Clinical utility of rapid on-site evaluation of brush cytology during bronchoscopy using endobronchial ultrasound with a guide sheath

• Published in: Scientific reports Vol. 14; no. 1; pp. 21334 - 7
• Main Authors: Nishiyama, Kazuhiro, Morikawa, Kei, Kaneko, Shotaro, Nishida, Makoto, Matsushima, Aya, Nishi, Yoshihiro, Numata, Yu, Shinozaki, Yusuke, Tsuruoka, Hajime, Kida, Hirotaka, Handa, Hiroshi, Shimada, Naoki, Okawa, Chie, Ohike, Nobuyuki, Koike, Junki, Mineshita, Masamichi
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 12.09.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 631/67/1612; 692/308; 692/699/1785; Adult; Aged; Aged, 80 and over; Biopsy; Bronchoscopy; Bronchoscopy - methods; Brushing; Cellular biology; Cytodiagnosis - methods; Cytology; Endobronchial ultrasound with a guided sheath; Endosonography - methods; Female; Humanities and Social Sciences; Humans; Lung Neoplasms - diagnosis; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Male; Middle Aged; multidisciplinary; Peripheral lung lesions; Pulmonary lesions; Rapid On-site Evaluation; Retrospective Studies; Science; Science (multidisciplinary); Sensitivity and Specificity; Ultrasonic imaging; Ultrasound; Brushing; Peripheral lung lesions; Endobronchial ultrasound with a guided sheath; Rapid on-site evaluation
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-72138-z

Previous studies have shown that rapid on-site evaluation (ROSE) improves the diagnostic yield of bronchoscopy using endobronchial ultrasound with a guide sheath (EBUS-GS) for peripheral pulmonary lesions (PPL). While ROSE of imprint cytology from forceps biopsy has been widely discussed, there are few reports on ROSE of brush cytology. This study investigated the utility of ROSE of brush cytology during bronchoscopy. We retrospectively analyzed data from 214 patients who underwent bronchoscopy with EBUS-GS for PPL. The patients in the ROSE group had significantly higher diagnostic sensitivity through the entire bronchoscopy process than in the non-ROSE group (96.8% vs. 83.3%, P = 0.002). The use of ROSE significantly increased the sensitivity of brush cytology with Papanicolaou staining (92.9% vs. 75.0%, P < 0.001). When ROSE was sequentially repeated on brushing specimens, initially negative ROSE results converted to positive in 79.5% of cases, and the proportion of specimens with high tumor cell counts increased from 42.1 to 69.0%. This study concludes that ROSE of brush cytology improves the diagnostic accuracy of bronchoscopy and enhances specimen quality through repeated brushing.