远程病理学在CT引导下经皮肺结节穿刺活检中触摸印片细胞学快速现场评估中的应用：我们多学科胸部肿瘤委员会的经验

Application of Telepathology for Rapid On-Site Evaluation of Touch Imprint Cytology in CT-Guided Percutaneous Transthoracic Core Needle Biopsy of Pulmonary Nodules: The Experience of Our Multidisciplinary Thoracic Tumor Board.

作者信息

Lucà Stefano, Monti Riccardo, Della Corte Carminia Maria, Cantisani Antonia, Cozzolino Immacolata, Clery Eduardo, Amato Martina, Marone Laura, Capasso Francesca, Di Guida Gaetano, Leonardi Beatrice, Morgillo Floriana, Fiorelli Alfonso, Franco Renato, Montella Marco, Vicidomini Giovanni

机构信息

Department of Mental and Physical Health and Preventive Medicine, Pathology Unit, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.

Department of Precision Medicine, Radiology Unit, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.

出版信息

Cancers (Basel). 2025 May 22;17(11):1738. doi: 10.3390/cancers17111738.

DOI:10.3390/cancers17111738

PMID:40507220

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12153523/

Abstract

BACKGROUND

Lung cancer remains the leading cause of cancer-related mortality, often diagnosed at advanced stages, where minimally invasive tissue sampling is essential for diagnosis and molecular profiling. Rapid On-Site Evaluation (ROSE) enhances the diagnostic yield of small biopsies, but is frequently limited by a shortage of pathologists and logistical constraints. Telepathology offers a potential solution by enabling remote real-time assessment. This study evaluates the feasibility, diagnostic accuracy, and efficiency of telecytology-assisted ROSE (TC-ROSE) using touch imprint cytology (TIC) during CT-guided transthoracic core needle biopsy (CNB) of pulmonary nodules.

METHODS

50 patients underwent CNB. TIC samples were assessed and evaluated on-site or remotely via a fully remote-controlled microscope system (OCUS). TIC slide preparation was performed by pathologists (30 cases), radiologists (10), and trained assistants (10). The study analyzed diagnostic concordance between remote and on-site assessments, time efficiency, and the feasibility of involving non-pathologists in TIC preparation.

RESULTS

Diagnostic samples were obtained in 86% of TIC samples, with full concordance (100%) between TC-ROSE and traditional ROSE. The slides required approximately 140 s for scanning, and the overall evaluation time was around 3 min per case. Overall, 100% of TICs were adequately assessed by both pathologists and non-pathologists. No increased number of complications was recorded among patients with TCROSE, compared to those ROSE evaluated. The remote setup allowed pathologists to maintain routine workflows, improving time efficiency.

CONCLUSIONS

The findings confirm that telecytology is a viable, accurate, and efficient approach to ROSE, offering a practical solution for overcoming workforce and logistical barriers, particularly in settings with limited pathology resources.

摘要

背景

肺癌仍然是癌症相关死亡的主要原因，通常在晚期才被诊断出来，而微创组织采样对于诊断和分子分析至关重要。快速现场评估（ROSE）提高了小活检的诊断率，但常常受到病理学家短缺和后勤限制的制约。远程病理学通过实现远程实时评估提供了一种潜在的解决方案。本研究评估了在CT引导下经胸芯针活检（CNB）肺结节过程中，使用触摸印片细胞学（TIC）的远程细胞学辅助ROSE（TC-ROSE）的可行性、诊断准确性和效率。

方法

50例患者接受了CNB。TIC样本通过完全远程控制的显微镜系统（OCUS）在现场或远程进行评估。TIC载玻片制备由病理学家（30例）、放射科医生（10例）和经过培训的助手（10例）进行。该研究分析了远程和现场评估之间的诊断一致性、时间效率以及非病理学家参与TIC制备的可行性。

结果

86%的TIC样本获得了诊断样本，TC-ROSE与传统ROSE之间完全一致（100%）。载玻片扫描大约需要140秒，每个病例的总体评估时间约为3分钟。总体而言，病理学家和非病理学家对100%的TIC进行了充分评估。与接受ROSE评估的患者相比，接受TC-ROSE评估的患者未记录到并发症数量增加。远程设置使病理学家能够维持常规工作流程，提高了时间效率。