The Essential Role of Rapid On-Site Evaluation (ROSE) in Fine Needle Aspiration
Accuracy and speed are at the heart of every successful biopsy. When a patient discovers a lump or mass, they deserve fast answers and precise results that guide the right course of care. One diagnostic advancement that makes this possible is Rapid On-Site Evaluation, or ROSE.
At her cytopathology practice, Dr. Celina Nadelman, a board-certified interventional pathologist and Fine Needle Aspiration (FNA) specialist, performs every biopsy and diagnostic review herself. Her expertise in ROSE sets her practice apart by delivering immediate results, higher diagnostic accuracy, and an improved patient experience.
What is Rapid On-Site Evaluation (ROSE)?
Rapid On-Site Evaluation, known as ROSE, is a specialized diagnostic step performed immediately after a Fine Needle Aspiration biopsy. Once the cells are collected, the cytopathologist prepares slides right at the bedside, stains them, and examines them under a microscope while the patient is still present.
This real-time evaluation confirms whether the sample contains sufficient diagnostic material and whether additional tissue is needed for further analysis. If necessary, the cytopathologist can take more samples during the same appointment, eliminating the need for a return visit or repeat biopsy.
ROSE transforms the biopsy experience from a waiting process into an efficient, proactive diagnostic encounter.
Why an Interventional Pathologist Makes the Difference
A well-trained interventional pathologist plays a vital role in ensuring the most accurate FNA results. Unlike other medical specialists who may perform biopsies, an interventional pathologist is specifically trained in cytology, laboratory preparation, and cellular interpretation.
Expertise in Real-Time Accuracy
Interventional pathologists can perform ROSE, a skill that requires both procedural precision and microscopic diagnostic knowledge. By reviewing the slides immediately after the sample is collected, they confirm the adequacy of the specimen and determine whether additional material is needed for ancillary studies such as immunocytochemistry or molecular testing. This ensures that every biopsy yields reliable information the first time.
Mastery of Laboratory and Smear Techniques
Preparing high-quality slides is an art as well as a science. Interventional pathologists understand how to create slides that minimize blood contamination and preserve cellular detail, both of which are essential for accurate interpretation. They are trained to prepare smears in two formats: air-dried and alcohol-fixed, allowing for a more complete cytologic evaluation.
This detailed laboratory knowledge is often beyond the training of non-pathologist physicians, which can lead to compromised samples and inconclusive results.
Specimen Triage and Preliminary Diagnosis
Another critical skill unique to interventional pathologists is specimen triage, deciding which samples require additional studies and where to direct them within the laboratory. During ROSE, Dr. Nadelman not only ensures sample adequacy but also begins the diagnostic process immediately. She can provide a preliminary assessment on the spot, offering faster insights and reducing patient anxiety.
The Limitations of Non-Specialists
While many physicians are qualified to perform biopsies, few possess the combination of technical skill and diagnostic knowledge that defines an interventional pathologist.
Non-specialists often face challenges such as:
- Poor smear technique, leading to slides with excessive blood or poor cell preservation.
- Insufficient sample collection, resulting in inconclusive reports and the need for repeat procedures.
- Limited understanding of laboratory processes which can delay triage or miss opportunities for ancillary testing.
These limitations underscore why Fine Needle Aspiration should be performed by a physician who not only collects the sample but also interprets it.
The Role of ROSE in Improving Patient Care
ROSE plays an essential role in modern cytopathology by bridging the gap between biopsy and diagnosis. Its advantages are both medical and emotional for patients:
- Immediate adequacy assessment: The cytopathologist confirms that the sample is sufficient before the patient leaves the room.
- Reduced repeat biopsies: Adequate sampling means fewer procedures, less discomfort, and lower cost.
- Faster results: Preliminary findings are often available within 24 hours.
- Accurate triage: Additional testing, such as flow cytometry or molecular analysis, can begin without delay.
- Patient reassurance: Knowing the sample is being reviewed in real time provides comfort and confidence.
How Dr. Celina Nadelman Performs ROSE
As both the physician and the board-certified cytopathologist, Dr. Celina Nadelman conducts ROSE during every Fine Needle Aspiration procedure. Using ultrasound guidance, she performs the biopsy with precision, collects the sample, and immediately prepares the slides in her lab.
She then examines the material under the microscope at the bedside, confirming sample adequacy and making preliminary assessments on the spot. If more material is needed, she collects it right away, ensuring that every biopsy is both complete and accurate.
This integrated approach means her patients receive:
- Results within 24 hours in most cases.
- One bill covering all aspects of the procedure.
- A streamlined experience guided by one expert from start to finish.
- Confidence knowing that their diagnosis is made by the same doctor who performed the biopsy.
Dr. Nadelman’s process reflects a level of attention and precision that few medical systems can replicate.
Timely Care in a Delayed Healthcare World
In large hospital systems, long waits and disconnected departments often slow down the diagnostic process. Appointments can take weeks to schedule, and samples are frequently sent to external labs for evaluation. These delays add to patient anxiety and can postpone important treatment decisions.
By contrast, Dr. Nadelman’s streamlined model of care ensures that patients receive timely access to testing and results. Her ability to perform ROSE on-site means that diagnostic clarity is achieved faster, often in a single visit.
This kind of responsiveness is not only convenient but essential to effective medical care.
Why Patients Nationwide Choose Dr. Nadelman
Dr. Nadelman’s commitment to accuracy, efficiency, and patient comfort has earned her recognition beyond her Los Angeles office. Patients travel from across the United States and abroad to benefit from her expertise in Fine Needle Aspiration and Rapid On-Site Evaluation. In select cases, she is also available to travel to patients in California who are unable to visit her directly.
Her practice reflects a rare combination of high-level medical training and genuine compassion. Every biopsy she performs is done with the goal of providing clarity, confidence, and peace of mind.
Schedule a Consultation with Dr. Nadelman
If you have been told you need a biopsy or have a lump that requires evaluation, choose a physician who performs and interprets the procedure with expert precision. Dr. Celina Nadelman provides Fine Needle Aspiration and Rapid On-Site Evaluation with fast results and unparalleled accuracy.
To schedule an appointment or learn more, visit drnadelman.com today.
