Abstract
BACKGROUND: Fine-needle aspiration cytology (FNAC) is a broadly accepted method for diagnostic evaluation of pathological lesions. Rapid On-Site Evaluation (ROSE) of smears has been proven to improve the diagnostic yield of image-guided FNACs significantly. There are limited studies on the use of ROSE for image-guided FNACs from biliary tract lesions in our country. OBJECTIVE: To determine the utility and efficacy of ROSE on FNAC from neoplastic and non-neoplastic lesions of the hepatobiliary tract. METHODOLOGY: A prospective study was conducted wherein ROSE was performed for FNACs from 50 patients with hepatobiliary tract lesions. Samples were stained with toluidine blue to check adequacy based on the proposed adequacy criteria. Cytological slides were later analyzed after staining with May-Grünwald Giemsa and Papanicolaou stains. Results were compared with those obtained from FNAC without on-site evaluation done retrospectively. RESULTS: From 2007 to 2016, 47 out of 330 image-guided FNACs (without ROSE) from hepatobiliary lesions were non-diagnostic. In contrast, during our study (2021-2022), only 2 out of 50 image-guided FNACs (with ROSE) were non-diagnostic. The diagnostic yield of FNAC increased from 85.76% to 96% (P = 0.044). CONCLUSIONS: ROSE with toluidine blue staining significantly increases the diagnostic yield of hepatobiliary FNACs and eliminates the need for repeat procedures.