Sir,We thank Drs Girish Sindhwani (GS) and Rakhee Khanduri (RK)[1] for interest in our work and their comments regarding our study of transbronchial needle aspiration (TBNA) in patients with lung cancer.[2] We agree that availability of rapid on-site evaluation (ROSE) improves the yield of TBNA and in ideal situations; it is preferable to have an on-site cytopathologist during performance of TBNA. However, in high volume multispecialty tertiary care centers, cytopathologists are involved in providing on site cytology services in various disciplines like image (CT/USG)-guided fine-needle aspiration cytology (FNAC) procedures, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), routine outpatient FNAC procedures etc., We would like to emphasize that ROSE was available at our center but during the study period, we were also involved in setting up an EBUS-TBNA programme and as per the availability, ROSE facilities were maximally being utilized for EBUS-TBNA and the outcomes of the same were very encouraging and these findings were published recently.[3] Still, conventional TBNA was routinely being performed at our center irrespective of the availability/non-availability of ROSE and that is one of the important points that we would like to highlight. As remarked by Drs GS/RK, more studies from India evaluating the utility of ROSE with TBNA/EBUS-TBNA are required.As Drs GS/RK correctly state, TBNA is a grossly underutilized flexible bronchoscopic modality. After the increasing acceptance of EBUS-TBNA, the very performance of conventional TBNA has been given up at many centers. Training of pulmonary fellows in performance of TBNA consequently has taken a setback. Due to operational cost concerns, EBUS-TBNA is available at only limited centers. Lack of EBUS facility and non-performance of TBNA by most pulmonologists leads to missed opportunity of obtaining a diagnosis during the flexible bronchoscopy procedure. Conventional TBNA is a safe, efficacious and cost-effective modality which adds to the diagnostic yield of other concurrently performed bronchoscopic procedures like transbronchial lung biopsy (TBLB).[4] We would like to emphasize that TBNA as a procedure should be utilized more often by pulmonologists. The previously published work by Dr Sindhwani and colleagues is appreciable in this regard.[5]We believe that non availability of ROSE is not the most important reason which is responsible for TBNA underutilization as highlighted in a large previously published Indian experience on TBNA without ROSE.[6] Rather, it is related to operator's inexperience and concerns regarding its safety and utility. Also, it would be incorrect to state that there is ample availability of trained pathology personnel to provide ROSE facilities at all the tertiary care centers in most parts of India.Therefore, the need of the hour is to train all pulmonologists involved in performing flexible bronchoscopy in the anatomical aspects and art of conventional TBNA. Lack of facilities for ROSE should not be a deterring factor limiting the performance of Conventional TBNA.