Rapid on site evaluation in digital pathology

Implementing ROSE for biopsy samples may save your pathologist from calling a sample nondiagnostic, but not every clinic think they can handle that extra step in the process. As seen on an awarded 2022 USCAP poster presentation, a Grundium customer recently solved a problem for ROSE using the Ocus®20 single slide scanner.


In the times of conventional microscopy, to perform ROSE, a professional used to have to be onsite. This is a bottleneck and a problem, since there just aren't enough professionals to go around for the ever increasing amount of pathology work to do.

Telepathology can help solve the problem by making the signout take place digitally online. Not only does the pathologist save a lot of time and energy not traveling to the hospital, but they get to really focus on what they do best – analyzing samples.

Especially understaffed labs benefit from telepathology by cutting down on time, cost, and effort spent on accommodating for an onsite pathologist. With telepathology, the lab is free to consult the services of any suitable professional online at the time the samples are scanned.


ROSE increases the diagnostic rate, i.e. cases with adequate samples for diagnosis, by removing bad samples from the process. As laboratory information systems are getting better, hospital IT is advancing, and increasing bandwidths are making online work faster it is clear that digital ROSE will be adopted by more healthcare providers in the foreseeable future. Small and practical equipment like the Grundium Ocus enables this change by lowering the threshold for hospitals and clinics to go digital.

Ocus and iPad


The Ocus series microscope single slide scanners are designed for remote operation and telepathology. The Ocus slide scanners are known for their exceptional image quality, ease of use and fast scanning, which are all reasons why they are used for telecytology ROSE by top hospitals in the USA, Canada, UK, and Italy.

The Ocus is operated on any computer that has a screen and a modern browser, and it's so simple to use that anybody can be trained to use it in just 15 minutes. Its very small footprint, 18 x 18 x 18 cm/ 8 x 8 x 8” means this scanner will easily find a place in any lab, or if run off a battery pack, it can be simply carried from one spot to another, or even wheeled around the hospital on a cart.


The Grundium Ocus®20 enables fast, simple and sharp imaging of samples. It’s small footprint means it can find a spot in the most cluttered of labs. If you are looking for a small footprint and sharp single slide scanner for your pathology solution or if you want to hear more about how to integrate an Ocus scanner into your system, book a free, non-binding online demo of the Ocus scanners, or just message us with any questions!

In the demo with our expert you will get to ask all the questions and discuss about your needs and how the Ocus scanners would be beneficial for you. We will be happy to talk with you, so feel free to book a demo by clicking the button below! After leaving your information our experts will get back to you regarding the schedule for the demo.



Rapid on-site evaluation (ROSE) is making sure you’re using your resources wisely. ROSE is typically done by needle biopsy, which is a minimally invasive procedure used to obtain a sample from a tissue for analysis. Needle biopsy is typically used for suspicious lesions, such as primary tumors or metastatic malignancies. In the ROSE process the needle biopsy sample is quickly examined to establish whether the taken sample is adequate for a successful diagnosis.

ROSE is shown to be suitable for biopsies obtained from various tissues, like thyroid, breast, or lung. It is especially useful in challenging sampling methods like endobronchial ultrasound guided biopsy where the probability to miss the right tissue is higher. [1,2,3]

When the biopsy sample has been taken, part of it can be prepared for a glass slide as a smear or touch preparation, stained, and examined for adequacy. The rest of the biopsy material can be used for example for cell or tissue block, or flow cytometry. ROSE can be performed by a cytopathologist or an alternative evaluator such as a cytotechnologist. [3] Sometimes the taken sample turns out to be inadequate – maybe the needle just barely missed the right spot or failed to capture enough tissue. Such samples are called non-diagnostic, e.g., a diagnosis just cannot be reached from examining them.

ROSE is an extra step in the diagnostic process to make sure the rest of the steps make sense and can be followed through. By eliminating the processing of potential bad samples ROSE can significantly shorten the total diagnosis time and reduce costs. [4] Both the patient and the healthcare system are spared added stress and costs when there is no need to come back for repeated procedure because the previous sample proved to be nondiagnostic.

[1] Muri, R., Trippel, M., Borner, U., Weidner, S. E., & Trepp, R. (2022). The impact of rapid on-site evaluation (ROSE) on the quality and diagnostic value of thyroid nodule fine-needle aspirations. Thyroid: official journal of the American Thyroid Association, 10.1089/thy.2021.0551. Advance online publication. https://doi.org/10.1089/thy.2021.0551 [2] Torous, V. F., Lopez, S. H., Xu, C., Sweeney, B. J., & Pitman, M. B. (2022). Performance of Rapid On-Site Evaluation in Breast Fine-Needle Aspiration Biopsies: Identifying Areas of Diagnostic Challenge. Acta cytologica, 66(1), 1–13. https://doi.org/10.1159/000518579 [3] Pearson, L. N., Layfield, L. J., & Schmidt, R. L. (2018). Cost-effectiveness of rapid on-site evaluation of the adequacy of FNA cytology samples performed by nonpathologists. Cancer cytopathology, 126(10), 839–845. https://doi.org/10.1002/cncy.22047 [4] Qi, J. C., Liao, L., Zhao, Z., Zeng, H., Wang, T., Hu, M., Wang, L., Wu, Z., Ye, Y., Ou, Y., Cai, Z., Wu, Q., Xu, Q., Zhang, W., Huang, W., Li, H., & Lin, L. (2022). Impact of rapid on-site evaluation combined with endobronchial ultrasound and virtual bronchoscopic navigation in diagnosing peripheral lung lesions. BMC pulmonary medicine, 22(1), 117. https://doi.org/10.1186/s12890-022-01917-z