Abstract
The purpose of this study was to assess the efficacy of using rapid on-site evaluation (ROSE) for samples taken during endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) at Austin Health, Victoria. This was compared to data collected for cases performed without ROSE. A retrospective analysis was conducted on 188 consecutive patients who underwent EBUS-TBNA from May 2012 to July 2014 whose data was collected prospectively at the time of the procedure. The presence of a cytologist during ROSE resulted in a significant reduction in the number of lesions sampled [mean: 1.5 ± 0.7 (1, 4) versus 1.9 ± 0.8 (1, 4), P = 0.0020] and the number of TBNAs required per case [mean: 3.6 ± 1.4 (1, 8) versus 4.2 ± 1.5 (1, 8), P = 0.0017]. This could potentially result in a shorter procedure time and, ultimately, a reduction in complication rate. The quality of the samples obtained during EBUS-TBNA with ROSE was higher. A larger proportion of samples yielded a satisfactory cell block allowing the potential benefit of additional pathology testing including immunohistochemistry and molecular pathology. In summary, the use of ROSE during EBUS-TBNA was superior to off-site cytological assessment of bronchoscopy specimens.
Highlights
Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is widely used for tissue sampling of mediastinal and hilar lesions adjacent to the proximal airway
Four patients were excluded as no TBNA samples were taken
This study demonstrated that during EBUS-TBNA, Rapid on-site evaluation (ROSE) led to a significant reduction in mean number of lesions sampled and a reduction in mean number of lymph node TBNAs performed
Summary
Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is widely used for tissue sampling of mediastinal and hilar lesions adjacent to the proximal airway. Indications for this procedure include mediastinal lymph node staging in patients with non-small cell lung cancer, assessment of mediastinal or hilar lymphadenopathy, and direct sampling of lung lesions adjacent to the proximal airway. EBUS increases the diagnostic yield of blind TBNA and reduces complications by allowing real-time ultrasound guidance during needle insertion [1, 2]. Rapid on-site evaluation (ROSE) is a technique where TBNA cytology samples are rapidly stained and screened for diagnostic material in the procedure room, during the procedure. There is a high agreement between the on-site and final pathologic evaluation of EBUS-TBNA specimens [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
