymph node stations. Conclusions EBUS‐ROSE is efficient to decide for the adequacy of the pathological specimen and provides diagnoses with reliable fidelity.

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Section: Discussionmentioning

confidence: 99%

EBUS ROSE‐guided cytological evaluations of intrathoracic lesions. Assessments of the pathological material adequacy and the diagnostic efficacy

Silav

Çıkrıkçıoğlu²,

Aydemir

et al. 2023

Diagnostic Cytopathology

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“…Elzamly et al highlights that performing ROSE can be challenging and stressful to cytotechnologists with limited time between passes to not only prepare and stain the slides but also review the cytology slides ( 11 ). While the mean time of sample preparation of the SOC slides was shorter than the mean combined time of preparation and machine run time of the device (147.7 vs. 204.7 seconds), the machine removes the work of slide sample deposition and staining, allowing time for the cytotechnologist to review slides without additional, competing responsibilities.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of automated sample preparation system for lymph node sampling

Duke,

Sturgis,

Hartley

et al. 2023

J Thorac Dis

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Background Endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-FNA) has revolutionized the diagnostic and staging approach to non-small cell carcinoma and thoracic lymphadenopathy. However, obstacles to efficacy of rapid on-site evaluation (ROSE) of the samples include variability in sample quality and slow and cumbersome process in the procedure room leading to extended procedure time. The purpose of this pilot study was to evaluate the feasibility and specimen quality of lymph node biopsies prepared through a novel automated system for automated fixation, drying and staining compared to standard slide preparation method. Methods We performed a prospective, single-center pilot feasibility study of patients undergoing EBUS. Samples were split into conventional standard of care (SOC) slide preparation and preparation using the device (“instrument”). Pathologists compared the SOC slides to the slides prepared by the automated system and assessed the following metrics: nuclear and cytoplasmic quality, presence of debris/artifact, staining quality, creation of a monolayer, and ease of adequacy/diagnosis assessment. A score between 1 (lowest quality) and 3 (highest quality) was assigned to the above metrics. Results Sixty patients were recruited. One to three lymph nodes were sampled for each patient for a total of 72 samples collected. The mean scores of each assessment category showed no statistical difference between the two preparation techniques except for improved monolayer creation in the instrument samples. Thirty of thirty-one (96.8%) paired samples in the final analysis showed diagnostic equivalency between the automated slides and conventional slides; the discordant pairing was reported to be suspicious on the instrument sample and atypical on the SOC. Conclusions Study results suggest that slides prepared by the automated system are of adequate quality for adequacy assessment with diagnostic concordance when compared to SOC slides.

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“…Elzamly et. al highlights that performing ROSE can be challenging and stressful to cytotechnologists with limited time between passes to not only prepare and stain the slides but also review the cytology slides [9]. While the mean time of sample preparation of the SOC slides was shorter than the mean combined time of preparation and machine run time of the ASP device (147.7 vs. 204.7 seconds), the machine removes the work of slide sample deposition and staining, allowing time for the cytotechnologist to review slides without additional, competing responsibilities.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Automated Sample Preparation System for Lymph Node Sampling

Duke

Sturgis

Hartley

et al. 2022

Preprint

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Purpose: The purpose of this study was to evaluate the feasibility and specimen quality of lymph node biopsies prepared through a novel automated system for automated fixation, drying and staining compared to standard slide preparation method. Methods: We performed a prospective, single-center study of patients undergoing endobronchial ultrasound. Samples were split into conventional standard of care (SOC) slide preparation and preparation using the device (ASP). Pathologists compared the SOC slides to the slides prepared by the automated system and assessed the following metrics: nuclear and cytoplasmic quality, presence of debris/artifact, staining quality, creation of a monolayer, and ease of adequacy/diagnosis assessment. A score between 1 (lowest quality) and 3 (highest quality) was assigned to the above metrics. Results: 60 patients were recruited. One to three lymph nodes were sampled for each patient with a total of 73 samples collected. The mean scores of each assessment category showed no statistical difference between the two preparation techniques except for improved monolayer creation in the ASP samples. All samples showed diagnostic equivalency between the automated slides and conventional slides except for one which was reported to be suspicious on the ASP sample and atypical on the SOC. Conclusion: Study results suggest that slides prepared by the automated system are of adequate quality for adequacy assessment with diagnostic concordance when compared to SOC slides.

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The optimal approach of EBUS-FNA rapid on-site evaluation (ROSE): a five-year experience from a large academic medical center

Cited by 4 publications

References 10 publications

EBUS ROSE‐guided cytological evaluations of intrathoracic lesions. Assessments of the pathological material adequacy and the diagnostic efficacy

EBUS ROSE‐guided cytological evaluations of intrathoracic lesions. Assessments of the pathological material adequacy and the diagnostic efficacy

Evaluation of automated sample preparation system for lymph node sampling

Evaluation of Automated Sample Preparation System for Lymph Node Sampling

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