Endobronchial ultrasound-guided transbronchial needle aspiration: performance of biomedical scientists on rapid on-site evaluation and preliminary diagnosis

ObjectivesRapid on-site evaluation (ROSE) of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) followed by a subsequent preliminary adequacy assessment and a preliminary diagnosis, was performed at Aarhus University Hospital by biomedical scientists (BMS). The aim of this study was to evaluate the BMS accuracy of ROSE adequacy assessment, the preliminary adequacy assessment and the preliminary diagnosis as compared with the cytopathologist-rendered final adequacy assessment and final diagnosis. MethodsThe BMS-rendered assessments for 717 sites from 319 consecutive patients over a 4-month period were compared with the cytopathologist-rendered assessments. Comparisons of adequacy and preliminary diagnoses were based on inter-observer Cohen's Kappa coefficient with a 95% confidence interval (CI). ResultsStrong correlations between ROSE and final adequacy assessments [Kappa coefficient of 0.90 (CI: 0.85-0.96)] and between the preliminary and final adequacy assessments [Kappa coefficient of 0.93 (CI: 0.87-0.99)] were found. As for the correlation between the preliminary and final diagnoses, the Kappa coefficient was 0.99 (CI: 0.98-1). ConclusionBoth ROSE and preliminary adequacy assessments as well as preliminary diagnoses, all performed by BMS, were highly accurate when compared with the final assessment by the cytopathologist. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of mediastinal lymph nodes is widely used in lung cancer staging. This retrospective study investigated the value of rapid on-site assessment performed by biomedical scientists (BMS) of EBUS-TBNA, including the accuracy of the preliminary diagnoses by BMS compared with the final diagnoses by a cytopathologist. Excellent correlation between the two groups was confirmed, suggesting that the expertise of well-qualified BMS in adequacy assessment and diagnosis in EBUS-TBNA could be utilised to ease cytpathologists' workload.