Session Descriptions

Quality Management Partnership 2018 Update – Kathy Chorneyko

Objectives:

  1. List the QMP activities to date
  2. Explain the QMP Guidance Document for Categorization of Discordance
  3. Discuss the 2018 QMP Quality Improvement study
  4. Outline QMP activities for 2018/19

Description:

This session will of value to all practicing pathologists, pathology residents, PAs and technologists.This presentation will give an overview of QMP activities and accomplishments over the past year. The Guidance Document for the Categorization of Discordance will be reviewed including the process involved in its’ development. Results of a quality improvement study conducted in 2017/18 will be summarized. The goals and activities for the upcoming 2018/19 year will be outlined.


Best Practices in Intraoperative Pathology Consultations – Matt CecchiniMarcio Gomes

Objectives:

  1. Identify potential patient safety issues
  2. Discuss strategies to mitigate risks and improve patient outcomes related to intra-operative consultations
  3. Consider different approaches to intra-operative consultations in order to optimize utilization of pathology resources
  4. Use a framework for workplace-based assessment of performance on intra-operative consultations

Description:

The speakers will dive into intra-operative pathology consultations using the patient safety and lab utilization lenses.
Through case-based discussions of critical incidents with interactive audience participation, different strategies to mitigate risks and optimize lab utilization will be analyzed. Also, educational aspects related to the workplace-based assessment of intra-operative consultations as a prototype of an Entrustable Professional Activity in pathology will be considered. The discussions will be informed by a focused literature review on the topic and the perspectives of Ontario pathologists from diverse practice settings, professional experience and scopes of practice.The speakers will dive into intra-operative pathology consultations using the patient safety and lab utilization lenses.
Through case-based discussions of critical incidents with interactive audience participation, different strategies to mitigate risks and optimize lab utilization will be analyzed. Also, educational aspects related to the workplace-based assessment of intra-operative consultations as a prototype of an Entrustable Professional Activity in pathology will be considered. The discussions will be informed by a focused literature review on the topic and the perspectives of Ontario pathologists from diverse practice settings, professional experience and scopes of practice.


Noninvasive Follicular Thyroid Neoplasm with
Papillary-like Nuclear Features (NIFTP): Significance, Histologic Diagnosis and Effects on Cytology Updates in Thyroid Tumors – Aaron Pollett

Objectives:

  1. Diagnose Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP)
  2. Distinguish NIFTP from potentially more aggressive thyroid carcinomas
  3. Discuss the significance of NIFTP
  4. Summarize recent changes to the Bethesda System for Reporting Thyroid Cytopathology as they pertain to NIFTP
  5. Discuss the utility of molecular testing in the pre-surgical triage of thyroid nodules

Description:

This session focuses on the recent nomenclature revision of the indolent thyroid tumor now designated
“Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features” (NIFTP). Specific histologic criteria are in place with the goal to exclude potentially more aggressive thyroid cancers from this diagnosis. These diagnostic criteria as well as some of the challenges in evaluating these features will be reviewed and discussed to allow participants to comfortably make this diagnosis. The significance of this diagnosis and its distinguishing features from other thyroid tumors will be reviewed. The session will also summarize the impact of NIFTP on the Bethesda System for Reporting Thyroid Cytology and discus recent changes in the American Thyroid Association guidelines which now include the option of molecular studies in the pre-operatively triage of thyroid nodules.This session focuses on the recent nomenclature revision of the indolent thyroid tumor now designated
“Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features” (NIFTP). Specific histologic criteria are in place with the goal to exclude potentially more aggressive thyroid cancers from this diagnosis. These diagnostic criteria as well as some of the challenges in evaluating these features will be reviewed and discussed to allow participants to comfortably make this diagnosis. The significance of this diagnosis and its distinguishing features from other thyroid tumors will be reviewed. The session will also summarize the impact of NIFTP on the Bethesda System for Reporting Thyroid Cytology and discus recent changes in the American Thyroid Association guidelines which now include the option of molecular studies in the pre-operatively triage of thyroid nodules.


The Evolution of Infectious Disease Diagnostics:
Emerging Technologies that Accelerate Detection & Management – Anu Rebbapragada

Objectives:

  1. Discuss advances in infectious disease diagnosis and clinical management
  2. Summarize key examples of advanced diagnostics / technology
  3. Describe enhanced cervical cancer screening with highly specific molecular testing to detect E6/E7 HPV oncogene expression
  4. Review application of next generation sequencing & metagenomic profiling for outbreak investigation and detection of novel pathogens
  5. Present a glimpse into the future of rapid portable diagnostic devices

Description:

This session will be of value to all physicians/residents, pathologists focused in obstetrics/gynecology, pathology laboratory directors and decision-makers in diagnostic platform implementation.This presentation aims to provide an overview of the technological evolution in the field of infectious diseases.
Key examples of technological advances will be used to highlight improvements in diagnosis, clinical management, outbreak investigation and control of infectious diseases.
Topics will focus on:
i) Advanced Cervical Cancer Screening: molecular detection of HPV oncogene expression for highly specific diagnosis of persistent infection with greater potential for carcinogenesis
ii) Next Generation Sequencing: deep sequencing of clinical specimens to identify novel pathogens and investigate relationships of strains causing outbreaks
iii) What’s On The Horizon: an overview of the research & development pipeline of future test devices


Barrett’s Esophagus – Reporting of Endoscopic Mucosal Resections – Rosewell Corwyn

Objectives:

  1. Develop an approach to proper handling of endoscopic resection specimens from the endoscopy suite to the histology lab
  2. Identify and classify pre-malignant lesions and early cancers of the esophagus
  3. Apply a staging system for intramucosal adenocarcinomas
  4. Formulate a complete, clinically useful pathology report for these specimens

Description:

Traditionally, high grade dysplasia and early adenocarcinomas of the esophagus were treated surgically with esophagectomy.
Increasingly, these are being managed with therapeutic endoscopy techniques such as endoscopic mucosal resection (EMR). With burgeoning demand for these less invasive procedures, more institutions are hiring therapeutic endoscopists. This in turn creates potential challenges for pathologists who must now handle, interpret, and report these cases. This presentation will demonstrate the approach used in a high volume therapeutic endoscopy referral centre from specimen procurement to case reporting.Traditionally, high grade dysplasia and early adenocarcinomas of the esophagus were treated surgically with esophagectomy.
Increasingly, these are being managed with therapeutic endoscopy techniques such as endoscopic mucosal resection (EMR). With burgeoning demand for these less invasive procedures, more institutions are hiring therapeutic endoscopists. This in turn creates potential challenges for pathologists who must now handle, interpret, and report these cases. This presentation will demonstrate the approach used in a high volume therapeutic endoscopy referral centre from specimen procurement to case reporting.


Part 1 – Slide Seminar: Breast Tumors – Fraser Symmans


Mucinous ovarian lesions : clinical perspective – Dr. Tien Le

Objectives:

  • Understand the uniqueness of mucinous ovarian tumours
  • Understand the challenges in the diagnosis and management of mucinous ovarian tumours
  • Be up to date on the current recommendations and future directions in
    the clinical management of mucinous ovarian cancer

Description:

This session will focus on the clinical diagnosis and management of mucinous ovarian lesions from a clinical perspective with a focus on mucinous ovarian cancer.
Challenges in pathologic diagnosis and updated management of mucinous tumours will be discussed as well as future direction in research in these pathologic entities.This session will focus on the clinical diagnosis and management of mucinous ovarian lesions from a clinical perspective with a focus on mucinous ovarian cancer.
Challenges in pathologic diagnosis and updated management of mucinous tumours will be discussed as well as future direction in research in these pathologic entities.


Quality in Grossing – Joanne Swift

Objectives:

  1. Will know the definition of Quality
  2. Understand how we achieve quality in Grossing in Surgical Pathology
  3. Will understand how to measure and improve the Quality of Grossing

Description:

Imagine a world in which the nature of the specimen is the only reason for recuts.
Our patients are our most important stakeholder, but they are not our only one. Education, Communication and mentoring of Pathologists’ Assistants is very important, but you must find your baseline to be able to make improvements. By the end of this session you will understand how you can measure and improve the Quality of your Grossing. Imagine a world in which the nature of the specimen is the only reason for recuts.
Our patients are our most important stakeholder, but they are not our only one. Education, Communication and mentoring of Pathologists’ Assistants is very important, but you must find your baseline to be able to make improvements. By the end of this session you will understand how you can measure and improve the Quality of your Grossing.


Grossing Mucinous Ovarian Tumours – Joanne Swift

Objectives:

  1. Understand the important precautions for grossing mucinous and friable ovarian tumours
  2. Know the importance in describing/ photographing/reviewing the specimen to give the pathologist a clear picture of the gross
  3. Understand the importance of the gross review and sectioning of these unique tumours

Description:

The Good, the bad, and the messy job of opening and grossing mucinous and friable ovarian tumours and what you need to know.
We will discuss how to go about this for your safety and the patient’s safety. When do you need to involve the Pathologist, photograph? What do you need to include in your gross and what to section? Join me for a case study or two that we can review together.The Good, the bad, and the messy job of opening and grossing mucinous and friable ovarian tumours and what you need to know.
We will discuss how to go about this for your safety and the patient’s safety. When do you need to involve the Pathologist, photograph? What do you need to include in your gross and what to section? Join me for a case study or two that we can review together.


OMA Lab Section Update – Neil Davis


Evolving Management of Metastatic Colorectal Cancer Lunch Symposium – Mark Vincent

Objectives:

  1. Discuss the data supporting the use of EGFRi therapy in previously untreated patients with metastatic colorectal cancer and current Cancer Care Ontario funding
  2. Discuss location of primary tumours: prognostic and predictive values
  3. Review the Canadian Colorectal Cancer Sidedness Consensus Guidelines
  4. Discuss the role of Biomarkers, and the impact Biomarkers have on the selection of treatment for metastatic colorectal cancer

Description:

This program will assist in better understanding the complexities of metastatic colorectal cancer management,
and the role of biomarkers in the management of mCRC. It will examine current evidence for various treatment options, including the role of biologics and targeted therapies, along with the prognostic and predictive values of primary tumour location; and explore the impact of genetic biomarkers on treatment selection.This program will assist in better understanding the complexities of metastatic colorectal cancer management,
and the role of biomarkers in the management of mCRC. It will examine current evidence for various treatment options, including the role of biologics and targeted therapies, along with the prognostic and predictive values of primary tumour location; and explore the impact of genetic biomarkers on treatment selection.


Updates on Biomarker Testing in Canada – Ming Tsao


Comparison of Four Commonly Used Guidelines
for Workload Measurement in Pathology – Fawaz Halwani

Objectives:

  1. List the similarities and differences of 4 commonly used workload management systems (WMS)
  2. List the advantages and disadvantages of the 4 WMS
  3. Select the WMS most suitable to their practice

Description:

Pathologists require a mechanism to ensure proper staffing and a workload that is reasonable, safe and practical but not excessive.
There are several published workload measuring systems that are available. We chose to evaluate 4 commonly used workload measuring systems: CAP, W2Q, RCP and CPT. We developed a software that automatically calculates the workload for all these systems simultaneously to evaluate which one is most appropriate for our practice.
The session will be of value to: anatomic pathologists