Rapid On-Site Cytologic Evaluation during Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Diagnosing Lung Cancer: A Randomized Study

Abstract

Background: Although rapid on-site cytologic evaluation (ROSE) is widely used during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), its role remains unclear. Objectives: The purpose of the present study was to evaluate the efficacy of ROSE during EBUS-TBNA in the diagnosis of lung cancer. Methods: One hundred and twenty patients highly suspected of having lung cancer who had hilar/mediastinal lymphadenopathy or a tumor adjacent to the central airway were enrolled in this study and randomized to undergo EBUS-TBNA with or without ROSE. Results: Twelve patients with visible endobronchial lesions were excluded in the analysis. Thus, a total of 108 patients (55 in the ROSE group, 53 in the non-ROSE group) were analyzed. Additional procedures including EBUS-TBNA for lesions other than the main target lesion and/or transbronchial biopsy in the same setting were performed in 11% of patients in the ROSE group and 57% in the non-ROSE group (p < 0.001). Mean puncture number was significantly lower in the ROSE group (2.2 vs. 3.1 punctures, p < 0.001), and mean bronchoscopy time was similar between both groups (22.3 vs. 22.1 min, p = 0.95). The sensitivity and accuracy for diagnosing lung cancer were 88 and 89% in the ROSE group, and 86 and 89% in the non-ROSE group, respectively. No complications were associated with the procedures. Conclusions: ROSE during EBUS-TBNA is associated with a significantly lower need for additional bronchoscopic procedures and puncture number.

Cell block samples from endobronchial ultrasound transbronchial needle aspiration provide sufficient material for ancillary testing in lung cancer—a quaternary referral centre experience

“…Onsite pathology advice reduces unnecessary TBNA when sufficient tissue has been obtained for diagnosis and all ancillary tests. More importantly this advice helps avoid repeat procedures for more tissue (16,17).…”

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: Patient Satisfaction under Light Conscious Sedation

“…The staff consisted of the proceduralist, an assistant and 2 endoscopy nurses. More specifically, there was no anaesthetist, cytologist or cytotechnician present in the room (rapid on-site evaluation for cytology [14] was not routinely available as samples were analysed by 2 lung histopathologists who double-reported all results). Modest doses of intravenous midazolam and fentanyl were administered at the discretion of the operator for achieving light conscious sedation.…”

Endoscopic Modalities in Diagnosis of Lung Cancer

“…Eğer moleküler ve genetik araştırmalar yapılacaksa bir fazla örnek alınması da önerilmektedir. Ayrıca işlem sırasında patolojik incelemenin yapılabilmesi [rapid on-site cytopathological evaluation (ROSE)] yeterli doku alınıp alınmadığını belirlemek için faydalı olabilmektedir (26).…”