Frozen Section or Intraoperative Cytology: Are We Ready for a Paradigm Shift in Thoracic Surgery?

Biancosino, Christian; Linde, Lea Isabell Shari van der; Krüger, M.; Hussam, S; Stellmacher, Florian; Welker, Lutz

doi:10.1007/5584_2021_696

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Biancosino et al estimated the relevance of intraoperative cytology by investigating a total of 532 surgically obtained specimens out of the 518 resected lung tumors from 360 patients. The specificity and sensitivity of fast intraoperative cytology were 99% and 82%, respectively, with positive and negative predictive values of 99% and 86%, respectively 14 . Our data on the positive and negative predictive values of cytology (100% and 96.7%, respectively) revealed that our results were more successful regarding the negative predictive value.…”

Section: Discussionmentioning

confidence: 47%

“…The specificity and sensitivity of fast intraoperative cytology were 99% and 82%, respectively, with positive and negative predictive values of 99% and 86%, respectively. 14 Our data on the positive and negative predictive values of cytology (100% and 96.7%, respectively) revealed that our results were more successful regarding the negative predictive value.…”

Section: Biancosino Et Al Estimated the Relevance Of Intraoperative C...mentioning

confidence: 54%

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Could cytology supplant frozen section for intraoperative evaluation of thoracic lesions? A single institutional experience in a developing country

Silav

Sönmez

Aydemir

et al. 2022

Diagnostic Cytopathology

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Background: The diagnostic performance of cytology was compared with the frozen results and its usability was evaluated as a rapid diagnosis method in intraoperative thoracic surgery in a single institution (Istanbul, Turkey).Methods: All 197 subsequent patient specimens (cases) from 158 patients who were sent to our department from the thoracic surgery clinic for an intraoperative diagnosis request between the years 2016 and 2021 were evaluated. Obtained results from frozen and cytology were compared with final paraffin section diagnoses. Lesions were grouped into three different groups as nonneoplastic, benign, and malignant neoplasms.Results: Diagnostic accuracy values of cytology and frozen sections in intraoperative consultation were 98.8% and 99.4%, respectively. Sensitivity values of cytology and frozen sections in intraoperative consultation were 96.3% and 98.7%, respectively. Specificity values of cytology and frozen sections in intraoperative consultation were 100% and 100%, respectively. Negative predictive values of cytology and frozen sections in intraoperative consultation were 96.7% and 98.9%, respectively. Positive predictive values of cytology and frozen sections in intraoperative consultation were 100% and 100%, respectively. Kappa statistics between cytology and frozen revealed a very high interrater reliability (Cohen's Kappa value: 0.911; p = .001; p < .01). The difficulty in distinguishing primary and metastatic carcinoma, which is mostly undecided in frozen sections and the definitive diagnosis is left to paraffin sections, seems also be a problem in the cytological examination.Conclusions: Cytological diagnosis can be used in the evaluation of small biopsy specimens that require tissue preservation in intraoperative consultation, especially for immunohistochemical and advanced genetic studies.

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Section: Discussionmentioning

confidence: 47%

Section: Biancosino Et Al Estimated the Relevance Of Intraoperative C...mentioning

confidence: 54%

Could cytology supplant frozen section for intraoperative evaluation of thoracic lesions? A single institutional experience in a developing country

Silav

Sönmez

Aydemir

et al. 2022

Diagnostic Cytopathology

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“…In recent years, cytological examinations have been used alongside intraoperative FS examinations and sometimes yield results as effective as FS examinations [ 23 ]. In a study of patients undergoing thoracic surgery who underwent a cytological examination as part of an intraoperative pathological examination, Biancosino et al reported a diagnostic sensitivity of 82 %, a specificity of 99 %, an NPV of 86 % and a PPV of 99 % for cytological examination [ 24 ]. Mohamed et al in their study comparing the effectiveness of FS examination with cytological examination of intraoperative fine needle aspiration materials in thoracic malignancies, reported that the sensitivity of FS was 97 % and the specificity was 99 % [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic efficacy of intraoperative histopathological examination of lesions with unknown diagnosis suspicious for malignancy

Akçam,

Köse,

Kahraman Aydın

et al. 2023

Heliyon

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“…At the same time, there is increasing interest in both cost-and timesaving, less invasive biopsy techniques, as well as in a reduced number of repeat biopsies and exploratory surgical procedures. 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].…”

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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Frozen Section or Intraoperative Cytology: Are We Ready for a Paradigm Shift in Thoracic Surgery?

Cited by 4 publications

References 7 publications

Could cytology supplant frozen section for intraoperative evaluation of thoracic lesions? A single institutional experience in a developing country

Could cytology supplant frozen section for intraoperative evaluation of thoracic lesions? A single institutional experience in a developing country

Diagnostic efficacy of intraoperative histopathological examination of lesions with unknown diagnosis suspicious for malignancy

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

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