Accuracy of intra-operative brain tumor squash cytology compared to large excision biopsy: a comparative study at the University Teaching Hospital of Kigali (CHUK), Rwanda.
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BACKGROUND: Accurate brain tumor diagnosis guides effective management, with large excision biopsy as the gold standard. Intra-operative cytologic smear techniques offer rapid analysis, particularly useful in resource-limited settings. The aim of this study was to evaluate the diagnostic accuracy and clinical utility of intra-operative cytologic smear techniques in brain tumor surgery at the University Teaching Hospital of Kigali (CHUK). OBJECTIVES: To evaluate the diagnostic accuracy and clinical utility of intra-operative cytologic smear compared to large excision biopsy in brain tumor surgery at CHUK. METHODS: A prospective cross-sectional study involving 77 patients with radiologically confirmed brain tumors undergoing surgery at CHUK. Squash cytology diagnoses were compared with final histopathology diagnoses for concordance. RESULTS: Squash cytology showed 89.6% agreement with histopathology. Major tumor types such as gliomas and meningiomas were reliably identified, facilitating timely surgical decisions. CONCLUSIONS: Intra-operative squash cytology is a rapid and reliable adjunct to large biopsy, improving brain tumor management in low-resource settings. Integration of advanced techniques could enhance diagnostic precision further.