ABSTRACT
Background: Telecytopathology (TCP) has a variety of different applications in clinical practice and is becoming more widely utilized especially during COVID pandemic. More recently, TCP use has been increasingly applied to the rapid on-site evaluation (ROSE) at our institution with immediate assessment by viewing cytologic smears remotely over web conferencing platform (zoom). As part of our quality control evaluation, we retrospectively investigated ROSE adequacy in two of the busiest FNA procedures at our institute (pancreas and lung) via TCP. Design: The study includes retrospective review of 151 of pancreatic lesions and 242 lung lesions over a two-year period. The air dried Diff-Quick slides were evaluated on site for adequacy by the cytopathology fellow/ cytotechnologist and cytopathologists via TCP at the same time. The ROSE adequacy diagnosis is recorded and transcribed to the preliminary report. We reviewed the adequacy and preliminary ROSE assessment and compared it to the final diagnosis as the gold standard. The non-diagnostic rate and discrepancy rate between initial and final diagnosis were calculated. Results: A total of 393 adequacy assessments of pancreas (151, 38%) and lung (242, 62%) were analyzed. Overall, 114 (75%) pancreatic cases and 199 (82%) lung lesions had adequate diagnosis at the time of the ROSE, while 37 (25%) of pancreatic cases and 43 (18%) of lung cases had non-adequate ROSE read specimens. Concordance between initial assessment of diagnosis and the final cytological diagnosis was identified in 94% (142 out of 151) of pancreatic cases and 93.4% (226 out of 242) of lung cases. Of the discordant cases, the final diagnosis was upgraded to adenocarcinoma in 7/9 pancreatic lesions and either SCC, adenocarcinoma or atypia in 5/16 lung lesions. The final diagnosis was downgraded to benign category in 2/9 pancreatic lesions and 11/16 lung lesions. Conclusions: Telecytopathology ROSE evaluation of pancreatic and lung lesions may have several advantages over in-person ROSE, including providing a suitable alternative technology, mitigating disease transmission during the COVID19 pandemic, while maximizing resources to allow more efficient use of the pathologist's time, thereby improving efficiency, eliminating downtime, and answering the increasing demand for on-site adequacy evaluation.
ABSTRACT
The Lucy mission is slated to launch in the fall of 2021 with the objective of making scientific observations of seven of Jupiter's Trojan asteroids. A complex system of ground based infrastructure is necessary to operate the spacecraft and process scientific data. This infrastructure is comprised of six ground elements. A significant verification and validation (V&V) effort must be undertaken to ensure reliable functionality of this geographically diverse system;this effort takes the form of Ground Readiness Testing (GRT). The two year GRT campaign requires extensive detailed planning, preparation and coordination across multiple mission elements for execution of many individual tests. The network connectivity, hardware and software functionality and a myriad of integrated systems need to be fully functionally tested. The GRT Manager must outline all testing opportunities in accordance with mission requirements, and element requirements to properly test the Ground System (GS) prior to launch, and needs to consider each mission element's internal schedule for testing and delivery to verify requirements in a timely manner. During the early stages of performing GRTs, the COVID-19 pandemic forced the team to restrict work primarily to remote operations with restricted physical access to those systems. This restriction brought with it new challenges in the management and execution of the GRTs, which would not normally have arisen in other pre-launch environments. The pandemic challenged GRT management to rethink their approach to a successful schedule of testing. Challenges came in the form of communication, lack of real-time in-person troubleshooting, and decisions that take into account the safety of the team as well as the need for engineering progress to be made. For example, work on the actual GS hardware and some software needed for testing and troubleshooting has slowed. The team needs to determine the true need for going into the office in order to update, integrate, or fix any issues for testing. No longer can someone walk down the hall to chat, brainstorm or fix issues of concern quickly. When face-to-face coordination is no longer available, new ways of communication need to be put in place. Ensuring successful completion of the GRT campaign is different in both its management and execution due to the pandemic. Prior to March 2020, the Lucy GS was already coordinating meetings and whiteboard sessions across the country since the mission elements were spread across the U.S. Now the entire GS has more opportunity to meet from the safety of their own home. For many this relieved some of the stress associated with the work environment and allowed team members to be more productive in their work life, and active in their home life. Less time and money is spent traveling via car or plane to accomplish ground readiness testing. The paper will describe how the Lucy team met new challenges and took advantage of the unforeseen benefits while staying on track to complete the GRT campaign successfully ahead of the October 2021 launch.