Opinion - (2025) Volume 16, Issue 4
Received: 02-Jul-2025, Manuscript No. jch-26-178774;
Editor assigned: 04-Jul-2025, Pre QC No. P-178774;
Reviewed: 17-Jul-2025, QC No. Q-178774;
Revised: 23-Jul-2025, Manuscript No. R-178774;
Published:
30-Jul-2025
, DOI: 10.37421/2157-7099.2025.16.807
Citation: Nguyen, Thomas J.. ”Rapid On-Site Evaluation: Enhanced Cytopathology Diagnostics.” J Cytol Histol 16 (2025):807.
Copyright: © 2025 Nguyen J. Thomas This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Rapid On-Site Evaluation (ROSE) has emerged as a critical component in modern cytopathology practice, offering a suite of advantages that significantly enhance diagnostic processes and patient care. This technique allows for immediate assessment of specimen adequacy and preliminary diagnoses in real-time, enabling adjustments to sample collection and reducing the need for repeat procedures, thereby improving the overall diagnostic yield [1].
ROSE plays a pivotal role in optimizing the quality of cytopathology specimens, particularly for Fine Needle Aspiration (FNA) procedures. By permitting immediate evaluation of cellularity, the presence of diagnostic material, and potential artifacts, ROSE effectively minimizes insufficient samples, ensuring that the collected material is optimal for accurate interpretation and directly impacting patient care and workflow efficiency [2].
The implementation of ROSE across various cytopathology subspecialties, including thyroid, lymph node, and pancreatic FNAs, has consistently demonstrated improvements in both diagnostic accuracy and efficiency. The ability to provide preliminary diagnoses on-site facilitates the immediate ordering of ancillary testing when needed and can expedite the decision-making process for subsequent management, such as surgical intervention [3].
While the benefits of ROSE are substantial, its effective integration into practice is not without challenges. These include potential interobserver variability in interpretation, the necessity for comprehensive training of personnel, and logistical considerations that need careful management. Addressing these limitations through standardized protocols and robust training programs is paramount to fully leveraging the utility of ROSE in cytopathology [4].
A significant advantage of ROSE is its capacity to markedly reduce the rate of unsatisfactory smears, leading to a conservation of healthcare resources and an enhancement of patient satisfaction. The direct visualization of samples during the procedure allows for immediate confirmation of adequacy, thereby preventing unnecessary repeat procedures and diagnostic delays, which is particularly crucial in settings with limited access to specialized cytology services [5].
In gynecologic cytology, the integration of ROSE has shown considerable promise in improving the quality of collected samples and potentially decreasing the requirement for repeat Papanicolaou tests. However, its widespread adoption in this specific area necessitates further in-depth investigation and the establishment of standardized protocols to ensure consistent and reliable outcomes [6].
ROSE proves to be particularly valuable in the evaluation of effusions, where it allows for preliminary classification and the identification of malignant cells directly at the bedside or within the procedure room. This immediate feedback mechanism is instrumental in guiding further diagnostic steps and informing clinical management decisions for patients presenting with pleural, peritoneal, or pericardial effusions [7].
The financial implications associated with the implementation of ROSE within a cytology laboratory warrant careful and thorough consideration. Although initial costs may arise from training and equipment acquisition, the long-term advantages derived from reduced repeat procedures and enhanced diagnostic efficiency can ultimately lead to significant cost savings and more effective resource allocation within healthcare systems [8].
Fundamentally, ROSE functions as a dynamic tool that thrives on close collaboration and open communication between the interventionalist performing the procedure and the cytopathologist providing the on-site evaluation. This synergistic partnership is essential for optimizing specimen collection and for addressing potential diagnostic pitfalls in real-time, thereby fostering a more robust and reliable diagnostic process [9].
Looking ahead, the evolving role of artificial intelligence (AI) in conjunction with ROSE presents exciting future opportunities for further enhancing diagnostic accuracy and efficiency in cytopathology. AI algorithms possess the potential to assist in the rapid interpretation of images during ROSE, thereby further streamlining the diagnostic workflow and improving turnaround times [10].
Rapid On-Site Evaluation (ROSE) offers distinct advantages in cytopathology by providing immediate feedback on specimen adequacy and preliminary diagnoses. This real-time assessment enables prompt adjustments to sample collection techniques, which consequently minimizes the need for repeat procedures and elevates the overall diagnostic yield. Furthermore, ROSE fosters improved communication channels between cytotechnologists, pathologists, and clinicians, leading to more streamlined patient management and timely therapeutic interventions [1].
ROSE plays an indispensable role in enhancing the quality of specimens obtained through cytopathology, especially in the context of Fine Needle Aspiration (FNA) procedures. Its ability to allow for immediate assessment of cellularity, the presence of diagnostic material, and the identification of potential artifacts is crucial in minimizing insufficient samples. This iterative evaluation process ensures that the collected material is of optimal quality for accurate interpretation, thereby directly impacting patient care and the efficiency of the diagnostic workflow [2].
The successful implementation of ROSE in various cytopathology subspecialties, including thyroid, lymph node, and pancreatic FNA, has been associated with significant improvements in both diagnostic accuracy and efficiency. The capability to deliver preliminary diagnoses on-site allows for the immediate ordering of ancillary testing if deemed necessary and can substantially expedite the decision-making process for subsequent patient management, such as surgical intervention [3].
Despite its numerous benefits, the effective implementation of ROSE in cytopathology practice is accompanied by certain challenges. These include the potential for interobserver variability in interpretation, the requirement for specialized training for personnel involved, and various logistical considerations that must be carefully addressed. Overcoming these limitations through the development and adherence to standardized protocols and comprehensive training programs is essential for maximizing the full utility of ROSE [4].
A significant benefit of ROSE is its ability to substantially reduce the rate of unsatisfactory smears, which in turn conserves healthcare resources and enhances patient satisfaction. The direct visualization of samples during the procedure allows for immediate confirmation of adequacy, thereby preventing the need for unnecessary repeat procedures and avoiding delays in diagnosis. This is particularly critical in settings where access to cytology services may be limited [5].
In the domain of gynecologic cytology, the integration of ROSE has demonstrated promising results in enhancing the quality of collected samples and has the potential to reduce the incidence of repeat Papanicolaou tests. However, its widespread adoption within this specific subspecialty is contingent upon further rigorous investigation and the establishment of standardized protocols to ensure consistent and reliable outcomes [6].
ROSE proves to be exceptionally valuable in the diagnostic evaluation of effusions, enabling preliminary classification and the identification of malignant cells directly at the patient's bedside or within the procedure room. This immediate feedback is instrumental in guiding subsequent diagnostic steps and informing clinical management decisions for patients presenting with pleural, peritoneal, or pericardial effusions [7].
Careful consideration must be given to the financial implications associated with the implementation of ROSE in a cytology laboratory. While there may be initial costs related to personnel training and the acquisition of necessary equipment, the long-term benefits, such as the reduction in repeat procedures and improved diagnostic efficiency, can lead to substantial cost savings and more effective allocation of healthcare resources [8].
ROSE operates as a dynamic tool that is fundamentally reliant on close collaboration and open communication between the interventionalist performing the procedure and the cytopathologist providing on-site assessment. This collaborative synergy ensures that specimen collection is optimized and that potential diagnostic pitfalls are identified and addressed in real-time, contributing to a more robust and accurate diagnostic process [9].
The future landscape of ROSE in cytopathology is poised for significant advancements through the integration of artificial intelligence (AI). AI algorithms hold the potential to revolutionize diagnostic accuracy and efficiency by assisting in the rapid interpretation of images during ROSE, thereby further streamlining the overall diagnostic workflow and improving patient outcomes [10].
Rapid On-Site Evaluation (ROSE) is a valuable technique in cytopathology that enhances specimen adequacy and provides preliminary diagnoses in real-time. This leads to fewer repeat procedures, improved diagnostic yield, and better communication among healthcare professionals, ultimately improving patient management and treatment decisions. ROSE is particularly effective in optimizing Fine Needle Aspiration (FNA) specimens by ensuring sufficient diagnostic material and minimizing artifacts. Its implementation has shown improved accuracy and efficiency in various cytopathology subspecialties like thyroid and lymph node evaluations, facilitating timely ancillary testing and subsequent management. While challenges such as interobserver variability and training requirements exist, standardized protocols can mitigate these issues. ROSE significantly reduces unsatisfactory smears, saving resources and improving patient satisfaction, especially in underserved areas. It is also beneficial for evaluating effusions, allowing for early identification of malignancy. The financial investment in ROSE can yield long-term cost savings through improved efficiency. Collaboration between interventionalists and cytopathologists is crucial for its success. Future integration with AI promises further advancements in diagnostic accuracy and workflow efficiency.
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