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.
背景：肺癌仍是癌症相关死亡的主要原因，常于晚期确诊，此时微创组织取样对诊断和分子谱分析至关重要。快速现场评估（ROSE）可提高小活检样本的诊断率，但常因病理医生短缺和物流限制而受限。远程病理学通过实现远程实时评估提供了潜在的解决方案。本研究评估了在CT引导下经胸肺结节芯针活检（CNB）过程中，使用接触印片细胞学（TIC）进行远程细胞学辅助ROSE（TC-ROSE）的可行性、诊断准确性和效率。 方法：50例患者接受CNB。TIC样本通过全远程控制显微镜系统（OCUS®）进行现场或远程评估。TIC玻片制备由病理医生（30例）、放射科医生（10例）和经过培训的助手（10例）完成。研究分析了远程与现场评估的诊断一致性、时间效率以及非病理专业人员参与TIC制备的可行性。 结果：86%的TIC样本获得诊断性材料，TC-ROSE与传统ROSE诊断完全一致（100%）。玻片扫描约需140秒，每例总体评估时间约3分钟。病理医生和非病理专业人员对所有TIC样本均能充分评估（100%）。与接受传统ROSE评估的患者相比，TC-ROSE组患者并发症数量未见增加。远程设置使病理医生能够维持常规工作流程，提高了时间效率。 结论：研究结果证实远程细胞学是实施ROSE的一种可行、准确且高效的方法，为克服人力与物流障碍提供了实用解决方案，尤其在病理资源有限的环境中具有重要价值。
肿瘤(癌症)患者之家