Feasibility and accuracy of rapid on-site evaluation of touch imprint cytology during transbronchial biopsy

Shikano, Kohei; Ishiwata, Tsukasa; Saegusa, Fumie; Terada, Jiro; Sakayori, Masashi; Abe, Mitsuhiro; Kawasaki, Takeshi; Ikari, Jun; Kawata, Naoko; Tada, Yuji

doi:10.21037/jtd-20-671

Cited by 11 publications

(12 citation statements)

References 19 publications

(21 reference statements)

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“…However, even when the sampling is not cytological but histological (e.g., endobronchial forceps biopsy, core needle biopsy) the agile cytopathologist can employ quick cytological techniques for rapid on-site evaluation and specimen triage [ 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 ]. Small biopsies can be used to prepare the whole array of cytological specimens in several ways.…”

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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“…The effectiveness of ROSE has been evaluated in various studies on material taken by EBUS‐TBNA with a variety of results. However, there are few studies that investigate the utility of ROSE during conventional bronchoscopy with FOB, 16,17 this is probably because this procedure is currently considered to be useless for visible lesions on FOB with respect to the commitment of human resources and time required. This therefore represents an important limitation for many laboratories.…”

Section: Discussionmentioning

confidence: 99%

“…A correlation between ROSE on TIC and/or on brushing and endobronchial biopsy for immunohistochemical and molecular predictive testing has not yet specifically been addressed. The study by Shikano et al 17 has shown high accuracy between ROSE by TIC and histology, as well as its value for obtaining a high‐success rate of molecular analysis for target therapy. Our data is similar for predictive testing, but discordant for diagnostic accuracy, which reported a higher level of sensitivity, specificity, and accuracy than our results have.…”

Section: Discussionmentioning

confidence: 99%

“…The main indication of ROSE in lung pathology is for the evaluation of peripheral tumors, mediastinal lymph nodes, or lesions adjacent to the proximal airway by endobronchial ultrasound with transbronchial needle aspiration (EBUS‐TBNA) 9‐13 . However, the utility of ROSE on touch imprint cytology (TIC) and/or on brushing during bronchoscopy, under direct vision, is rarely reported, 16,17 and so its role has remained unclear.…”

Section: Introductionmentioning

confidence: 99%

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The role of rapid on site evaluation on touch imprint cytology and brushing during conventional bronchoscopy

Botticella

Summa

Cisternino

et al. 2021

Diagnostic Cytopathology

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Background The increase in immunohistochemical and molecular predictive tests in lung cancer requires new strategies for managing small samples taken during bronchoscopic procedures. The value of Rapid On Site Evaluation (ROSE) during conventional bronchoscopic procedures on endobronchial neoplasms in optimizing small biopsies and cytologlogical tissue specimens for diagnostic testing, and ancillary studies was evaluated. Method ROSE on touch imprint cytology (TIC) and brushing was performed on 690 consecutive cases of patients undergoing biopsies, using fiber optic bronchoscopy. Immunohistochemical assay for PD‐L1, ALK, and ROS1 and molecular testing, via next generation technique for EGFR, KRAS, and BRAF, were performed. Results The concordance between ROSE and final diagnoses was almost perfect for brushing (sensitivity: 0.84; specificity: 0.96), and less so for touch preparations (sensitivity: 0.77; specificity: 0.89). Immunohistochemical assay for PD‐L1 was evaluated on 256 bioptic cases with only six unsuitable samples. Material available for immunohistochemistry for ALK was sufficient in 151 biopsies with no inadequate cases. ROS1 was evaluated in 132 biopsies, with only two unsuitable samples. Molecular analysis was performed on 128 biopsies, 29 TIC, and 17 brushing. Out of these, only ten were considered to be unsuitable. Conclusions ROSE is an effective procedure for monitoring the quality and quantity of material taken during conventional bronchoscopic procedures for evaluating the suitability of small samples that must undergo immunohistochemical and molecular assay.

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“…17,18 Moreover, the accuracy of ROSE with both histological diagnosis using EBUS-GS and final pathological findings was approximately 80% to 90% for diagnosing such lesions. [19][20][21] Therefore, if ROSE during EBUS-GS for small peripheral lung cancer did not include malignant cells when the probe was located either within or adjacent to the lesion, the bronchoscopic diagnosis had a high possibility of failure. Identification of factors that affected the results of ROSE during EBUS-GS in such a probe position might contribute toward performing additional devices during EBUS-GS, which might lead to overcome the lower diagnostic yield.…”

Section: Introductionmentioning

confidence: 99%

The Value of Additional Conventional Transbronchial Biopsy in the Negative Results of Rapid On-site Evaluation During Endobronchial Ultrasound With Guide Sheath to Diagnose Small Peripheral Lung Cancer

Itō

Okachi

Ikenouchi

et al. 2021

Technol Cancer Res Treat

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Objective: The accuracy of rapid on-site evaluation (ROSE) during endobronchial ultrasonography with guide sheath (EBUS-GS) was reported to be approximately 90% for diagnosing small peripheral pulmonary lesions (PPLs). When ROSE during EBUS-GS for diagnosing small peripheral lung cancer is carried out and does not include malignant cells in a position whereby the probe was located within or adjacent to the lesion, the best technique for overcoming the lower diagnostic yield remains unknown. This study aimed to evaluate factors affecting positive results of ROSE during EBUS-GS in such a probe position. Moreover, when the results of ROSE were consistently negative, we evaluated the effectiveness of conventional transbronchial biopsy (TBB) in addition to EBUS-GS alone. Methods: We performed a retrospective analysis of consecutive patients who underwent EBUS-GS combined with ROSE for diagnosing small peripheral lung cancer (≤30 mm). We classified the results of ROSE into two groups based on the presence of malignant cells: the ROSE positive group (included malignant cells) and the ROSE negative group (did not include malignant cells). The significant predictors of positive ROSE results during EBUS-GS were analyzed using multivariate logistic regression analyses. Results: We identified 67 lesions (43 lesions in the ROSE positive group and 24 lesions in the ROSE negative group, respectively). Multivariate logistic analysis revealed that the significant factor affecting positive ROSE results was lesion size (>15 mm) (OR = 9.901). The diagnostic yield of additional conventional TBB to EBUS-GS was significantly higher than that of EBUS-GS alone (75.0% vs 33.3%, P = .041). Conclusion: The positive results of ROSE during EBUS-GS were significantly influenced by lesion size (>15 mm). When the results of ROSE during EBUS-GS were consistently negative in a position whereby the probe was located within or adjacent to the lesion, additional conventional TBB was effective to improve the diagnostic yield compared with EBUS-GS alone.

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Feasibility and accuracy of rapid on-site evaluation of touch imprint cytology during transbronchial biopsy

Cited by 11 publications

References 19 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 role of rapid on site evaluation on touch imprint cytology and brushing during conventional bronchoscopy

The Value of Additional Conventional Transbronchial Biopsy in the Negative Results of Rapid On-site Evaluation During Endobronchial Ultrasound With Guide Sheath to Diagnose Small Peripheral Lung Cancer

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