B80-4-17 Comparison of Time to Result of Lung Cancer Diagnosis in Dynamic Cell Imaging Versus Rapid On-Site Evaluation

Rationale Ensuring procedural efficiency and sample adequacy is essential in lung cancer diagnostics to ensure accuracy of diagnosis, obtain adequate material for molecular analysis, and reduce morbidity associated with repeated biopsy attempts. Current practice frequently relies on Rapid On-Site Evaluation (ROSE) to assess real-time sample adequacy during navigational bronchoscopy. ROSE requires cytopathology support and is limited to evaluation of a fraction of the sample obtained. Dynamic cell imaging (DCI) is an emerging technology that provides immediate feedback on a specimen’s diagnostic adequacy without staining or cytology personnel, scanning the entirety of the sample and possibly improving procedural efficiency; however, there is limited data to currently support its routine use in bronchoscopy. Methods In this study, we compared the time to adequacy determination by DCI with the time to malignancy call by ROSE in a total of 45 patients who obtained a lung cancer diagnosis via navigation bronchoscopy at the University of Chicago Medical Center between October 2024 and September 2025. Recorded timestamps for both methods were extracted from procedure logs and were measured from time of sampling to lesional adequacy call (DCI) and malignancy determination (ROSE). Data were analyzed using a Shapiro-Wilk W test for normal data followed by a two-sided Wilcoxon signed-rank test for nonparametric data at an alpha of 0.05. Results Mean time-to-call for DCI was 6.9 min and 10.18 min for ROSE. Upon Wilcoxon analysis, of the 45 samples, DCI was faster in 26 cases, ROSE was faster in 15 cases, and both methods took the same amount of time in 4 cases. The median difference in time-to-call with respect to DCI was -1 minute (IQR -6 to 2), indicating that DCI generally achieved adequacy determination sooner than ROSE (p = 0.047). Conclusion In patients who have undergone lung cancer diagnosis via navigation bronchoscopy, DCI achieved a faster time to determination of tissue adequacy compared to ROSE on average. These findings suggest DCI may be a viable alternative or adjunct to ROSE in lung cancer diagnosis in the right clinical setting. This abstract is funded by: None