Endobronchial Ultrasonographic Practices with Rapid Onset Pathological Evaluation

INTRODUCTION: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure to evaluate suspicious mediastinal lesions. The utility of rapid on-site evaluation (ROSE) during EBUS-TBNA is still controversial. The aim of this study is to assess the role of ROSE during EBUS-TBNA on the last pathologic diagnosis.
METHODS: 597 EBUS cases were included into the study. The records were analyzed retrospectively according to demographic characteristics, indications of the procedure, number of stations, ROSE diagnosis and final diagnosis.
RESULTS: 455 (76.2%) of EBUS cases could be applied by the pathologist, while ROSE procedure could not be applied to 142 (23.8%). In 43 (7.2%) cases, the result of sampling was not diagnostic. The rate of non-diagnostic patients was 3.7% in 455 cases with ROSE, whereas the rate was 18.3% for no-ROSE group. There is a statistical difference between these two rates (p <0.001).
DISCUSSION AND CONCLUSION: We think that ROSE of EBUS-TBNA improves efficiency of the biopsy and yield of the procedure if performed by an experienced cytopathologist or cytotechnologist. Our diagnosis rate increased when our pathologist guided us about the adequacy of the sample during the procedure and influenced our decision to terminate or continue accordingly.