To Evaluate the Diagnostic Performance of Rapid on-Site Evaluation (ROSE) in Combination with Endobronchial Ultrasound (EBUS) for Pulmonary Lesions.

Background: Currently, Endobronchial ultrasound (EBUS) and rapid on-site evaluation (ROSE) are extensively utilized in the clinical practice of respiratory medicine. The combined diagnostic approach has been shown to enhance the clinical diagnostic accuracy; however, certain controversies remain.

Methods: This study included 200 patients who underwent endobronchial ultrasound combined with transbronchial lung biopsy with a guide sheath (EBUS-GS-TBLB) or endobronchial ultrasound combined with transbronchial needle aspiration (EBUS-TBNA) and received histopathological diagnoses at the Bronchoscopy Department, from January 2021 to January 2022. Of these, 168 patients were assigned to the ROSE group and 32 to the non-ROSE group. The diagnosis rates of EBUS-GS-TBLB and EBUS-TBNA, both with and without ROSE, along with the secondary biopsy rate, complication probability, and mean number of biopsies, were compared to analyze the differences between tumors and non-tumors. The safety of EBUS-GS-TBLB and EBUS-TBNA was also evaluated.

Results: The overall diagnostic accuracy was 85.71% in the ROSE group and 65.62% in the non-ROSE group. The diagnostic accuracy of the ROSE group was significantly higher than that of the non-ROSE group (P < 0.05). Compared to the non-ROSE group, the rate of secondary biopsy in the ROSE group was significantly reduced (P < 0.05), particularly in non-tumor cases. However, there was no significant difference in the incidence of complications and the average number of biopsies between the two groups (P > 0.05). Compared to the EBUS-GS-TBLB group, the EBUS-TBNA group showed a significantly lower incidence of complications and fewer biopsies (P < 0.05).

Conclusion: The integration of ROSE with EBUS enhanced the diagnostic rate and reduced the need for secondary examinations in the biopsy diagnosis of lung lesions, particularly in the definitive diagnosis of non-neoplastic lesions. The combination of ROSE technology appears to be more advantageous. Compared to EBUS-GS-TBLB, EBUS-TBNA demonstrated a lower incidence of complications and fewer biopsies.