Our Summary

This study looks at how effective and safe it is to use rapid on-site evaluation (ROSE) in combination with a procedure called computed tomography-guided transthoracic core needle biopsy (CT-guided TCNB), for diagnosing suspected lung cancer. This combination is not often studied.

Researchers looked back at clinical data from 285 patients who had a CT-guided TCNB procedure for suspected lung cancer at Huashan Hospital between 2015 and 2018. Of these, 163 also had ROSE (ROSE group), while 122 did not (non-ROSE group). The samples taken during the biopsy were quickly stained and analysed by a skilled professional on-site.

The study found that the results from ROSE very much agreed with the final diagnosis, being accurate 95.7% of the time. The diagnostic accuracy was significantly higher in the ROSE group compared to the non-ROSE group (96.3% vs 86.1%). The overall rate of complications was 36.8% in the ROSE group and 23.8% in the non-ROSE group. Minor pneumothorax (a condition where air gets between the lung and the chest wall) without needing drainage was slightly higher in the ROSE group (14.1% vs 6.6%). However, there was no significant difference in serious complications between the two groups.

In conclusion, ROSE was very consistent with the final diagnosis for suspected lung cancer. Using ROSE improved the diagnostic accuracy of the CT-guided TCNB procedure without increasing the chance of serious complications.

FAQs

  1. What is the purpose of combining ROSE with CT-guided TCNB in diagnosing lung cancer?
  2. How does the diagnostic accuracy of the ROSE group compare to the non-ROSE group?
  3. Did the use of ROSE increase the chance of serious complications during the CT-guided TCNB procedure?

Doctor’s Tip

A doctor may advise a patient undergoing a lung biopsy to discuss the option of rapid on-site evaluation (ROSE) with their healthcare provider. ROSE can help improve the accuracy of the biopsy results and potentially reduce the need for additional procedures. Additionally, the patient should be aware of the potential risks, such as minor pneumothorax, and discuss any concerns with their healthcare team. It is important to follow all post-procedure instructions provided by the healthcare provider to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for a lung biopsy include those with suspected lung cancer, suspicious lung nodules or masses, unexplained lung infections, abnormal lung imaging findings, and other lung diseases such as interstitial lung disease or pulmonary fibrosis. Additionally, patients who have failed to respond to other diagnostic tests or treatments may also be recommended for a lung biopsy to obtain a definitive diagnosis.

Timeline

Before the lung biopsy:

  1. Patient presents with symptoms suggestive of lung cancer, such as persistent cough, chest pain, or coughing up blood.
  2. Patient undergoes imaging tests, such as a CT scan, to identify suspicious lesions in the lungs.
  3. Biopsy is recommended to obtain a tissue sample for further evaluation.
  4. Patient is informed about the procedure and any potential risks or complications.

After the lung biopsy:

  1. Patient undergoes CT-guided TCNB procedure with or without ROSE.
  2. Sample is quickly analysed on-site for immediate feedback.
  3. Patient may experience minor complications such as pneumothorax.
  4. Final diagnosis is determined based on biopsy results.
  5. Treatment plan is discussed with the patient, which may include surgery, chemotherapy, or radiation therapy, depending on the diagnosis.
  6. Patient is monitored for any further complications or side effects from the biopsy procedure.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung biopsy include:

  1. What is the purpose of the lung biopsy and why do I need it?
  2. What are the risks and potential complications of the CT-guided TCNB procedure?
  3. Will ROSE be used during my biopsy procedure? What are the benefits of using ROSE?
  4. How accurate is ROSE in diagnosing suspected lung cancer?
  5. How does ROSE improve the diagnostic accuracy of the biopsy procedure?
  6. What are the potential outcomes of the biopsy results and how will they impact my treatment plan?
  7. What should I expect during and after the biopsy procedure in terms of pain, recovery, and follow-up care?
  8. Are there any alternative diagnostic tests or procedures that could be considered instead of a lung biopsy?
  9. How experienced is the healthcare provider who will be performing the biopsy procedure?
  10. Are there any specific instructions or precautions I need to follow before and after the biopsy procedure?

Reference

Authors: Yiminniyaze R, Zhang X, Zhang Y, Chen K, Li C, Zhu N, Zhou D, Li J, Zhang Y, Li S. Journal: Cytopathology. 2022 Jul;33(4):439-444. doi: 10.1111/cyt.13123. Epub 2022 May 10. PMID: 35362154