Concordance Between Rapid On-Site Evaluation and Final Cytologic Diagnosis in Patients Undergoing Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Non-Small Cell Lung Cancer Staging

Caupena, Cristina; Esteban, Lluis; Jaén, Ángeles; Barreiro, Bienvenido; Albero-González, Raquel; Pérez-Ochoa, Francisco; Souza, Patricia Pontes De; Gibert, Oriol; Ferrer, Carme; Forcada, Pilar; García, F. Andreo; Tarroch, X.; Sanz-Santos, José

doi:10.1093/ajcp/aqz146

Cited by 15 publications

(17 citation statements)

References 25 publications

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“…The study by Stevenson et al a showed an increase in diagnostic yield within the first six years of seven years of ROSE practice [ 42 ]. This is supported by higher concordance rates between ROSE and final diagnosis reported by Caupena and colleagues (96.1%) in 637 lymph node samples obtained via EBUS-TBNA during that year compared to older publications [ 43 ].…”

Section: Rapid On-site Evaluationsupporting

confidence: 64%

Linear Endobronchial Ultrasound in the Era of Personalized Lung Cancer Diagnostics—A Technical Review

Oezkan

Eisenmann

Darwiche

et al. 2021

JCM

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Major advances in molecular profiling for available targeted treatments and immunotherapy for lung cancer have significantly increased the complexity of tissue-based diagnostics. Endobronchial ultrasound-guided transbronchial needle aspirations (EBUS-TBNA) are commonly performed for diagnostic biopsies and lymph node staging. EBUS-TBNA has increasingly become one of the main sources of tumor cells for molecular analyses. As a result, there is a growing need for high quality EBUS-TBNA samples with adequate cellularity. This has increased the technical demands of the procedure and has created additional challenges, many of which are not addressed in the current EBUS guidelines. This review provides an overview of current evidence on the technical aspects of EBUS-TBNA in light of comprehensive sample processing for personalized lung cancer management. These include sonographic lymph node characterization, optimal needle choice, suction biopsy technique, and the role of rapid on-site evaluation. Attention to these technical details will be important to maximize the throughput of EBUS-TBNA biopsies for molecular testing.

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Section: Rapid On-site Evaluationsupporting

confidence: 64%

Linear Endobronchial Ultrasound in the Era of Personalized Lung Cancer Diagnostics—A Technical Review

Oezkan

Eisenmann

Darwiche

et al. 2021

JCM

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“…In fact, several studies investigated the contribution of ROSE to the adequacy of sampling for lung cancer diagnosis during EBUS-TBNA, with contradictory results ( 2 , 6 , 15 , 35 , 40 ). Some of the trials reported a significant contribution of ROSE to the diagnosis and staging of lung cancer and a high concordance between ROSE and the final diagnosis ( 6 , 41 ).On the contrary, randomized trials failed in finding differences in diagnostic yield when EBUS-TBNA is performed with or without the use of ROSE ( 33 , 34 , 42 ).…”

Section: The Impact Of Rose In Diagnosis Staging and Molecular Profiling Of Lung Cancermentioning

confidence: 99%

“…As discussed by Caupena et al , the absence of differences in the duration of the procedures may be due to a reduction of the number of sampled nodes and passes per target associated with the use of ROSE. In fact, when following ROSE a diagnosis of positive N3 node is reached, no further sampling on N2/N1 sampling has necessarily to be performed ( 41 ). Moreover, without ROSE a minimum of three passes per target is advised ( 44 ), while the use of ROSE may allow to reduce the number of biopsies required to obtain diagnosis ( 35 ).…”

Section: The Impact Of Rose In Diagnosis Staging and Molecular Profiling Of Lung Cancermentioning

confidence: 99%

The impact of pathological analysis on endobronchial ultrasound diagnostic accuracy

Bandiera¹,

Arrigoni²

2020

Mediastinum

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Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure used for lung cancer diagnosis and staging. Several aspects, including pathological analysis, may impact on its diagnostic accuracy. Differences in diagnostic accuracy between the different specimen processing techniques have not been demonstrated. Cytological slides are generally adequate for diagnosis, subtyping and genotyping. However, some pathological laboratories may require cell blocks or histological core biopsies for a complete molecular profiling. Rapid on-site evaluation (ROSE) is a technique for immediate evaluation of samples obtained with EBUS-TBNA. The aims of ROSE are to increase sampling adequacy, improving diagnostic yield of EBUS-TBNA and ensuring collection of adequate material for ancillary studies. However, the reported data on the impact of ROSE in the diagnostic yield of EBUS-TBNA and in lung cancer diagnosis and staging are controversial. Some series reported a valuable contribution of ROSE to diagnosis and staging of lung cancer and a high concordance between ROSE and the final diagnosis. However, randomized trials failed in finding differences in diagnostic yield between EBUS-TBNA performed with and without ROSE. The yield of EBUS-TBNA for molecular analyses varies between 72% and 98%, and ROSE may warrant the collection of adequate material for molecular profiling. In lung cancer diagnosis and staging a recommended number of three to four passes during EBUS-TBNA at each target is a minimum requirement to obtain enough material for molecular analysis. The use of ROSE may reduce the number of passes for molecular profiling and the number of additional invasive diagnostic procedures. EBUS-TBNA is a procedure with a high accuracy rate and ROSE may contribute to a further improvement of the results. The possibility to avoid additional invasive procedure is an important advantage leading to an overall improvement of patient care.

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“…The latter approach facilitates rapid onsite evaluation (ROSE), whereby direct slides are rapidly stained and evaluated in real‐time in the endoscopy suite for adequacy and the presence of diagnostic material 5‐7 …”

Section: Introductionmentioning

confidence: 99%

Rapid onsite evaluation uses a very small proportion of total material aspirated at endobronchial or endoscopic ultrasound in the investigation of suspected thoracic malignancy

et al. 2021

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Introduction The objectives were: to measure the proportion of aspirated material used to make direct slides for rapid onsite evaluation (ROSE) at endobronchial (EBUS) and endoscopic ultrasound (EUS) in suspected thoracic malignancy; and to correlate pass weights with ROSE category and needle size. Method All EBUS and EUS cases for possible thoracic malignancy October 2018‐May 2019 were included. All material from each pass was expelled into a Petri dish. One drop of material was placed on each of two slides; one used for ROSE, the other fixed and remaining material processed to cell block. Dish and slides were weighed before and after this procedure on a sensitive balance and weight of aspirate and slide material calculated. When ROSE identified malignancy, slide production ceased but target sampling for ancillary studies continued. Results ROSE accuracy was 96.8%. Mean percentage by target of aspirated material used to make direct slides for ROSE was 1.9% in malignant cases and 3.6% in non‐malignant cases (P = .027 for difference). Mean percentage by pass was 5.9%. Mean weight of a single aspirate was 128.8 mg. Mean weight of aspirates insufficient on ROSE (175.7 mg) was significantly higher than the mean weight of benign or malignant aspirates (117.1 and 114.0 mg, respectively). Mean weight of aspirates using 22G needles (132.6 mg) was significantly higher than that for 25G needles (87.1 mg). Conclusion Material made into direct slides at EBUS and EUS and used in part for ROSE uses a tiny proportion of aspirated material with over 98% processed to cell block and available for ancillary testing in malignant cases.

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Concordance Between Rapid On-Site Evaluation and Final Cytologic Diagnosis in Patients Undergoing Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Non-Small Cell Lung Cancer Staging

Cited by 15 publications

References 25 publications

Linear Endobronchial Ultrasound in the Era of Personalized Lung Cancer Diagnostics—A Technical Review

Linear Endobronchial Ultrasound in the Era of Personalized Lung Cancer Diagnostics—A Technical Review

The impact of pathological analysis on endobronchial ultrasound diagnostic accuracy

Rapid onsite evaluation uses a very small proportion of total material aspirated at endobronchial or endoscopic ultrasound in the investigation of suspected thoracic malignancy

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