Case ReviewsRapid On-Site Evaluation for Endoscopic Ultrasound–Guided Fine-Needle Aspiration Diagnosis of Pancreatic LesionsCai, Guoping MD; Sun, Xiu MD, PhD; Aslanian, Harry R. MD; Chhieng, David MDAuthor Information From the Yale University School of Medicine, New Haven, CT. Reprints: Guoping Cai, MD, Department of Pathology, Yale University School of Medicine, 310 Cedar St, CB 506B, New Haven, CT 06510. E-mail: email@example.com. The authors have no funding or conflicts to declare. AJSP: Reviews & Reports: July/August 2015 - Volume 20 - Issue 4 - p 164-168 doi: 10.1097/PCR.0000000000000099 Buy Metrics Abstract Rapid on-site evaluation (ROSE) has repeatedly been shown to improve diagnostic performance of endoscopic ultrasound–guided fine-needle aspiration of pancreatic lesions. However, the practice of providing ROSE service varies among institutions. ROSE helps to ensure adequate sampling, appropriate specimen triage, and timely patient management. In this review, we discuss the practice and clinical significance of ROSE, the factors influencing the ROSE diagnosis, the financial considerations for providing ROSE service, and pitfalls to render a ROSE diagnosis. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.