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

Stevenson, T D; Powari, Manish; Bowles, Christopher

doi:10.1002/dc.23967

Cited by 21 publications

(32 citation statements)

References 11 publications

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“…It is well known that it is best for the collection of the sample to be performed directly by the cytopathologist who will then evaluate it microscopically, and not by some other professional figure [ 85 ]. In the procedure known as rapid on-site evaluation (ROSE), the cytopathologist can smear the material on glass slides, air-dry them, stain them with a quick cytological stain (such as Diff-Quik) and evaluate them for adequacy on the spot, using a microscope [ 86 , 87 , 88 , 89 ]. While a morphological diagnosis can be rendered directly in some cases, the most important thing is that ROSE allows the cytopathologist to perform two crucial steps: sampling can be repeated on the spot if the first smears are inadequate or non-diagnostic, thus greatly reducing the rate of inadequate diagnoses, patient anxiety, and diagnostic delay; by integrating clinical, imaging (ultrasonography, computed tomography) and microscopic cytologic data, the material can be allocated in the best way possible [ 90 , 91 , 92 ].…”

Section: Discussionmentioning

confidence: 99%

Testing EGFR with Idylla on Cytological Specimens of Lung Cancer: A Review

Caputo

D'Ardia

Sabbatino

et al. 2021

IJMS

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The current standard of care for advanced non-small-cell lung cancer is based on detecting actionable mutations that can benefit from targeted therapy. Comprehensive genetic tests can have long turn-around times, and because EGFR mutations are the most prevalent actionable mutation, a quick detection would enable a prompt initiation of targeted therapy. Furthermore, the scarcity of diagnostic material means that sometimes only cytologic material is available. The Idylla™ EGFR assay is a real-time PCR–based method able to detect 51 EGFR mutations in 2.5 h. Idylla is validated for use only on FFPE sections, but some researchers described their experiences with cytological material. We reviewed the relevant literature, finding four articles describing 471 cases and many types of cytological input material: smears, cell-block sections, suspensions, and extracted DNA. The sensitivity, specificity, and limit of detection appear comparable to those obtained with histological input material, with one exception: the usage of scraped stained smears as input may reduce the accuracy of the test. In conclusion, usage of cytological material as input to the Idylla EGFR test is possible. A workflow where common mutations are tested first and fast, leaving rarer mutations for subsequent comprehensive profiling, seems the most effective approach.

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Section: Discussionmentioning

confidence: 99%

Testing EGFR with Idylla on Cytological Specimens of Lung Cancer: A Review

Caputo

D'Ardia

Sabbatino

et al. 2021

IJMS

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“…However, most studies show patient benefit with noted decrease in the number of required repeat procedures to obtain diagnostic tissue [28][29][30]. Further, most studies that highlight the use of cytology samples for molecular testing have an on-site adequacy assessment component [29][30][31][34][35][36]. Importantly, the Centers for Medicare and Medicaid Services (CMS) recently provided clarification related to fine needle aspiration (FNA) and ROSE under CLIA (Clinical Laboratory Improvement Amendments) 1988.…”

Section: The Use Of Cytopathology Specimens For Molecular Testingmentioning

confidence: 99%

The diagnosis of non-small cell lung cancer in the molecular era

Brainard

Farver

2019

Modern Pathology

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Lung carcinoma is the leading cause of cancer mortality for both genders in the United States and throughout the world. Many of these tumors are being diagnosed with minimally invasive means resulting in small samples. There is a need to extract an increasing amount of therapeutic and prognostic information from progressively smaller samples. Collaboration among clinicians and pathologists is needed to produce a comprehensive final diagnosis in patients with lung cancer. This collaboration facilitates triage of small samples for ancillary studies including molecular testing. What follows represents a review of the current required testing for lung cancer specimens, an example of an algorithm currently employed at the Cleveland Clinic so that all required tests can be performed even on the smallest of specimens and suggestions on how pathologists may approach this new era of "doing more with less".

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“…1,2,3 The value of ROSE is to optimize the benefit of the procedure for patient and doctor as well; for the shake of accurate treatment plan, for the convenience of a single-step surgery process, and for economic reasons. 3,4,5 Not infrequently the clinical and imaging data render similar possible diagnostic which lead to different techniques and approach. 4,5,6 Lytic lesions or single pathological fracture are the most dispute cases which may be caused by neoplastic, inflammation, or a degenerative process.…”

Section: Rapid On Site Evaluation (Rose) Ismentioning

confidence: 99%

“…3,4,5 Not infrequently the clinical and imaging data render similar possible diagnostic which lead to different techniques and approach. 4,5,6 Lytic lesions or single pathological fracture are the most dispute cases which may be caused by neoplastic, inflammation, or a degenerative process. 4,6,7 When there's window in the periosteum, fine needle aspiration biopsy (FNAB) could be arranged prior to surgery, yet for single lytic or fractured lesion, FNAB is not an option.…”

Section: Rapid On Site Evaluation (Rose) Ismentioning

confidence: 99%

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The Role Of Rose (Rapid Onsite Evaluation) On Spinal Lesion Surgery Decision

Sindrawati

Agung

Binti³

et al. 2019

J.Widya Medika

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Introduction: Exposure and instrumentation of the spine must be meticulous and thorough regardless the techniques and approach selected. Management of the whole surgery process should be decided based on the best available evidence whenever possible. ROSE (Rapid Onsite Evaluation) cytology wrap up the surgical decision. Case Description: Fifteen cases comprise of lytic lesions and/or single pathological fractures of the corpus vertebrae will be presented and discuss as to how the surgical techniques and approaches are assisted by ROSE. ROSE cytology was performed in the operating theater during the surgery. Samples were taken after exposure of the minimal lesion using (18–21) G trocar needle or under fluoroscopy guided. Direct smear, air dried fixation, and Diff Quik staining would take about 10 minutes. Pathologist evaluated the specimen and provided the result in about 20 minutes. The overall 30 minutes allowed surgeon to prepare the further steps. Results would be malignant or benign without pursuing further detail diagnostic. Benign results should be categorized as infection, suspicious of granulomatic tuberculosis, or normal host population cells. The cases outcome were 8 normal host population cells advanced for vertebroplasty to fill the porotic bone. Three spondylitis tuberculosis were debrided without unnecessary instrumentation, and four malignant processes were assured to have enough samples for immunohistochemistry evaluation afterward. All ROSE cytology was confirmed accordingly by the histopathology result afterward. Conclusion: ROSE is easy and offers accurate sampling from the lesion itself. It is quick, therefore during surgery surgeon could decide the best management for the patient.

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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

Abstract: ROSE at EBUS FNA provides access to suitable material for molecular testing with increased yields in the form of needle washings for EGFR with FFPE materials for ALK and PDL1 testing.

Cited by 21 publications

References 11 publications

Testing EGFR with Idylla on Cytological Specimens of Lung Cancer: A Review

Testing EGFR with Idylla on Cytological Specimens of Lung Cancer: A Review

The diagnosis of non-small cell lung cancer in the molecular era

The Role Of Rose (Rapid Onsite Evaluation) On Spinal Lesion Surgery Decision

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