RT Journal Article SR Electronic T1 Diagnostic utility and accuracy of rapid on-site evaluation of bronchoscopic brushings JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1653 OP 1660 DO 10.1183/09031936.00111314 VO 45 IS 6 A1 Daniel P. Steinfort A1 Tracy L. Leong A1 Irena F. Laska A1 Anne Beaty A1 Alpha Tsui A1 Louis B. Irving YR 2015 UL http://erj.ersjournals.com/content/45/6/1653.abstract AB The aim of the study was to determine the accuracy of rapid on-site examinations, performed on transbronchial brushings of peripheral pulmonary lesions, in determining final bronchoscopic diagnosis. In addition to determining if rapid on-site examination impacts procedural outcomes. A prospective cohort study of consecutive patients with peripheral pulmonary lesions, which had been located by radial endobronchial ultrasound, was undertaken. Bronchoscopy was terminated if rapid on-site examination demonstrated diagnostic malignant material. Non-diagnostic rapid on-site examination resulted in further bronchoscopic sampling, including transbronchial lung biopsy and/or sampling from different locations. 128 peripheral pulmonary lesions were located by endobronchial ultrasound in 118 patients. The final bronchoscopic diagnoses included nonsmall cell lung cancer (n=76), carcinoid (n=3), and metastatic malignancy (n=3). Procedure times were significantly shorter for procedures when rapid on-site examinations demonstrated malignancy compared to those where rapid on-site examination was non-diagnostic (19±8 min versus 31±11 min, respectively; p<0.0001). In four procedures, initial negative rapid on-site examination results prompted redirection of sampling from alternate bronchial segments, resulting in positive diagnostic tissue being obtained. Positive and negative predictive value of rapid on-site examination for a malignant bronchoscopic diagnosis was 63 (97%) out of 65, and 43 (68%) out of 63, respectively. Rapid on-site examination of brushing specimens has a very high, positive, predictive value for bronchoscopic diagnosis of cancer and shortens the bronchoscopy procedure times. It has the potential to reduce complications, improve cost-effectiveness, and may improve diagnostic performance via live feedback. ROSE of bronchial brushings during bronchoscopy for PPL can shorten procedure times and increase diagnostic yield http://ow.ly/FASOW