Rapid on‐site evaluation using telecytology: A major cancer center experience

• Published in: Diagnostic cytopathology 2019-01, Vol.47 (1), p.15-19
• Main Authors: Lin, Oscar, Rudomina, Dorota, Feratovic, Rusmir, Sirintrapun, S. Joseph
• Format: Article
• Language: English
• Subjects: adequacy; Biopsy, Fine-Needle - methods; Cancer; Cytological Techniques - methods; Cytology; Diagnosis; Evaluation; Female; Humans; Liver; Lungs; Lymph nodes; Lymph Nodes - pathology; Male; Neoplasms - diagnosis; Neoplasms - pathology; Retrospective Studies; telecytology; Telemedicine; telepathology; validation
• ISSN: 8755-1039; 1097-0339
• DOI: 10.1002/dc.23925

Background Rapid on‐site evaluation (ROSE) with cytology preparations plays a critical role in minimally invasive procedures. The time spent by a pathologist performing ROSE is unpredictable and could be used for more cost‐effective activities. The solution encountered by several institutions to address this issue is the use of telecytology (TC). This study analyzes the experience of using telecytology for ROSE in a major cancer center over a period of over 2 years. Methods A retrospective analysis of all remote TC evaluations for adequacy on fine needle aspiration (FNA) and touch preparations (TP) of core biopsies (CB) performed at a major cancer center was performed. The preliminary adequacy assessment was then compared to the adequacy assessment at final diagnosis. Results A total of 12 949 adequacy assessments were analyzed. The most common sites biopsied in our institution were lymph node, lung, and liver. There were 7725 adequacy assessments for CB (59.7%), while adequacy assessment for FNA specimens represented 40.3% (n = 5224) of the total number of specimens evaluated by ROSE. Perfect concordance between initial adequacy assessment and the adequacy assessment at final cytologic diagnosis was 93% (12 049/12 949). The final diagnosis adequacy upgrade rate was 6.7% (n = 863), and the adequacy downgrade (a specimen considered adequate on‐site that was determined to be nondiagnostic on final examination) was 0.3% (n = 37). Conclusions TC can be easily implemented with the current technologies available. It is cost‐effective and allows for better patient care with a more efficient use of the pathologist's time and laboratory resources.