Digital-Rapid On-site Examination in Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (DEBUT): a proof of concept study for the application of artificial intelligence in the bronchoscopy suite

Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has become the standard of care for sampling mediastinal and hilar lesions and is finding increased acceptance for diagnostic as well as staging purposes [1]. EBUS-TBNA is an expensive procedure due to the high cost of equipment [2]. A repeat procedure in case of an inconclusive outcome adds to the burgeoning expenditure. To circumvent this, rapid on-site examination (ROSE) has been adopted to reduce the number of needle punctures and decrease the requirement for additional procedures [3]. However, ROSE requires presence of a pathologist or cyto-technicians in the bronchoscopy suite. Artificial intelligence using open source deep neural network is able to classify on-site cytology smears during EBUS-TBNA procedure in the bronchoscopy suite