The Milestone RoseSTATION is an all-in-one, mobile Workstation for Rapid On-Site evaluation of FNA Cytology. It is the first mobile workstation developed for highly professional, standardized ROSE procedures equipped to solve all potential on-site problems.
RoseSTATION Basic is an ergonomic mobile working station, studied to manipulate and analyze cytological samples in a safe and reliable manner. With RoseSTATION Basic it is possible to work far from the pathologic laboratory because the station is mobile and equipped with various features.
The system has been conceived for laboratory use and can therefore withstand the harshest laboratory conditions (indoor use only).
Rapid On-Site Evaluation (ROSE) is a service that the cytopathology laboratory provides for patients and their physicians. The advantages of immediate on-site evaluation include assurance of fine needle aspirations (FNA) biopsy adequacy, the ability to triage the specimen, shorten the length of the procedure, help guide and direct the biopsy in real time, and overall assist in managing the patient’s procedure with the performing clinician at the point of care. ROSE service for FNA biopsy is a time-limited procedure which occurs while the patients are subject to varying degrees of sedation and while they have endoscopes or large needles placed within the cavity or abdomen. As such, it is important to collect and deliver images as quickly as possible in the highest quality. [1]
Telepathology in cytopathology is becoming more commonly utilized, and newer technologic infrastructures afford the laboratory a variety of options. The options and design of a telepathology system are driven by the clinical needs. This is primarily focused on providing rapid on-site evaluation service for fine needle aspiration. Study design: The clinical requirements and needs of a system are described. Available tools to design and implement a telepathology system are covered, including methods of image capture, network connectivity and remote viewing options. Results: The primary telepathology method currently used and described involves the delivery via a network connection of a live video image to a remote site which is passively viewed by an internet web-based browser. By utilizing live video information and a voice connection to the on-site location, the remote viewer can collect clinical information and direct their view of the slides. Conclusions: Telepathology systems for use in cytopathology can be designed and implemented with commercially available infrastructure. It is necessary for the laboratory to validate the designed system and adhere to the required regulatory requirements. Telepathology for cytopathology can be reliably utilized by adapting existing technology, and newer advances hold great promise for further applications in the cytopathology laboratory. [1]
The challenge is that until now there has been no mobile dedicated unit/system to carry out ROSE on location. At time of call cytology personnel must assemble items that will be required and transport them to the on-site location with a mobile cart. The RoseSTATION is Milestone’s solution to this problem. The new RoseSTATION allows personnel to rapidly reach the selected site with a standardized work platform containing all tools required to accomplish this important diagnostic task.
Rapid, on-site evaluation (ROSE) takes place at a patient’s bedside and a fine needle aspiration (FNA) biopsy gives the cytologist the ability to triage the specimen, shorten the procedure length, help guide and direct the biopsy in real time, and overall assist in managing the patient’s procedure with the performing clinician at the point of care.
FNA biopsy is a time-sensitive procedure which occurs while patients are under varying degrees of sedation and while they have endoscopes or large needles placed within the cavity or abdomen.
Many scientific publications state the importance of applying rapid, on-site evaluation, as it provides immediate feedback regarding cellular adequacy to aid in obtaining a definitive diagnosis. Moreover it has the potential to eliminate repeat procedures. As such, it is important to collect and deliver high quality images as quickly as possible to Cytopathologists
Today there is not a dedicate mobile bench for such a procedure. At the time of a call, cytology personnel must collect items that will be required for both FNA and slide staining/evaluation, and transport them to the on-site location.
RoseSTATION is Milestone’s solution to arriving rapidly on-site with a standardized mobile work platform containing all tools required to accomplish this important diagnostic task. The total absence in the market of any similar workstation makes RoseSTATION a unique product, offering customer a high value solution for a professional service to patients.
The RoseSTATION is an all-in-one cytology FNA cart with all of the items needed always available to the operator to assure rapid turnaround time. The system is mobile and always ready to go. Just disconnect the UPS power supply form the wall and transport it to the desired location. It is self-supporting by using a rechargeable UPS that allows for the operation of the lamp, forced air slide dryer and microscope for up to 4 hours in case of lack of power on-site. The RoseSTATION is delivered from Milestone without consumable items or reagents. Each laboratory will outfit the RoseSTATION with items required according to their own standard operating procedure the produce Rapid On-Site Evaluation.
The mobile RoseSTATION comes standard with a forced air dryer for slides, LED lamp, AISI 304 stainless steel work bench, drawers for consumables and spares, Universal Power Supply, Industrial casters, tray for a laptop, shock absorbing base for microscope and a slide out drawer with form support for the microscope. In addition, the standard configuration there is an optional Olympus microscope model CX23.
Practical considerations in implementing an on-site FNA service include the need to bring cytopathology equipment and the cytopathologist “into the field”. At our institution and at many others, the practice has been to equip a number of wheeled cytology carts with the supplies that are needed to collect, evaluate, and transport specimens. These carts have exhibited varying degrees of technical sophistication over the years, ranging from an open metal cart with two shelves to a “med cart” with increased storage and working space. The most recent prototype in use at our institution (Penn-A-Cart) includes a lift mounted microscope equipped with a camera and LCD display, allowing the entire clinical team to view the specimen along with the cytopathologist and trainees.An exciting development is the possibility of incorporating TeleCytoPathology (TeleCyP) into the FNA program. By equipping the Penn-A-Cart with a high-speed digital video camera and a computer with wireless internet capabilities, it is possible for an attending pathologist to view glass slides in real time from his or her office, either for primary rendering of a preliminary diagnosis or in consultation. We have piloted this technology at our institution and expect that it will become increasingly common in the future. TeleCyP shall permit FNA services not only within the Health System Network but also remote sites that can be supported by trained support staff members. [3]Fine-needle aspiration (FNA) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin (23–25 gauge), hollow needle is inserted into the mass for sampling of cells that, after being stained, will be examined under a microscope (biopsy). The sampling and biopsy considered together are called fine-needle aspiration biopsy (FNAB) or fine-needle aspiration cytology (FNAC) (the latter to emphasize that any aspiration biopsy involves cytopathology, not histopathology). [2]
The sampling and biopsy considered together are called fine-needle aspiration biopsy (FNAB) or fine-needle aspiration cytology (FNAC) (the latter to emphasize that any aspiration biopsy involves cytopathology, not histopathology). Fine-needle aspiration biopsies are very safe minor surgical procedures. Often, a major surgical (excisional or open) biopsy can be avoided by performing a needle aspiration biopsy instead, eliminating the need for hospitalization. In 1981, the first fine-needle aspiration biopsy in the United States was done at Maimonides Medical Center. Today, this procedure is widely used in the diagnosis of cancer and inflammatory conditions. [2]A needle biopsy is a procedure to obtain a sample of cells from your body for laboratory testing. Common needle biopsy procedures include fine-needle aspiration and core needle biopsy. Needle biopsy may be used to take tissue or fluid samples from muscles, bones, and other organs, such as the liver or lungs.
Your doctor may suggest a needle biopsy to help diagnose a medical condition or to rule out a disease or condition. A needle biopsy may also be used to assess the progress of a treatment.The sample from your needle biopsy may help your doctor determine what’s causing:• A mass or lump. A needle biopsy may reveal whether a mass or lump is a cyst, an infection, a benign tumor or cancer.
• An infection. Analysis from a needle biopsy can help doctors determine what germs are causing an infection so that the most effective medications can be used.
• Inflammation. A needle biopsy sample may reveal what’s causing inflammation, and what types of cells are involved.
You may also undergo imaging tests, such as a computerized tomography (CT) scan or an ultrasound, before your needle biopsy. Sometimes these tests are also used during the needle biopsy procedure to more accurately locate the area to be biopsied.Your health care team will position you in a way that makes it easy for the doctor to access the area where the needle will be inserted. You may be asked to lie flat on a table.In certain cases, you may undergo imaging procedures, such as a CT scan or ultrasound. These allow your doctor to see the target area and plan the best way to proceed. Imaging procedures are sometimes done before your needle biopsy and sometimes performed during the biopsy. What type of imaging you’ll undergo, if any, will depend on what part of your body is being biopsied.Your health care team will clean the area of your body where the needle will be inserted. An anesthetic may be injected into the skin around the area to numb it. In some cases, you’ll receive an IV sedative or other medication to relax you during the procedure. Sometimes general anesthesia is used during a needle biopsy. If this is the case, you’ll receive medications through a vein in your arm that will relax you and put you in a sleep-like state.During the needle biopsy, the doctor guides a needle through your skin and into the area of interest. A sample of cells is collected and the needle is withdrawn. This process may be repeated several times until enough cells are collected.Common types of needle biopsy techniques include:• Fine-needle aspiration. This type of needle biopsy uses a thin, hollow needle to draw cells from your body.
• Core needle biopsy. This type of needle biopsy uses a wider needle than does fine-needle aspiration. The needle used during a core needle biopsy is a hollow tube that allows the doctor to extract a core of tissue for testing.
Pathologists — doctors who specialize in studying cells and tissue samples for signs of disease — will study the biopsy sample in the laboratory and make a diagnosis. Pathologists create a pathology report for your doctor. Once your doctor receives the report, you will be contacted with the results.

You can request a copy of your pathology report from your doctor. Pathology reports are usually filled with technical terms, so you may find it helpful to have your doctor review the report with you.

Your pathology report may include:

• A description of the biopsy sample. This section of the pathology report, sometimes called the gross description, describes the biopsy sample in general. For instance, it may describe the color and consistency of the tissues or fluid collected by the needle biopsy procedure. Or it may say how many slides were submitted for laboratory analysis.
• A description of the cells. This section of the pathology report describes how the cells appear under a microscope. This section may include how many cells and what types of cells were seen. Information on special dyes that were used to study the cells in order to gather more information about the diagnosis and the best treatments also may be included.
• The pathologist’s diagnosis. This section of the pathology report lists the pathologist’s diagnosis. It may also include comments, such as whether other tests are recommended.
The results of your needle biopsy will determine the next steps in your medical care.

[1] Telepathology in Cytopathology: Challenges and Opportunities-Brian T. Collins-ACTA CYTOLIGICA-Volume 53, No. 3, 2013
[2] en.wikipedia.org/wiki/Fine-needle_aspiration
[3] Progression from on-site to point-of-care fine needle aspiration service: Opportunities and challenges Prabodh K Gupta Cytojournal. 2010; 7: 6. Published online 2010 May 12.