Endobronchial Ultrasonography (EBUS) with Lymph Node Aspiration: On-site Evaluation and Final Pathology Correlation

OBJECTIVE: Rapid on-site evaluation (ROSE) during endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) may improve sample adequacy and expedite clinical decision-making; however, its impact on diagnostic performance and concordance with final pathology remains unclear. MATERIAL AND METHODS: We retrospectively analyzed consecutive adult patients who underwent EBUS-TBNA between February 2023 and January 2024. ROSE adequacy, final diagnostic adequacy, and ROSE-final pathology concordance were calculated. Factors associated with these outcomes were assessed using logistic regression analysis. RESULTS: = 0.015, respectively). CONCLUSION: ROSE during EBUS-TBNA yielded high sensitivity and overall accuracy, demonstrated strong sample adequacy, and showed substantial concordance with the final pathology. Optimizing the number of passes and considering LN size can enhance adequacy, and recognizing the limitations of cytological subtyping and potential observer variability is essential for multidisciplinary decision-making.