Cytotechnologist-attended on-site evaluation of adequacy for fine-needle aspiration of bone and soft tissue neoplasms

Matthew T. Olson, Anna Novak, Thiraphon Boonyaarunnate, Hinna Shahid, John Kirby, Syed Z. Ali

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Introduction: On-site evaluation of adequacy (OSEA) is commonly used to increase the adequacy rate of fine-needle aspiration (FNA) procedures. OSEA is increasingly necessary with the widespread use of image-guided procedures, which are expensive to perform and repeat. The increased demand for OSEA has prompted an increasing reliance on cytotechnologists for OSEA in many practices, including ours. However, the performance of cytotechnologists has not been compared with that of cytopathologists for OSEA in FNA of bone and soft tissue tumors. Materials and methods: We retrospectively analyzed 10 years of data in which both cytotechnologists and cytopathologists performed OSEA for 632 bone and soft tissue tumor FNA. We calculated adequacy and accuracy statistics in conjunction with other variables including imaging modality, biopsy site, accompanying core biopsy, tissue type, final diagnosis, and number of smears. Results: Of the 632 bone and soft tissue tumor FNA procedures, OSEA was performed in 223 (35.3%) by cytotechnologists and in 409 (64.7%) by cytopathologists. There was no difference in the adequacy downgrade rate for cytotechnologists versus cytopathologists during this study period (4.5 versus 2.4%, P = 0.23). The adequacy rates for procedures in which OSEA was performed by cytotechnologists and cytopathologists did not differ significantly (78.9 versus 84.1%, P = 0.13). Conclusions: Cytotechnologists and cytopathologists are comparably accurate in OSEA of bone and soft tissue neoplasms.

Original languageEnglish (US)
Pages (from-to)60-66
Number of pages7
JournalJournal of the American Society of Cytopathology
Issue number2
StatePublished - Mar 1 2014


  • Bone
  • Cytotechnologists
  • Fine-needle aspiration
  • On-site evaluation of adequacy
  • Soft tissue sarcoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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