Annual Meeting On-Demand - Short Course #15 - Diagnostic Challenges Including Atypia in Urine Cytology Using Digitized Case-Based Approach: From Paris to Morphometry and Artificial Intelligence Models

Version 2 of The Paris system for reporting high-grade urothelial carcinoma (HGUC) has helped lower call rates of atypia with a concomitant increase in risk prediction and high specificity of urine cytology. However, practicing cytopathologists/cytologists continue to face challenges with achieving full compliance with a < 15% TPS recommended call rate of atypia. Other challenges include estimation of N:C ratios, and the sub-optimal sensitivity for upper tract specimens.

This interactive session will strive to address these issues via a challenging case-based discussion featuring digitized slides. We will explore the exciting role of objective morphometry and the emerging use of novel AI models. Furthermore, an emphasis will be placed on accurate n:c ratio estimation and the additional criteria needed for true atypia categorization as detailed in TPS. Finally, we intend to highlight the role of ancillary tests in upper tract diagnosis.

Target Audience

This educational activity is designed for pathologists, cytopathologists, cytotechnologists, students and other members of the cytopathology community.

Learning Objectives

  • Understand the role of novel morphometry in the objective determination of nuclear to cytoplasmic ratios, and the potential application of AI in HGUC diagnosis
  • Enhance skills in applying key TPS cytomorphological criteria for diagnosing HGUC and its variants via an interactive approach on diagnostically challenging digitized urine cytology cases (lower and upper urinary tract).
  • Recognize diagnostic gray zones and true atypia in urine cytology. Can AI models fine tune the differences? Provide comparative statistical summary of TPS criteria for HGUC in both lower and upper tract
  • Understand the complementary role for ancillary tests in the evaluation of urothelial carcinoma especially upper tract.
Course summary
Available credit: 
  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 California Credits
  • 1.50 CMLE
  • 1.50 Florida Credits
  • 1.50 Participant
Course opens: 
01/01/2026
Course expires: 
12/31/2028
Cost:
$125.00

Presenter(s):
Rubina Cocker, MD
Louis Vaickus, MD, PhD
Olisaemeka Chukwudebe, MBBS

DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS
The faculty, committee members, Executive Board and staff who are in position to control the content of this activity are required to disclose to the ASC and to learners any financial relationships that have occurred within the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. The ASC has reviewed the disclosures and mitigated all relevant financial relationships.

The following individuals have reported financial relationships:
Israh Akhtar, MD, FIAC: Consultant - Astra Zeneca
Zaibo Li, MD, PhD: Consultant - PathAI, AlxMed; Board of Directors - Digital Pathology Association
Louis Vaickus, MD, PhD: Consultant - Gala/Galvanize Therapeutics, Ruby Robotics, Veracyte; Advisory Board Member - Agilent
Paul VanderLaan, MD, PhD: Consultant – Gala Therapeutics

The following individuals have reported no relevant financial relationships:
Kristen Atkins, MD, Catherine Bammert, PhD, CT, MB(ASCP), CT(IAC), Christine Booth, MD, Marilyn Bui, MD, PhD, Amy Clayton, MD, Jacqueline Cuda, BS, SCT(ASCP), Fang Fan, MD, PhD, Beverly Haigler-Daly, BS, CT(ASCP), Michael Henry, MD, Angelique Levi, MD, Xiaoying Liu, MD, Abberly Lott Limbach, MD, Maria Cecilia Lozano, MD, PhD, MIAC, Varsha Manucha, MD, Sean McNair, MPH, CT(ASCP), Sara Monaco, MD, Maheswari Mukherjee, PhD, MSc, BPT, SCT(ASCP)CM, Dianna Ng, MD, Michiya Nishino, MD, PhD, Christopher O'Conor, MD, PhD, Melissa Randolph, BS, SCT(ASCP), Michelle Reid, MD, MSc, Marilin Rosa, MD, Sinchita Roy-Chowdhuri, MD, PhD, Momin Siddiqui, MD, FIAC, Zoon Tariq, MD, Michael Thrall, MD, Gary Tse, MBBS, Christopher VandenBussche, MD, PhD, Philippe Vielh, MD, PhD, Joe Walker, Jr, MS, SCT(ASCP), Vivian Weiss, MD, PhD, Lisa Zhang, MD, Rubina Cocker, MD, Olisaemeka Chukwudebe, MBBS

The ASC staff associated with the development of content for this activity reported no relevant financial relationships.

ACCREDITATION AND DESIGNATION STATEMENTS

Continuing Medical Education (CME) Statement
The American Society of Cytopathology is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.  The American Society of Cytopathology designates this enduring educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

American Board of Pathology Maintenance of Certification (CC)
This product can help fulfill the CME requirements mandated by the American Board of Pathology Continuing Certification (CC) process.  Earn up to 1.5 Credit Hours.

Continuing Medical Laboratory Education (CMLE)
The ASC designates this activity for a maximum of 1.5 Continuing Medical Laboratory Education (CMLE) credit hours for non-physicians.  The CMLE credit hours meet the continuing education requirements for the ASCP Board of Registry Certification Maintenance Program. Participants should claim only the credit commensurate with the extent of their participation in the activity.

Cytotechnologists with Licenses in Florida and California
This program is approved for 1.5 continuing education credits in the States of Florida and California.

Available Credit

  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 California Credits
  • 1.50 CMLE
  • 1.50 Florida Credits
  • 1.50 Participant

Price

Cost:
$125.00
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