Telecytology – remote rapid on-site evaluation for ultrasound-guided head and neck fine needle aspiration utilising a clinical imaging assistant with an extended practice role

IF 1.2 4区医学 Q4 CELL BIOLOGY

Cytopathology Pub Date : 2024-02-19 DOI:10.1111/cyt.13370

Sarah Martyn, Leonie Wheeldon

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引用次数: 0

Abstract

Objective

Rapid On-Site Evaluation (ROSE) of fine needle aspirations (FNA) is widely accepted as best practice, resulting in better outcomes and delivery of care for patients. However, it is not always practical for cytology laboratories to release staff. To increase the availability of ROSE, this study aimed to robustly test the effectiveness of Telecytology ROSE (TCROSE) utilising a clinical imaging assistant (CIA) to prepare the samples and operate the microscope.

Methods

The study was divided into 3 phases. Phase 1, equipment testing, validation and in-house training for the CIA and the Consultant Biomedical Scientist (CBMS) performing TCROSE. Phase 2, Verifying TCROSE on the same site as the cytology laboratory and phase 3, TCROSE utilising a clinic at a peripheral site away from the cytology laboratory.

Results

78/80 (97% sensitivity, 95% accuracy) of TCROSE cases matched the final report for assessment of adequacy and sufficient sampling, demonstrating 94% reliability with a 95% confidence value. An appropriately trained CIA effectively prepared the samples and operated the microscope for remote interpretation. The samples were triaged effectively, and biopsy requests were appropriate to reduce the need for repeat procedures and delays in treatment. This approach received positive feedback from patients.

Conclusion

TCROSE utilising a CIA provides a highly effective alternative to conventional ROSE, minimising the resources required from cytopathology services and improving patient care and access to best practice. This study supports the validity of trained CIAs for a more involved role in the ultrasound-guided FNA service.

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远程细胞学--利用临床成像助理的扩展实践角色，对超声引导下的头颈部细针穿刺进行远程快速现场评估。

目的：对细针抽吸术（FNA）进行快速现场评估（ROSE）已被公认为最佳做法，可为患者带来更好的治疗效果和护理服务。然而，细胞学实验室并不总能腾出人手。为了提高远程细胞学ROSE的可用性，本研究旨在利用临床成像助理（CIA）准备样本和操作显微镜，对远程细胞学ROSE（TCROSE）的有效性进行有力的测试：研究分为三个阶段。第 1 阶段：设备测试、验证，并对 CIA 和执行 TCROSE 的生物医学科学家顾问（CBMS）进行内部培训。第 2 阶段，在细胞学实验室的同一地点验证 TCROSE；第 3 阶段，利用细胞学实验室外围地点的诊所进行 TCROSE：78/80（灵敏度为 97%，准确度为 95%）个 TCROSE 病例与最终报告中的适当性和充分取样评估相匹配，显示出 94% 的可靠性和 95% 的置信度。经过适当培训的 CIA 有效地准备了样本，并操作显微镜进行远程判读。对样本进行了有效的分流，并提出了适当的活检要求，以减少重复程序和治疗延误的需要。这种方法得到了患者的积极反馈：利用 CIA 的 TCROSE 为传统的 ROSE 提供了一种高效的替代方法，最大限度地减少了细胞病理学服务所需的资源，改善了患者护理并使患者能够获得最佳治疗。这项研究支持经过培训的 CIA 在超声引导 FNA 服务中发挥更重要的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cytopathology 生物-病理学

CiteScore

2.30

自引率

15.40%

发文量

107

审稿时长

6-12 weeks

期刊介绍： The aim of Cytopathology is to publish articles relating to those aspects of cytology which will increase our knowledge and understanding of the aetiology, diagnosis and management of human disease. It contains original articles and critical reviews on all aspects of clinical cytology in its broadest sense, including: gynaecological and non-gynaecological cytology; fine needle aspiration and screening strategy. Cytopathology welcomes papers and articles on: ultrastructural, histochemical and immunocytochemical studies of the cell; quantitative cytology and DNA hybridization as applied to cytological material.