Guided by ultrasound, ROSE thyroid biopsies obviate do-overs

South American radiology and pathology researchers have reduced unsatisfactory biopsy samples of thyroid nodules by almost a third using the rapid on-site evaluation (ROSE) technique guided by ultrasound, according to a study published online July 19 in Current Problems in Diagnostic Radiology.

ROSE enables immediate assessment of tissue specimens’ adequacy for evaluation, the idea being to avoid the need to repeat the biopsy.

Flor Marina Medina Chamorro, MD, of Fundación Valle del Lili hospital in Cali, Colombia, and colleagues reviewed 522 fine-needle aspiration biopsies of thyroid nodules that were performed with ultrasound guidance on 473 patients between January 2012 and December 2015.

The researchers’ primary interests were in the percentage of unsatisfactory samples in the procedures performed with and without the use of the ROSE technique, and how the cytology adequacy assessment stacked up with cytopathology results.

They also assessed ROSE performance in light of radiologists’ respective years of experience.

The team found ultrasound-guided ROSE yielded 30.5 percent fewer unsatisfactory samples than the procedures done without ROSE.

By 2014, they report, more than half of the procedures were performed with the ROSE technique, and the percentage of unsatisfactory samples decreased progressively each year.

Meanwhile, the concordance between the ROSE technique and the cytopathology report was good (Cohen κ = 0.75).

As for radiologist experience, the ROSE implementation improved the results of all of them. However, the radiologists with the fewest years of experience “showed the greatest benefits from the implementation of the ROSE technique,” the authors write.

“In our experience, the implementation of the ROSE technique has helped to reduce the percentage of unsatisfactory samples, which improves the quality and safety of patient care,” the authors conclude.

For more on ROSE and how it varies by practice, click here.