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Diagnostic accuracy of rapid on-site evaluation (ROSE) during robotic bronchoscopy.

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Rapid on-site evaluation (ROSE) during robotic bronchoscopy (RB) shows high concordance with final pathology results. This supports its use for guiding intra-procedural decisions in diagnosing lung lesions.

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Lung cancercytologylung nodulerapid on-site evaluation (ROSE)robotic bronchoscopy (RB)

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Area of Science:

  • Pulmonology
  • Interventional Pulmonology
  • Cytopathology

Background:

  • Robotic bronchoscopy (RB) is increasingly utilized for peripheral pulmonary lesion sampling, offering high diagnostic yield and low complication rates.
  • Rapid on-site evaluation (ROSE) provides intra-procedural feedback on specimen adequacy, using fine needle aspiration (FNA) or touch imprint cytology (TIC).
  • Limited data exists on the utility of ROSE specifically within robotic bronchoscopy procedures.

Purpose of the Study:

  • To evaluate the concordance between Rapid on-site evaluation (ROSE) and final cytology and pathology results in robotic bronchoscopy (RB).

Main Methods:

  • Retrospective review of robotic bronchoscopy (RB) cases performed at the University of Colorado Anschutz Medical Campus from May 2021 to December 2024.
  • Analysis of concordance between FNA-ROSE and final cytology, and TIC-ROSE and final pathology for 137 patients.
  • Assessment of overall concordance between ROSE and final results, including linear EBUS-ROSE for lymph node cytology.

Main Results:

  • The overall concordance between Rapid on-site evaluation (ROSE) and final cytology/pathology was 88% (Pearson χ²=174, P<0.001).
  • Concordance was 83% for FNA-ROSE with final cytology and 81% for TIC-ROSE with final pathology.
  • The diagnostic yield for robotic bronchoscopy (RB) was 75%, with 80.1% concordance for linear EBUS-ROSE with lymph node cytology.

Conclusions:

  • Rapid on-site evaluation (ROSE) via FNA and TIC demonstrates high concordance with final results in robotic bronchoscopy (RB) cases.
  • ROSE facilitates intra-procedural decision-making regarding lesion sampling, tool selection, and technique optimization.
  • ROSE is a valuable tool for enhancing the diagnostic process in robotic bronchoscopy.