Rapid On-Site Cytologic Evaluation: A Feasibility Study Using Ancillary Interventional Pulmonary Personnel

Area of Science:

• Pulmonology
• Cytopathology
• Medical Training

Background:

• Ancillary health professionals commonly assist in procedural services.
• Rapid On-site Cytologic Evaluation (ROSE) is crucial for interventional pulmonary procedures.

Purpose of the Study:

• To assess the feasibility of using ancillary personnel for ROSE in interventional pulmonary procedures.
• To evaluate the accuracy of ancillary personnel-performed ROSE compared to cytopathology.

Main Methods:

• A trained respiratory therapist (RT) performed ROSE on 70 consecutive interventional pulmonary cases (163 sites).
• RT findings were correlated with cytopathology-performed ROSE (CYTO-ROSE) and final histopathology.
• Key metrics included specimen adequacy and malignancy detection.

Main Results:

• High concordance was observed between RT-ROSE and CYTO-ROSE for specimen adequacy (Cohen's κ = 0.74) and malignancy detection (Cohen's κ = 0.83).
• RT-ROSE agreed with CYTO-ROSE on the adequacy of 159/163 specimens and malignancy in 92% of cases.
• Case-level malignancy agreement between RT-ROSE and CYTO-ROSE yielded a Cohen's κ of 0.68.

Conclusions:

• Ancillary personnel can be effectively trained to perform initial ROSE for interventional pulmonary procedures.
• This training and implementation streamlines ROSE evaluation, potentially reducing time and costs.
• Cytopathology confirmation is recommended after adequate samples are obtained by trained ancillary staff.