International Journal of General Medicine (Apr 2025)
To Evaluate the Diagnostic Performance of Rapid on-Site Evaluation (ROSE) in Combination with Endobronchial Ultrasound (EBUS) for Pulmonary Lesions
Abstract
Shan Xu,1,2 Qianlong Yin,3 Jisong Zhang,1,2 Xiaoling Xu,1,2 Enguo Chen,1,2 Kejing Ying1,2 1Respiratory and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Disease, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 2Cancer Center, Zhejiang University, Hangzhou, People’s Republic of China; 3Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, Xinjiang Corps Alaer Hospital, Alaer, People’s Republic of ChinaCorrespondence: Kejing Ying, Respiratory and Critical Care Medicine, Regional medical center for National Institute of Respiratory Disease, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 Eastern Qingchun Road, Hangzhou, 310020, People’s Republic of China, Email [email protected]: 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 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.Keywords: rapid on‐site evaluation, ultrasound bronchoscopy, diagnostic efficacy, safety comparison, lung biopsy, pulmonary lesions
