“ ROSE ” Revealing Its True Beauty—Comparing the Efficacy of Rapid On‐Site Evaluation ( ROSE ) in Determining Specimen Adequacy in Fine Needle Aspiration Cytology Relative to Without ROSE : A Single‐Center Study

Introduction Fine needle aspiration cytology (FNAC) is widely used to evaluate various lesions. Rapid on‐site evaluation (ROSE) can be incorporated into cytology procedures. Our study aims to determine the efficacy of ROSE on the specimen adequacy of FNAC as compared to non‐ROSE cases. Methods We conducted a prospective study that included consecutive FNAC cases from various sites between January 10th, 2025, and April 9th, 2025. All cases performed in our laboratory's FNAC clinic had undergone ROSE using a Diff‐Quik stain, whereas all FNAC cases in which the glass slides were received from other institutions for cytological evaluation were not subjected to ROSE. The specimen adequacy of ROSE‐performed FNAC cases was compared with that of the non‐ROSE group. Results This study included 350 patients. ROSE‐performed cases constituted 30.8% ( n = 108), while non‐ROSE cases accounted for the remaining 69.2% ( n = 242). The thyroid was the most frequently sampled site overall (38.86%, n = 136), followed by lymph nodes (31.14%, n = 109), breast (16.58%, n = 58), salivary gland (9.14%, n = 32), and soft tissue (3.14%, n = 11). Cell block preparations were performed in 22.85% ( n = 80) of cases, of which 88.75% ( n = 71) belonged to the ROSE group. Among the 286 overall adequate cases (81.7%), ROSE was performed in 106 cases (98.14% specimen adequacy, p < 0.001), while 180 out of 242 cases in the non‐ROSE group were adequate (74.38% specimen adequacy, p < 0.001). Conclusion The current study validates ROSE as a relevant and beneficial method that can be used as an adjunct to FNAC to improve the specimen adequacy.