Rapid on‐site evaluation of fine‐needle aspiration specimens using cytotechnologist‐performed telecytology: Insights and advantages

• Published in: Cytopathology (Oxford) 2025-01, Vol.36 (1), p.2-11
• Main Author: Tinnirello, Agata Angelita
• Format: Article
• Language: English
• Subjects: Biopsy; Biopsy, Fine-Needle - methods; cytopathologist; Cytopathology; cytotechnologist; Diagnosis; fine‐needle aspiration; Humans; Laboratories; Microscopes; Rapid On-site Evaluation; Telecytology; Telepathology
• ISSN: 0956-5507; 1365-2303; 1365-2303
• DOI: 10.1111/cyt.13428

With multiple health care centres expanding and implementing remotely controlled technologies, the role of cytopathology laboratories will become crucial in optimizing collection and assessment of small biopsy specimens for diagnosis and personalized treatment. Cytopathology services provide rapid assessments of samples obtained from fine‐needle aspirations and occasionally core needle biopsies (analysed by touch imprints). Over the past few decades, the cost barrier for hospitals, especially small ones, to support a cytopathologist or cytotechnologist for rapid on‐site evaluation (ROSE) has been reduced by the introduction of computerized microscopes that allow cytopathologists to perform ROSE without being present at the satellite laboratory (i.e. remotely). Utilization of the cytotechnologist's experience in ROSE alongside these technologies made it possible to perform ROSE with telecytology (ROSE‐TC), which positively impacts diagnosis and treatment and also lowers the cost of care. The satellite laboratories that successfully implemented ROSE‐TC operate with experienced cytotechnologists who, working independently between the cytopathology laboratory and the biopsy suite, prepare the smears and stain the slides on site for the distant cytopathologists, who can evaluate the slides remotely (usually from their office) simply using the facility intranet. This article aims to encourage big and small centres to use senior‐level cytotechnologists for both ROSE and ROSE‐TC. This article also defines different types of ROSE, explains our institution's approach to ROSE procedures, and outlines some experience‐driven considerations for successful ROSE‐TC and its future evolution. It's proposed here the use of telecytology for all cytology specimens where rapid on‐site evaluation (ROSE) is beneficial, through cytopathologists immediate assessment and cytotechnologists' first evaluation. Different types of ROSE, pre‐established adequacy categories, and future billing codes are discussed for the benefits of expanding medical centres.