Telecytology versus in-room Cytopathologist for Endoscopic Ultrasound Fine Needle Aspiration or Biopsy of Solid Pancreatic Lesions

Published:October 13, 2022DOI:
      This paper is only available as a PDF. To read, Please Download here.


      Background and Aims

      Rapid On-Site-Evaluation (ROSE) with an in-room pathologist (ROSE-P) has been shown to improve the diagnostic yield of specimens obtained from patients undergoing Endoscopic Ultrasound fine needle aspiration or biopsy (EUS-FNAB) of pancreatic lesions. Recently, there has been an increased interest and utilization of Telecytology (ROSE-T) to optimize clinical workflows, and to address social distancing mandates created during the COVID-19 pandemic. The purpose of this study is to compare diagnostic outcomes of ROSE-P and ROSE-T.


      A single center cohort study of patients who underwent EUS-FNAB of solid pancreatic lesions with ROSE was conducted. The primary outcome was overall diagnostic yield of cancer. All patients who underwent EUS-FNA were entered into a prospectively maintained database. Statistical analyses were performed using descriptive statistics and univariate analysis.


      There were 165 patients in each arm. There was no difference in diagnostic yield between ROSE-P and ROSE-T (96.4% vs 94.5%, p=.428). ROSE-T was associated with increased use of 22-gauge needles (p=.006) and more needle passes (p<.001). There was no significant difference in age, gender, lesion size, needle type, procedure times, or adverse events between the two groups (p<.05 for all). There were more pancreatic tail lesions sampled in the ROSE-P group (p<.001).


      Rapid on-site evaluation using Telecytology was not associated with any difference in final histologic diagnosis for EUS-FNAB of solid pancreatic masses. This has important implications for optimizing clinical workflows.



      ROSE (Rapid On-Site Evaluation), ROSE-P (Rapid On-Site Evaluation with an in-room Cytopathologist), EUS-FNAB (Endoscopic Ultrasound Fine Needle Aspiration or Biopsy), ROSE-T (Rapid On-Site Evaluation utilizing Telecytology (remote Cytopathologist)), CT (Computed tomography), UCSF (University of California, San Francisco), ED (Emergency department), EHR (Electronic health record)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Gastrointestinal Endoscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect