Remote Rapid Onsite Evaluation (ROSE) for Head and Neck Fine Needle Aspirations (FNA)
Condition: Head and Neck Neoplasms
MeSH terms: Head and Neck Neoplasms
Study type: Observational

Summary: 
      Rapid On-Site Evaluation (ROSE) of cytology FNA samples performed by a Pathologist or
      Biomedical Scientist is a real time morphological assessment of the sample in the clinical
      setting with the aim of acquiring all the diagnostic material in one appointment resulting in
      reduction in costs, improved patient care and reduced referral to treatment time.

      It is not practical or possible for the ROSE team to be present in every location where an
      FNA is performed. Telecytology (TC) or remote ROSE is a digital form of ROSE which allows a
      biomedical scientist or pathologist working in a remote laboratory to review the cytology
      slides in real time, using microscope images fed from the location where the FNA procedure is
      being performed.
    

Detailed description: 
      The new faster diagnostic standards (FDS) alongside NICE guidance and the British association
      of Head and Neck Oncologists (BAHNO) guidelines, state that ROSE should be provided for all
      FNA's. It is not practical or possible for the ROSE team to be present in every location
      where an FNA is performed. Telecytology (TC) or remote ROSE is a digital form of ROSE which
      allows a biomedical scientist or pathologist working in a remote laboratory to review the
      cytology slides in real time, using microscope images fed from the location where the FNA
      procedure is being performed.

      A trained a clinical imaging assistant (CIA) will prepare the slides and drive the microscope
      in the ultrasound room. Using the Olympus software Cellsens and the screen share option in
      Microsoft teams, the remote biomedical scientist / pathologist will be able to assess the
      sample in real time and provide both verbal and written methods of communication (relevant
      clinical information and instructions). An additional camera will allow visualisation of the
      slide preparation and residual material in real time to the scientist / pathologist
      performing the assessment.

      This study will investigate whether ROSE can be performed remotely. This study will be based
      in the cytology department at the Royal Cornwall Hospital as part of a service improvement.
      Phase 2 will involve the use of the Tower Block ultrasound room located on the Royal Cornwall
      Hospitals Truro site and in phase 3 the ultrasound room at The Royal Cornwall Hospital's
      Camborne and Redruth site.

      Patients between the ages of 18 and 90 years attending for an ultrasound guided fine needle
      aspiration of lesions in the head and neck and supraclavicular fossa nodes will be consented
      for remote ROSE to be performed over a 12-month period.
    

Intervention name(s): Olympus Cellsens software
Intervention type(s): Device
Intervention description(s): Olympus cellsens software will be used to visualise the cells and MS teams screen share will be used to send the live images in real time.
Other intervention name(s): Microsoft teams
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Participants attending for an ultrasound guided fine needle aspiration of lesions in the
        head and neck and supraclavicular fossa nodes.
      
Biospecimen description: 
      Cytology fine needle aspiration samples