Pulmonary Rapid Intraoperative Diagnostic Evaluation (PRIDE): A Comparative Study of Imprint Cytology and Frozen Section in Interventional Pulmonology

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Introduction: Rapid intraoperative diagnostic methods are essential for confirming sampling accuracy and providing quick pathological insights. Frozen section (FS), a well-established technique, involves tissue freezing and microscopic examination, requiring specialized equipment. Imprint cytology (IC) offers a simpler alternative, involving pressing tissue on the slides for immediate cytological assessment. This study compares FS and IC in pulmonary biopsies to evaluate IC as a rapid diagnostic tool. Methods: This study analysed 119 biopsy specimens (55 endobronchial, 56 pleural, and 8 transbronchial) from May 2023 to November 2024 at a tertiary care hospital in Eastern India. Specimens were evaluated using IC, FS, and final histopathology. Sensitivity, specificity, and procedure time were calculated for each technique. Results: FS demonstrated an overall sensitivity of 89.74% and specificity of 90.24%, compared to 58.44% sensitivity and 92.86% specificity for IC. For endobronchial specimens, FS sensitivity and specificity were 92.30% and 87.50%, respectively, while IC achieved 64.10% sensitivity and 93.75% specificity. Procedure times averaged 28.4 minutes for FS and 11.2 minutes for IC. Both methods showed comparable positive predictive values (PPV) for malignant and tubercular lesions: FS at 94.11% and 100%, and IC at 92.5% and 100%, respectively. Conclusion: IC exhibited significant specificity for both endobronchial and pleural specimen. PPV of IC almost equal to FS. Procedure time is significantly shorter in IC. IC offers a reliable, cost-effective and rapid diagnostic alternative

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