The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology

Barkan, Güliz A.; Wojcik, Eva M.; Nayar, Ritu; Savic-Prince, Spasenija; Quek, Marcus L.; Kurtycz, Daniel F.I.; Rosenthal, Dorothy L.

doi:10.1159/000446270

Cited by 239 publications

(289 citation statements)

References 47 publications

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“…However, it was determined that with SPIDs, patient management was changed in 11.04% (19) of the cases in comparison to microscopic diagnoses. [17][18][19][20] ( Table 4). This result indicated that it was risky to make a primary diagnosis with SPIs in telecytology.…”

Section: Discussionmentioning

confidence: 99%

Telecytology: Is it possible with smartphone images?

Şahin

Hacısalihoğlu

Kirimlioglu

2017

Diagnostic Cytopathology

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IntroductionThis study aimed to discuss smartphone usage in telecytology and determine intraobserver concordance between microscopic cytopathological diagnoses and diagnoses derived via static smartphone images.MethodsThe study was conducted with 172 cytologic material. A pathologist captured static images of the cytology slides from the ocular lens of a microscope using a smartphone. The images were transferred via WhatsApp® to a cytopathologist working in another center who made all the microscopic cytopathological diagnoses 5‐27 months ago. The cytopathologist diagnosed images on a smartphone without knowledge of their previous microscopic diagnoses. The Kappa agreement between microscopic cytopathological diagnoses and smartphone image diagnoses was determined.ResultsThe average image capturing, transfer, and remote cytopathological diagnostic time for one case was 6.20 minutes. The percentage of cases whose microscopic and smartphone image diagnoses were concordant was 84.30%, and the percentage of those whose diagnoses were discordant was 15.69%. The highest Kappa agreement was observed in endoscopic ultrasound‐guided fine needle aspiration (1.000), and the lowest agreement was observed in urine cytology (0.665). Patient management changed with smart phone image diagnoses at 11.04%.ConclusionsThis study showed that easy, fast, and high‐quality image capturing and transfer is possible from cytology slides using smartphones. The intraobserver Kappa agreement between the microscopic cytopathological diagnoses and remote smartphone image diagnoses was high. It was found that remote diagnosis due to difficulties in telecytology might change patient management. The developments in the smartphone camera technology and transfer software make them efficient telepathology and telecytology tools.

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Section: Discussionmentioning

confidence: 99%

Telecytology: Is it possible with smartphone images?

Şahin

Hacısalihoğlu

Kirimlioglu

2017

Diagnostic Cytopathology

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“…It proposes 7 diagnostic categories, arising from a worldwide consensus [12,13] . It is a semiquantitative interpretation of urine samples that relies heavily on increased N/C ratios and on a combination of varying degrees of hyperchromasia, nuclear membrane irregularity and coarse irregular chromatin to arrive at the diagnosis of atypia, suspicious or high-grade urothelial carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Applying the Paris System for Reporting Urine Cytology Increases the Rate of Atypical Urothelial Cells in Benign Cases: A Need for Patient Management Recommendations

et al. 2016

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The Paris System (TPS) for reporting urinary cytology attempts to unify the terminology in this field. Objectives: To analyze the impact of adopting TPS by measuring nomenclature agreement and cytohistological correlation. Materials and Methods: Voided urine liquid-based cytology samples corresponding to 149 biopsy-proven cases (76 high-grade carcinomas, 40 low-grade carcinomas, and 33 benign lesions), were reclassified by the same pathologist using TPS. Diagnostic agreement and sensitivity for both nomenclature systems was measured. Results: When using TPS, the rate of atypical samples increased 8 times (from 3 to 24.2%) in benign cases, 10 times (from 2.5 to 25%) in low-grade carcinomas, and 2.4 times (from 6.6 to 15.8%) in high-grade carcinomas. The false-positive rate (abnormal cytology in negative or low-grade carcinoma cases) increased from 11 to 34.2%. Sensitivity was higher (63 vs. 49%) with TPS at the expense of a lower specificity (73 vs. 91%). The agreement between both nomenclatures was moderate for negative and high-grade carcinoma cases (k = 0.42 and 0.56, respectively) and weak for low-grade tumors (k = 0.35). Conclusions: Adopting TPS for reporting urine cytology results in a considerable increase in atypical diagnoses, improving sensitivity but lowering specificity. Appropriate management recommendations for patients with an atypical cytological diagnosis are required.

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“…The visualization of tumors during cystoscopy and ureteroscopy is considered the gold standard method of detection but is an invasive procedure that is time-consuming, costly, and uncomfortable for the patient. Urinary tract cytology (UTC) is a useful, noninvasive adjunct for surveillance because of its high specificity for the detection of high-grade urothelial carcinoma (HGUC) [3, 4]. Unfortunately, UTC has limited sensitivity for the detection of HGUC and poor sensitivity and specificity for the detection of low-grade urothelial neoplasms, such as low-grade urothelial carcinoma (LGUC) [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Sienna Cancer Diagnostics hTERT Antibody on 500 Consecutive Urinary Tract Specimens

Allison¹,

Sharma²,

Cowan³

et al. 2018

Acta Cytologica

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Objectives: Telomerase activity can be detected in up to 90% of urothelial carcinomas (UC). Telomerase activity can also be detected in urinary tract cytology (UTC) specimens and indicate an increased risk of UC. We evaluated the performance of a commercially available antibody that putatively binds the telomerase reverse transcriptase (hTERT) subunit on 500 UTC specimens. Study Design: Unstained Cytospin^TM preparations were created from residual urine specimens and were stained using the anti-hTERT antibody (SCD-A7). Two algorithms were developed for concatenating the hTERT result and cytologic diagnosis: a “no indeterminates algorithm,” in which a negative cytology and positive hTERT result are considered positive, and a “high-specificity algorithm,” in which a negative cytology and positive hTERT result are considered indeterminate (and thus negative for comparison to the gold standard). Results: The “no indeterminates algorithm” and “high-specificity algorithm” yielded a sensitivity of 60.6 and 52.1%, a specificity of 70.4 and 90.7%, a positive predictive value of 39.1 and 63.8%, and a negative predictive value of 85.0 and 85.8%, respectively. Conclusions: A positive hTERT result may identify a subset of patients with an increased risk of high-grade UC (HGUC) who may otherwise not be closely followed, while a negative hTERT immunocytochemistry result is associated with a reduction in risk for HGUC.

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The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology

Cited by 239 publications

References 47 publications

Telecytology: Is it possible with smartphone images?

Telecytology: Is it possible with smartphone images?

Applying the Paris System for Reporting Urine Cytology Increases the Rate of Atypical Urothelial Cells in Benign Cases: A Need for Patient Management Recommendations

Evaluation of Sienna Cancer Diagnostics hTERT Antibody on 500 Consecutive Urinary Tract Specimens

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