https://doi.org/10.4081/monaldi.2025.2997

Diagnostic yield of rapid on-site cytology evaluation on fluoroscopic-guided transbronchial biopsy in a private hospital in Jakarta: a one-year retrospective study

Early Access
Submitted: March 19, 2024
Accepted: January 20, 2025
Published: March 19, 2025
Rapid on-site examination, transbronchial lung biopsy, cytology evaluation, lung tumor, peripheral pulmonary lesions
Abstract Views: 473
PDF_EARLY VIEW: 96
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Mohamad Fahmi Alatas
fahmialatasdr@gmail.com
https://orcid.org/0000-0001-5368-6577
Department of Pulmonology, St. Carolus Hospital, Jakarta; Department of Pulmonology and Respiratory Medicine, Universitas Indonesia, Jakarta, Indonesia.
Bernadina Chyntia
https://orcid.org/0000-0002-0212-1979
Department of General Medicine, St. Carolus Hospital, Jakarta, Indonesia.
Andika Chandra Putra
Department of Pulmonology, St. Carolus Hospital, Jakarta; Department of Pulmonology and Respiratory Medicine, Universitas Indonesia, Jakarta, Indonesia.
Wiwien Heru Wiyono
https://orcid.org/0009-0001-3430-8834
Department of Pulmonology, St. Carolus Hospital, Jakarta; Department of Pulmonology and Respiratory Medicine, Universitas Indonesia, Jakarta, Indonesia.
Renaningtyas Tambun
Department of Anatomy Pathology, St. Carolus Hospital, Jakarta, Indonesia.

Rapid on-site cytology examination (ROSE) with a fluoroscopic-guided transbronchial biopsy (TBLB) involves the immediate evaluation of cytological specimens during a diagnostic procedure. This research aims to investigate the potential yield of this diagnostic technique, shedding light on its benefits, limitations, and the evidence supporting its efficacy. A retrospective analysis of the data was conducted on 26 patients who underwent ROSE and TBLB procedures in the hospital between July 2022 and August 2023. A total of 21 patients met the requirements for the inclusion criteria: patients with peripheral pulmonary lesions found by chest X-rays or chest computed tomography scans consented to have a bronchoscopy with both ROSE and TBLB examination. A total of 5 patients were excluded because of the exclusion criteria: patients who only took either ROSE or TBLB examination and were noncompliance with bronchoscopy. The statistical software SPSS 29.0 was used for the analyses. The chi-square test was employed to evaluate differences between two groups of categorical variables and was considered significant when the p-value was under 0.05. ROSE evaluated 21 lesions and followed up with the final pathological biopsy. Malignant tumors were identified in 12 cases by ROSE and TBLB procedures. One case was benign by the biopsy results but was malignant by ROSE examination. Similarly, 8 cases were benign, as determined by ROSE examination and TBLB. Between ROSE and TBLB, there was a statistical difference with p<0.001. The sensitivity is 100%, and the specificity is 11.1%. However, high sensitivity was proven by ROSE compared to biopsy, which is the gold standard in this study. No significant complications were observed after the procedure. According to this study, ROSE has a high diagnostic value with high sensitivity values for real-time diagnosis but still has not been able to replace the biopsy function as the gold standard. ROSE should only be considered for screening and sample adequacy in the bronchoscopy suite.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Steinfort DP, Leong TL, Laska IF, et al. Diagnostic utility and accuracy of rapid on-site evaluation of bronchoscopic brushings. Eur Respir J 2015;45:1653-60. DOI: https://doi.org/10.1183/09031936.00111314
Park S, Yoon HY, Han Y, et al. Diagnostic yield of additional conventional transbronchial lung biopsy following radial endobronchial ultrasound lung biopsy for peripheral pulmonary lesions. Thorac Cancer 2020;11:1639-46. DOI: https://doi.org/10.1111/1759-7714.13446
Shepherd RW. Bronchoscopic pursuit of the peripheral pulmonary lesion: Navigational bronchoscopy, radial endobronchial ultrasound, and ultrathin bronchoscopy. Curr Opin Pulm Med 2016;22:257-64. DOI: https://doi.org/10.1097/MCP.0000000000000273
Suzuki S, Ichikawa K, Kouno Y, et al. Transbronchial biopsy of peripheral lung lesions using fluoroscopic guidance combined with an enhanced ray-summation display. Radiol Phys Technol 2020;13:52-61. DOI: https://doi.org/10.1007/s12194-019-00546-2
Iwabu N, Izumo T, Nakamura Y, et al. Molecular analysis of liquid cytological samples collected by bronchoscopy with radial endobronchial ultrasonography and guide sheath. Ann Thorac Cardiovasc Surg 2014;20:692-6. DOI: https://doi.org/10.5761/atcs.cr.13-00336
Wang J, Zhang T, Xu Y, et al. Comparison between percutaneous transthoracic co-axial needle CT-guided biopsy and transbronchial lung biopsy for the diagnosis of persistent pulmonary consolidation. Insights Imaging 2023;14:80. DOI: https://doi.org/10.1186/s13244-023-01436-3
Ong PG, Debiane LG, Casal RF. Recent advances in diagnostic bronchoscopy. JTD 2016;8:3808-17. DOI: https://doi.org/10.21037/jtd.2016.12.70
Ning J, Ge T, Jiang M, et al. Jing Ning early diagnosis or lung cancer. Aging 2021;13:6214-27. DOI: https://doi.org/10.18632/aging.202504
Nooreldeen R, Bach H. Current and future development in lung cancer diagnosis. Int J Mol Sci 2021;22:8661. DOI: https://doi.org/10.3390/ijms22168661
Diacon AH, Schuurmans MM, Theron J, et al. Utility of rapid on-site evaluation of transbronchial needle aspirates. Respiration 2005;72:182-8. DOI: https://doi.org/10.1159/000084050
Yarmus L, Van Der Kloot T, Lechtzin N, et al. A randomized prospective trial of the utility of rapid on-site evaluation of transbronchial needle aspirate specimens. J Bronchology Interv Pulmonol 2011;18:121-7. DOI: https://doi.org/10.1097/LBR.0b013e31821707ee
Bo L, Li C, Pan L,et al. Diagnosing a solitary pulmonary nodule using multiple bronchoscopic guided technologies: a prospective randomized study. Lung Cancer 2019;129:48-54. DOI: https://doi.org/10.1016/j.lungcan.2019.01.006
Baram D, Garcia RB, Richman PS. Impact of rapid on-site cytologic evaluation during transbronchial needle aspiration. Chest 2005;128:869-75. DOI: https://doi.org/10.1378/chest.128.2.869
Jiang D, Zang Y, Jiang D, et al. Value of rapid on-site evaluation for ultrasound-guided thyroid fine needle aspiration. J Int Med Res 2019;47:626-34. DOI: https://doi.org/10.1177/0300060518807060
Xu C, Wang W, Yuan Q, et al. Rapid on-site evaluation during radial endobronchial ultrasound–guided transbronchial lung biopsy for the diagnosis of peripheral pulmonary lesions. Technol Cancer Res Treat 2020;19:1533033820947482. DOI: https://doi.org/10.1177/1533033820947482
Xu C, Wang Y, Wang W, et al. Improved diagnostic yield of transbronchial lung biopsy in peripheral pulmonary lesions using a combination of endobronchial ultrasound and rapid on-site evaluation. J Int Med Res 2021;49:300060521999535. DOI: https://doi.org/10.1177/0300060521999535
Xu C, Liu W, Wang W, et al. Diagnostic value of endobronchial ultrasound combined with rapid on-site evaluation of transbronchial lung biopsy for peripheral pulmonary lesions. Diagn Cytopathol 2021;49:706-10. DOI: https://doi.org/10.1002/dc.24725
Park JS, Kang YA, Kwon SY, et al. Nested PCR in lung tissue for diagnosis of pulmonary tuberculosis. Eur Respir J 2010;35:851-7. DOI: https://doi.org/10.1183/09031936.00067209
Trisolini R, Baughman RP, Spagnolo P, Culver DA. Endobronchial ultrasound-guided transbronchial needle aspiration in sarcoidosis: beyond the diagnostic yield. Respirology 2019;24:531-42. DOI: https://doi.org/10.1111/resp.13537
Oki M, Saka H, Kitagawa C, et al. Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing lung cancer: a randomized study. Respiration 2013;85:486-92. DOI: https://doi.org/10.1159/000346987
Bandiera A, Arrigoni G. The impact of pathological analysis on endobronchial ultrasound diagnostic accuracy. Mediastinum 2020;4:19. DOI: https://doi.org/10.21037/med-20-28
Sehgal IS, Dhooria S, Aggarwal AN, Agarwal R. Impact of rapid on-site cytological evaluation (ROSE) on the diagnostic yield of transbronchial needle aspiration during mediastinal lymph node sampling: systematic review and meta-analysis. Chest 2018;153:929-38. DOI: https://doi.org/10.1016/j.chest.2017.11.004

Ethics Approval

This retrospective study has been approved by our hospital's institutional ethical review board, which has also waived the need for informed permission in order to collect data from the relevant patients. (Ethics committee approval number: 003/SB/KEP- RSSC/LOLOS UJI ETIK/II/2024, February 13th, 2024).

How to Cite

Alatas, Mohamad Fahmi, Bernadina Chyntia, Andika Chandra Putra, Wiwien Heru Wiyono, and Renaningtyas Tambun. 2025. “Diagnostic Yield of Rapid on-Site Cytology Evaluation on Fluoroscopic-Guided Transbronchial Biopsy in a Private Hospital in Jakarta: A One-Year Retrospective Study”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2025.2997.
Copyright (c) 2025 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.


Similar Articles

<< < 3 4 5 6 7 8 9 10 11 12 > >> 

You may also start an advanced similarity search for this article.