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Review
. 2025 Jul;133(7):e70027.
doi: 10.1002/cncy.70027.

Current landscape and emerging opportunities for using telecytology for rapid on-site assessment in cytopathology

Savitri Krishnamurthy  1
Affiliations
Review

Current landscape and emerging opportunities for using telecytology for rapid on-site assessment in cytopathology

Savitri Krishnamurthy. Cancer Cytopathol. 2025 Jul.

Abstract

In recent years, cytopathology practices increasingly are considering the adoption of digital modalities to support remote rapid on-site evaluation (ROSE) of fine-needle aspiration biopsies. Currently, various digital options are available, each of which has unique advantages and limitations. This review covers all relevant aspects of telecytology for ROSE, including digital pathology options, operators, validation, quality assurance, reimbursement, and recommendations from professional organizations. The evolving landscape of telecytology for ROSE, including the development of devices for standardized specimen preparation and staining, next-generation digital microscopy techniques, and deep-learning-based artificial intelligence tools as decision-support aids for the interpretation of digital images, also is outlined.

Keywords: artificial intelligence (AI); digital cytopathology; digital microscopy; rapid on‐site evaluation (ROSE); telecytology.

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Conflict of interest statement

Savitri Krishnamurthy reports personal/consulting fees from ASP Health outside the submitted work.

Figures

FIGURE 1
FIGURE 1
Illustration of a video camera–based digital option (Realtime Telepathology Imaging System; Meyer Instruments, Inc.) that can be used for rapid on‐site evaluation of fine‐needle aspiration biopsies. The system includes a compression–decompression device (green arrow) with its own built‐in web server that allows users to view a live signal from a fully automatic, high‐definition video camera (red arrow).
FIGURE 2
FIGURE 2
Illustration of a hybrid digital pathology option including a digital microscope for live viewing and a scanner for the acquisition of whole‐slide images (MOTIC Pro Scan 6; MOTIC Digital Pathology).
FIGURE 3
FIGURE 3
Illustration of a device for automated specimen preparation and Diff‐Quik staining suitable for telecytology for ROSE (ASP Health). A specimen of pleural fluid prepared and stained with Diff‐Quik using (A) the device showing (B) metastatic adenocarcinoma. ROSE indicates rapid on‐site evaluation.
See this image and copyright information in PMC

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