Author of

• 12759

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  P3.17 - Poster Session 3 - Bronchoscopy, Endoscopy (ID 185)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12762

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    P3.17-003 - Implementation of Rapid On-Site Evaluation for Linear EBUS: Local experience from the Austin Hospital, Melbourne (ID 2027)

    09:30 - 09:30  |  Author(s): G. Mitchell
    • Abstract

    Background
    Linear endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is widely used for tissue sampling of mediastinal and hilar lesions. Rapid On-Site Evaluation (ROSE) is a technique where TBNA samples are rapidly processed and screened for diagnostic material intra-procedure. The use of ROSE improves diagnostic yield, cost-effectiveness, and reduces procedural time. Until recently, at Austin Health, EBUS TBNA samples were prepared in the endoscopy room and evaluated off-site. Preliminary results were conveyed to the bronchoscopist via telephone leading to significant delay. We propose that the implementation of ROSE to assist EBUS-TBNA procedures will reduce the number of lymph node aspirates performed without reducing the quality or diagnostic yield.

    Methods
    Consecutive EBUS-TBNA cases were prospectively evaluated following institution of ROSE. The number of lymph node stations sampled and the number of aspirations per lymph node station were recorded. This was compared to a retrospective dataset of 69 consecutive cases preceeding the commencement of ROSE. Specimen Preparation Material obtained from TBNA was transferred onto numbered slides with at least one air-dried smear and one 95% alcohol fixed smear prepared per puncture. Remaining material was put into a saline pot for cell block preparation. A cytologist's assessment of specimen adequacy and presence of diagnostic material was performed on-site after a rapid H&E stain. Lymph node stations sampled and number of aspirations performed was recorded.

    Results
    Preliminary results

    	Pre-ROSE	Post-ROSE	p value
    Number of cases	69	21	-
    Median number of punctures	4	4	0.23
    Median number of punctures per lesion	2	2.5	0.46
    > 1 lesion investigated (%)	66	48

    For suspected lung cancer cases, the concordance rate between ROSE and final cytologic diagnosis was 92%. Data collection is ongoing.

    Conclusion
    Utilising ROSE during EBUS TBNA lead to a non-significant reduction in the number of lymph node stations sampled. However, it did not change the number of punctures performed.