The Evolving Role of Pathologists in the Era of Predictive Biomarkers and Precision Medicine

 

SATURDAY JULY 7

0830-1730

Essential Skills In Pathology Workshop

0830-1200

Preconference Workshops W0711, W0712, W0713, W0714, W0715

1200-1400

Lunch

  • Residents’ Networking Lunch

1400-1730

Preconference Workshops W1021, W1022, W1023, W1024

1700-1900

Assemblée générale annuelle de l’Association des pathologistes du Québec

1800-2000

Pathologists’ Assistants Reception

1800-2100

Residents’ Symposium and Dinner

 

 

SUNDAY JULY 8

0730-0830

Satellite Symposium Breakfast

0830-0945

Opening Plenary Session: The Impact of Predictive Biomarker Testing on Patient Outcomes

0945-1015

Refreshment Break

1015-1215

Concurrent Sessions

1215-1345

Lunch

1345-1515

Concurrent Sessions

1515-1545

Refreshment Break

1545-1715

Concurrent Sessions

1730-1800

CAP-ACP Junior Scientist Award Lecture

1800-1830

CAP-ACP William Boyd Award Lecture

1900-2100

President’s Reception at Le Parlementaire

MONDAY JULY 9

0730-0830

Satellite Symposium Breakfast

0830-0945

Plenary Debate: “Pathologists Should Stay Behind Their Microscopes and Let Oncologists Take Care of Biomarker Testing”

1015-1215

Concurrent Sessions

1215-1345

Lunch

1345-1515

Concurrent Sessions

1515-1545

Refreshment Break

1545-1715

Concurrent Sessions

1700-1900

Exhibit Hall Wine & Cheese Reception and Poster Presentations

1900-2100

Saskatoon Health Region Dinner for Residents

TUESDAY JULY 10

0730-0830

Satellite Symposium Breakfast

0830-0945

Dr. Cam Coady Symposium: From Bench to Bedside: Implementation of Predictive Biomarker Tests

1015-1215

Concurrent Sessions

1215-1345

CAP-ACP Annual General Meeting Lunch

1345-1515

Concurrent Sessions

1515-1545

Refreshment Break

1545-1715

Concurrent Sessions

1730-1815

Closing Plenary: The Evolving Role of Pathology in Multidisciplinary Teams

1900-2200

Gala Banquet and Awards Presentations at Musée national des beaux-arts du Québec

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Opening Plenary Session: The Impact of Predictive Biomarker Testing on Patient Outcomes
Sunday July 8, 0830-0945

 

Shantanu Banerji, University of Manitoba

 

Learning Objectives:

At the end of this presentation attendants will be able to:

  • Describe the impact of targeted therapies and immunotherapies on cancer patient outcomes.
  • Contrast different types of predictive biomarkers currently used in cancer care.
  • Discuss the importance of collaborative practice in interprofessional teams for improving health care outcomes.

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Paediatric Section Symposium: Precision Medicine and Molecular Diagnostics: the Integral Role of Paediatric Pathology
Sunday July 8, 1015-1215

 

Gino Somers, University of Toronto, Hospital for Sick Children

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Acquire a greater understanding of the role of pediatric pathology in molecular oncology.
  • List three important molecular alterations in pediatric pathology.
  • Describe some of the steps involved in molecular test development.
  • Discuss future areas of development in molecular pediatric pathology.

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Advanced Diagnostics Section Symposium
Sunday July 8, 1015-1215

 

1020-1105

Precision Diagnostics in Prostate Cancer Needle Biopsy Pathology: Challenges in Getting the Most Effective Information from the Smallest Source

Samson W. Fine, Memorial Sloan Kettering Cancer Centre

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Apply up to date prostate cancer grading parameters.
  • Recognize ‘watershed’ areas of prostate cancer grading which cause challenge and may benefit from consultation with colleagues.
  • Recognize variation in methods of tumor quantitation on needle biopsy and how these parameters are used in clinical decision making.
  • List well-accepted definitions of intraductal carcinoma and difficulties in its diagnosis and clinical import when identified on needle biopsy.
  • Restate the need for robust evidence when incorporating new pathologic/molecular markers into prostate needle biopsy reporting.

Precision Diagnostics in Prostate Cancer Needle Biopsy Pathology: Challenges in Getting the Most Effective Information from the Smallest Source” and will detail up to date information regarding the use and utility of a variety of prostate needle biopsy parameters in prostate cancer management.

The session will be of value to: pathology residents and fellows, general and GU-trained anatomic pathologists1 List the differential diagnosis of cribriform glandular lesions in the prostate.

 

1105-1125

Advanced Molecular Diagnostics in the Bone and Soft Tissue Pathology

Brendan Dickson, Mount Sinai Hospital

 

1105-1125

Molecular Neuropathology: Empowering Precision Medicine

Jason Karamchandani, McGill University

 

1145-1205

Challenges in the Implementation of Genomic Pathology

George M. Yousef, University of Toronto, St. Michael’s Hospital

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Gynecological Pathology Specialty Network Symposium: Emerging Trends in Gynecologic Pathology: Scientific Update and Discussion
Sunday July 8, 1015-1215

 

Emerging Trends in Gynecologic Pathology: Scientific Update and Discussion

Lien Hoang, Vancouver Coastal Health

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • List the 2014 WHO classification of uterine stromal sarcomas.
  • Describe the variant morphologic patterns seen in low-grade and high-grade endometrial stromal sarcomas.
  • List the most common genetic rearrangements seen in low-grade and high-grade endometrial stromal sarcomas.
  • Recognize the evolving classification of uterine stromal sarcomas.

This presentation will review the classic and variant morphologic patterns seen the spectrum of endometrial stromal neoplasms (endometrial stromal nodules, low-grade endometrial stromal sarcoma, high-grade endometrial stromal sarcoma, undifferentiated uterine sarcoma). It will also review the molecular aberrations associated with each class of tumor, and the shifting paradigm of endometrial stromal neoplasm classification.The session will be of value to residents and general/anatomical pathologists, particularly those with interest in gynecologic pathology.

 

Mesonephric Lesions of the Female Genital Tract

Jelena Mirkovic, University of Toronto

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Describe spectrum of mesonephric lesions of the female genital tract.
  • Summarize morphologic and immunohistochemical features of mesonephric carcinoma.
  • List molecular features of mesonephric carcinoma and other related lesions.

Invasive Cervical Adenocarcinomas: IECC Pathogenetic Classification and Diagnostic Algorithm Proposal

Simona Stolnicu, University of Medicine and Pharmacy Targu Mures

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Workshop: A Practical Approach to Quality and Patient Safety in Anatomical Pathology
Sunday July 8, 1015-1215

 

Iris Teo, University of Ottawa, The Ottawa Hospital

Bibianna Purgina, University of Ottawa, The Ottawa Hospital

Sergey Pyatibrat, University of Ottawa, The Ottawa Hospital

 

Learning Objectives:

At the end of this workshop participants will be able to:

  • Analyze situations where quality events have been identified.
  • Design a plan using the PDSA framework.

This workshop will be heavily case-based. Introductory information (not more than 15-30 minutes) will be presented, and will include information on the anticipated structure of the workshop. There will be a brief note on patient safety culture, a focus on the systemic causes of adverse events, appropriate accountability, nonjudgemental attitudes, the selection and problems with objective metrics. The bulk of the time will be spent discussing two (potentially three cases). Any needed theoretical information (such as RCA, fishbone diagrams, etc.) will be presented, followed by the case stems. The participants will then be broken up into small groups and discussion will occur. The number of the groups will likely depend on the number and nature of the participants. The course directors will listen and facilitate as needed in the small groups but should not be primary contributors to the small group discussion. After 10-15 minutes, there will be a large group session (10-15 minutes), when the groups will discuss their results. After this, the workshop directors will summarize the main (explicit) learning points from the case. At the end of the session, we will recapitulate the objectives and also emphasize the implicit educational objectives, that is, demonstration of elements of the patient safety culture, taking an objective, nonjudgemental attitudes, the need for openness and transparency, etc.

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Cytopathology Section Symposium: Cytopathology HPV Testing for Cervical Cancer Screening
Sunday July 8, 1345-1715

 

Timothy Palmer, National Health Service

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Discuss the principles underlying Cervical cancer screening programmes.
  • Apply the principles underlying Cervical Cancer screening programmes to the monitoring of quality in screening.
  • Demonstrate the link between quality monitoring in Cervical cancer screening and service improvement.
  • Explain the benefits of hr-HPV immunization.
  • Assess the effects of HPV primary screening in Cervical cancer rates.
  • Determine a development path for their Cervical cancer screening programme.

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Neuropathology Section Symposium: Neuropathology for Anatomic Pathologists
Sunday July 8, 1345-1515

 

Perinatal Neuropathology – Why Autopsies are Still Important

Marc DelBigio, University of Manitoba

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Describe how in utero insults, premature birth, and perinatal insults can negative impact subsequent brain development.
  • Describe the mechanisms through which ischemia or hemorrhage damages the immature brain.
  • Describe the general mechanisms through which viral infections damage the fetal brain.

Deep Learning and Artificial Intelligence in Precision Neuro-Oncology

Phedias Diamandis, University Health Network, Princess Margaret Cancer Centre

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • List 3 ways computer vision can help pathologists function at their best.
  • Discuss why deep learning appears to outperform traditional machine learning approaches for pattern recognition.
  • Identify the major limitations of deep learning.

Topic TBA

Marie-Christine Guiot, McGill University Health Centre

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Canadian Society of Dermatopathology Specialty Network Symposium: Challenging Cases In Dermatopathology; Melanocytic and Non-melanocytic Tumors and Inflammatory Dermatoses
Sunday July 8, 1345-1515

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Workshop: Shifting the Focus From Professional Liability To Accountability
Sunday July 8, 1345-1515

 

Tino Piscione, The Canadian Medical Protective Association (CMPA)

 

Learning Objectives:

At the end of this workshop participants will be able to:

  • Distinguish between professional liability and accountability.
  • Explain how demonstrating professional accountability may mitigate risk of patient harm and medical-legal liability.
  • Design a personal action plan that incorporates principles of professional accountability and patient safety.

Reframing Canadian Pathology Practice in the Era of Patient-Centred Care: This course addresses professional accountability and physician-to-physician communication in the Pathology practice setting. It will take place during the CAP-ACP Annual Scientific Meeting as two independent 90-minute facilitated, interactive workshops. Educational activities will be case-based and engage learners in large and small group discussions as well as individual reflection. Learning objectives aim at aligning attitudes and behaviours of pathologists with the model of patient-centred care. As part of the learning experience, learners will be asked to complete pre- and post- course assignments.

Case-based discussions examining: a) the relationship between liability, accountability, and patient harm; and b) attitudes and/or behaviours modelling professional accountability that may mitigate patient harm and liability. Individual and group reflective exercises to identify opportunities for improving actions and behaviours reflecting professional accountability in one’s own practice setting.

As a result of attending this workshop, the learner will have gained personal insight into the significance of professional accountability and communication in delivering safe patient care which might also mitigate medical-legal liability.

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Canadian Network of Uropathology Symposium: Practical Approaches to Problem Areas in GU Pathology
Sunday July 8, 1545-1715

 

Cribriform Lesions of the Prostate

Jennifer Merriman, Dalhousie University, QE II Health Science Centre

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • List the differential diagnosis of cribriform glandular lesions in the prostate.
  • Distinguish between cribriform glandular lesions in the prostate.

A brief presentation on the differential diagnosis of cribriform glandular lesions in the prostate and how to approach cases with these lesions.
This presentation will be of value to pathology residents and practicing pathologists who see prostate needle biopsies, TURP and prostatectomy specimens in community and academic practice settings.

 

Assessment of Early Invasion (pT1) In Bladder Cancer

Michelle Downes, University of Toronto, Sunnybrook Health Sciences Centre

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Recognize the histological features of early invasion in bladder cancer.
  • Identify potential mimics and pitfalls in the diagnosis of early invasion in bladder cancer.
  • Evaluate methods of pT1 substaging in bladder cancer.

Needle Biopsies of Eosinophilic/Oncocytic Renal Masses

Andrew J. Evans, University Health Network, Toronto General Hospital

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Explain the rationale for performing needle biopsies of incidentally found small renal masses.
  • Understand current barriers among urologists to the adoption of needle biopsies of small renal masses.
  • List the major differential diagnosis of oncocytic or eosinophilic renal masses on biopsy.
  • Explain the role and appropriate use of immunohistochemistry in the workup of these biopsies.

Open Panel Discussion on CNUP Plans and Project Proposals

Fadi Brimo, McGill University Health Center

George M. Yousef, University of Toronto, St. Michael’s Hospital

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Workshop: B-cell Lymphomas: the WHO and WHAT in 2017
Sunday July 8, 1545-1715

 

René P. Michel, McGill University, McGill University Health Center

 

This workshop will be in lecture format, outlining the major changes of the B-cell lymphomas in the 2017 WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (4th Edition). This will cover new terminology, work-up of these cases, comprehensive diagnostic features (morphologic, molecular and cytogenetic), and considerations of differential diagnosis. The morphologic (including immunohistochemical), molecular and related features of the main entities will be presented to provide to place the updates in the context of a comprehensive overview.

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Workshop: How to Resolve Diagnostic Disagreement Between Physicians
Sunday July 8, 1545-1715

 

Tino Piscione, The Canadian Medical Protective Association (CMPA)

 

Learning Objectives:

At the end of this workshop participants will be able to:

  • Discuss the impact of diagnostic disagreement on safe patient care.
  • Provide examples of how to communicate disagreement professionally with other pathologists and physicians.
  • Apply effective communication strategies to resolve diagnostic disagreement in Pathology practice.

Reframing Canadian Pathology Practice in the Era of Patient-centred Care: This course addresses professional accountability and physician-to-physician communication in the Pathology practice setting. It will take place during the CAP-ACP Annual Scientific Meeting as two independent 90-minute facilitated, interactive workshops. Educational activities will be case-based and engage learners in large and small group discussions as well as individual reflection. Learning objectives aim at aligning attitudes and behaviours of pathologists with the model of patient-centred care. As part of the learning experience, learners will be asked to complete pre- and post- course assignments.

Case-based discussions eliciting factors that contribute to disagreement between physicians and which may directly lead to patient harm; Debriefing on a video presentation illustrating ineffective, unprofessional communication between physicians, followed by a discussion of professional communication behaviours; Small group breakout activity using case vignettes depicting scenarios relevant to Pathology practice to identify effective physician-to-physician communication strategies.

As a result of attending this workshop, the learner will have gained personal insight into the significance of professional accountability and communication in delivering safe patient care which might also mitigate medical-legal liability.

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Plenary Session: Debate: “Pathologists Should Stay Behind Their Microscopes and Let Oncologists Take Care of Biomarker Testing”
Monday July 9, 0830-0945

 

Facilitator: Judith Hugh, University of Alberta

 

Debaters:

Shantanu Banerji, University of Manitoba

Aaron Pollett, University of Toronto, Mount Sinai Hospital

 

Learning Objectives:

At the end of this presentation participants will be able to:

  • Discuss issues related to the initiation of predictive biomarker testing.
  • Outline how emerging technologies in molecular diagnostics might impact the practice of oncology and pathology.
  • Describe the role of multidisciplinary coordination for successful strategies in personalized cancer care.

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Workshop: The World of Ocular Pathology, Intraocular and Periocular Neoplastic and Non-neoplastic Lesions
Monday July 9, 1015-1215

 

Sabrina Bergeron, McGill University, McGill University Health Centre

Miguel N Burnier Jr., McGill University, McGill University Health Centre

Alexandre Odashiro, Université Laval – Québec, Centre hospitalier de Laval

 

Learning Objectives:

At the end of this workshop participants will be able to:

  • Review how to diagnose eyelid malignancies, sebaceous cell carcinoma and adenocarcinoma and image them by OCT.
  • Discuss the diagnosis and prognosis of conjunctival neoplasms and primary acquired melanosis (PAM).
  • Discuss the diagnosis and prognosis of intraocular and periocular melanomas.
  • Discuss the diagnosis and prognosis of intraocular tumors in adult and children.
  • Discuss the diagnosis and prognosis of orbital tumors in adult and children.

This workshop aims to familiarize pathologists, trainees and pathologist assistants with both routine and challenging cases in ocular pathology. Topics covered include, but are not limited to; eyelid tumors, conjunctival melanocytic lesions, intraocular melanoma, retinoblastoma and orbital tumors.

This workshop will on macroscopic and microscopic features of ocular specimens and give a thorough overview of clinicopathological correlations of these lesions. We plan to emphasize on the use of digital pathology in ocular pathology and describe techniques and programs employed by our laboratory. Connections between digital pathology and other imaging modes pertaining to ophthalmology, such as optical coherence tomography, will be presented.

Workshop material will be digitalized and made available to participants upon request after the workshop. Participants will be encouraged to participate in the workshop and bring cases they wish to share with other participants and the ocular pathology specialists hosting the workshop. This workshop will be offered in English and French.

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Workshop on the Expert Witness
Monday July 9, 1015-1215

 

Christopher Milroy, University of Ottawa, The Ottawa Hospital

Jacqueline Parai, University of Ottawa, The Ottawa Hospital

 

Learning Objectives:

At the end of this workshop participants will be able to:

  • Plan how to give effective evidence in court.
  • Differentiate the role of the expert in criminal and civil cases.
  • Identify different ways lawyers examine witnesses.
  • Apply pathology knowledge in writing a report for the court.

The courts depend upon physicians to act as expert witnesses. Physicians may choose to practice in this area or may end up as an expert witness because of their everyday practice. Testifying at trial is most commonly done by Forensic Pathologists in criminal cases; surgical pathologists however can also be called as expert witnesses in civil litigation, as assessors and experts for medical licensing bodies or as witnesses in an inquest.

This workshop will provide practical experience on how to be an expert witness. The workshop will discuss the rules of evidence as they apply to witnesses and how they apply to civil as well as criminal cases. It will provide an analysis of report writing in both civil and criminal matters. The workshop will also include practical demonstrations of being a witness in court and how evidence in chief and cross examinations are conducted.

The presenters are experienced expert witnesses and have given evidence in many jurisdictions in criminal and civil cases, inquests and for medical licensing bodies.

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Platform Presentations A
Monday July 9, 1015-1215

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Platform Presentations B
Monday July 9, 1015-1215

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Combined Anatomical Pathology & Patient Safety and Quality Assurance Sections Symposium: Molecular Pathology Practice in the Canadian Landscape – The Evolution of Integrated Molecular Pathology
Monday July 9, 1345-1715

 

Laboratory medicine is undergoing major changes with emphasis on precision medicine and personalized care. It is finally at the forefront of the fight against disease. This is the era of “High Stakes Diagnosis” and Molecular diagnostics is at the core of this paradigm shift. As we embark on these exciting times, there are emerging challenges and questions that will change the way we practice our discipline and break down our current ‘silos’. The challenges are at multiple fronts: resources, leadership of the molecular lab, training of our residents and lab medicine professionals.

Resources have not kept pace with the increasing demands and workload for pathologists. Over the last 30 years there has been an evolution of the pathologist from a generalist to a specialist in a specific tumour site. Today, this specialization extends even further, requiring pathologists to be increasingly comfortable in incorporating results from molecular tests into their practice. Pathologists are key members of multidisciplinary tumour boards. They are faced with ethical issues of when to test a patient’s cancer, i.e. early in the natural history of the cancer versus at metastases. The age of precision medicine provides exciting opportunities for pathologists to perform cutting edge research. Are pathologists availing themselves of this opportunity? Recent studies comparing artificial intelligence (AI) algorithms with a panel of pathologists for diagnosis of cancer have shown that AI was as good as pathologists. This observation is thought-provoking but importantly, is the technology potentially disruptive for the pathology field? Finally, the cost of healthcare continues to rise at an alarming rate, yet physicians are caught between being advocates for their patients versus maximizing limited resources to benefit the most people. Pathologists will need to be part of these difficult discussions.

 

This symposium is structured to enable some of the experts within our national organizations to talk, debate and share their stories and expertise and more importantly answer questions from the audience about this critical area of medicine. Ultimately it is the pathologists who will be tasked with helping to make sense of much new knowledge, and advocate for patients along with their clinical and molecular genetics colleagues in an environment of fiscal restraints. The symposium also aims to have an interactive discussion about who leads the molecular pathology lab, what does it means to have a dyad and where do partnerships fit into the conversation.

The symposium will have short “elevator pitch” presentations by keynote speakers followed by two interactive panel discussions with interactions with the audience.

 

3 questions to be addressed:

  • Who should run the molecular pathology labs
  • How best do you create a collaborative functional integrated molecular pathology laboratory
  • How best to create harmonized information to clinicians in a clear concise fashion with recommendations

Goals and Objectives:

At the end of this symposium participants will be able to:

  • Create a framework for how best to run a collaborative molecular lab.
  • Describe how leadership impacts on issues like workflow and ultimately, in the success of a molecular lab.
  • Describe the advantage of integrated, interpretative pathology reports which include pertinent molecular testing results.
  • Recognize the importance of integrated molecular reports in prognostication and patient management.
  • Identify the most important quality indicators and limitations of molecular tests, and recognize specific challenges in molecular test validation.
  • Discuss particularly significant changes in the field of pathology over the last 35 years.
  • Highlight the very important role of pathologists in both patient care and research in the age of molecular medicine.
  • Summarize the many challenges faced by pathology in the rapidly changing healthcare system.

1345-1515 Part I

How does a functional molecular pathology department work in Canada?

 

Overview

George M. Yousef, University of Toronto, St. Michael’s Hospital

Introduction to molecular pathology and how it functions in the Canadian Landscape – (current state).

 

Brief Presentations Addressing the Questions Below

Christopher Howlett, Western University

Harriet Feilotter, Queen’s University

  • Who should run the molecular pathology labs
  • How best do you create a collaborative functional program

Panel Discussion

Moderators:

Nadia Ismiil, University of Toronto, Sunnybrook Health Sciences Centre

David Lebrun, Queen’s University

 

Panelists:

Harriet Feilotter, Queen’s University

Christopher Howlett, Western University

Mark Levine, McMaster University

George M. Yousef, University of Toronto, St. Michael’s Hospital

  1. Describe one of the successes/achievements and what do you think contribute to this success (support from department, role of industry etc.).
  2. Could you identify some of the challenges /barriers to implementing new testing or reporting?
  3. Are there issues with respect to quality (including things such as turnaround times etc.) that you feel need more attention and how do you address this?
  4. Where do you feel that the Canadian training programs should be headed with respect to training of residents technologists etc.?

1515-1545 Refreshment Break

 

1545-1715 Part II

Role of Biomarkers and the Value of Pathology Information: The Evolving Role of the Pathologist in the Era of Precision Medicine

Guest Speaker (Medical Oncologist):Mark Levine, McMaster University

 

Panel Discussion

Moderators:

Catherine Ross, McMaster University

Monalisa Sur, McMaster University

 

Panelists:

Harriet Feilotter, Queen’s University

Christopher Howlett, Western University

David Lebrun, Queen’s University

Mark Levine, McMaster University

George M. Yousef, University of Toronto, St. Michael’s Hospital

 

How best to create harmonized information to clinicians in a clear concise fashion with recommendations?

How are molecular results and information best delivered to our clinical colleagues?

  1. What are the critical components of the report and how should they be written/how are reports best integrated with the patient information?
  2. How do you try to create a meaningful transition between current clinical practice and planning for the future?
  3. How do we train future generations of pathologists?

 

 

Forensic Pathology Section Symposium: Detection and Documentation of Fractures in the Deceased Infant and Small Child & Unusual Child Deaths
Monday July 9, 1345-1715

 

1345-1515 PART I

 

1515-1545 Refreshment Break

 

1545-1715 PART II

 

Detection and Documentation of Fractures in the Deceased Infant and Small Child & Unusual Child Deaths

Andrew Baker, Chief Medical Examiner Hennepin County

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Incorporate postmortem plain film radiography in the autopsy of deceased infants and small children.
  • Describe the gross and histological features useful in assessing acute and healing fractures in the deceased infants and small child.
  • Explain the importance of proper fracture identification and classification in the investigation of pediatric deaths.
  • Integrate findings outside of the traditional autopsy in the investigation of unusual pedia.

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Biobanking Special Interest Group Symposium: Biobanking: A Forum for Discussion and Networking
Monday July 9, 1545-1715

 

Sidney Croul, Capital Health

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Workshop: Boosting the Role of Cytopathology in the Molecular Era – Lung Cancer Paving the Way
Monday July 9, 1345-1515

 

Omar Al-Nourhji, University of Saskatchewan, Saskatoon City Hospital

Harman Sekhon, University of Ottawa, The Ottawa Hospital

 

Learning Objectives:

At the end of this workshop participants will be able to:

  • Describe the cytomorphologic features of common primary pulmonary malignancies in cytologic specimens with an emphasis on histologic correlation and updated cytologic diagnostic terminology for lung carcinoma and immunohistochemical profiling for specific diagnosis.
  • Learn the value of radio-morphological features, techniques of image guided tissue acquisition and utility of multidisciplinary approach to integrate and constructyour cytologic diagnosis of lung cancer.
  • Describe the role of cytopathologist in patient management beyond diagnosis to guide targeted therapies by improving tissue acquisition, performing tumour adequacy assessment, tissue conservation by optimizing diagnostic protocols and prioritizing molecular testing.
  • Review the need for molecular testing and when to order testing.
  • Describe when to order and which tests to order as it relates to tissue selection.
  • Review when to test for test protocols.

Fine needle aspiration is commonly used to diagnose and stage lung malignancies. While the amount of tissue provided to pathologists is decreasing, the volume of information requested by clinicians is increasing. This session will detail the diagnostic features of malignant entities encountered in respiratory cytologic specimens and their histologic correlates. A practical approach to immunohistochemical workup with an emphasis on tissue preservation will be outlined. The radiologic characteristics of primary lung malignancies will be discussed with emphasizes on tissue acquisition procedures and the pathologists role in specimen optimization.

Finally, a detailed outline of the cytopathologist’s role in molecular testing will be addressed (Indications for testing, tissue selection and optimization, methods of molecular testing).

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Workshop: NIFT-P of the Thyroid, Friend or Foe – A Review of the Most Recent Classification of the Thyroid Tumors
Monday July 9, 1545-1715

 

Olga Gologan, Centre hospitalier de l’Université de Montréal (CHUM)

 

The follicular variant of papillary carcinoma remains a diagnostic challenge and a therapeutic dilemma. The NIFT-P concept was adopted in order to select those indolent neoplasms which can be cured by lobectomy, eliminating the “carcinoma” label. The presentation will include cases demonstrating the diagnostic algorithm, cytological correlation and clinico-pathological significance of this entity. Challenges, limitations and applicable ancillary tests are also discussed.

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Workshop: Pathological Assessment of Breast Cancer Post-neoadjuvant Therapy
Monday July 9, 1545-1715

 

Fang-i Lu, Sunnybrook Health Sciences Centre

Steffi Regpala, Sunnybrook Health Sciences Centre

 

Learning Objectives:

At the end of this workshop participants will be able to:

  • List indications for neoadjuvant therapy in breast cancer .
  • Recognize the clinical relevance of pathologic response post neoadjuvant therapy.
  • Optimally examine and sample breast specimens post neoadjuvant therapy.
  • Evaluate and report residual breast cancer post neoadjuvant therapy using the Residual Cancer Burden (RCB) method.

This workshop will be co-chaired by a breast pathologist and pathologists’ assistant experiences in the examination of breast specimins post neoadjuvant therapy. The workshop will consist of 3 didactic lectures, followed by a 30 minute interactive component. During the first 30 minute lecture , the pathologist will discuss varous methos of assessing and reporting residual breast cancer post neoadjuvant therapy. We also plan to conduct a Pan-Canadian survey on the current state of handling and reporting of breast cancer post neoadjuvant therapy in Canada and share our results during this workshop.

During the second 15-minute lecture, the pathologist assistant will discuss various issues in the gross examination of breast specimen post-neoadjuvant therapy and ways to overcome them, using real-life examples that we have encountered at our center.

During the third 15-minute lecture, the pathologist will discuss various issues specific to the microscopic examination and reporting of breast cancer post-neoadjuvant therapy, focusing on the use of Residual Cancer Burden (RCB) method to report residual breast cancer, using real-life examples that we have encountered at our center.

During the 30-minute interactive component, the participants will be quizzed on various issues discussed during the lectures, and will practice examination and reporting of several actual breast cancer cases using color photographs and virtual slides.

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Dr. Cam Coady Symposium: From Bench to Bedside: Implementation of Predictive Biomarker Tests
Tuesday July 10, 0830-0945

 

Christian Couture, Institut universitaire de cardiologie et de pneumologie de Quebec

Patrice Desmeules, Institut the Cardiologie et Pneumologie du Quebec

Philippe Joubert, Quebec Heart and Lung Institute

 

Learning Objectives:

At the end of this presentation, the participant will be able to:

  • Describe the steps in designing and implementing biomarker testing from tissue and cytology samples.
  • Discuss key quality assurance steps relevant to biomarker testing.
  • Compare different strategies and platforms for biomarker analysis in the era or personalized medicine.

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Hematopathology Section Symposium: Mimics and Pitfalls in Diagnosing Myeloid Neoplasms
Tuesday July 10, 1015-1215

 

Robert Hasserjian, Harvard Medical School

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Recognize clues that suggest a non-myeloid etiology for cytopenias and elevated peripheral blood counts.
  • Understand how to incorporate ancillary testing information in distinguishing between morphologically similar myeloid neoplasms.
  • Adopt the diagnostic criteria for new and revised entities in the 2016 WHO Classification of Myeloid Neoplasms.

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Evidence-Based Medicine Section Symposium: Evaluating Biomarkers for Practice Readiness
Tuesday July 10, 1015-1215

 

Predictive markers in Pathology Practice: Evidence We Wish For vs Evidence We Have

Nickolas Myles, University of British Columbia

 

Economic Evaluation – the Basics

Clare Reade, McMaster University

 

Learning Objectives:

At the end of this presentation participants will be able to:

  • Describe the types of economic evaluations.
  • Summarize the statistical analyses underpinning economic evaluations.
  • Discuss how economic evaluations are being used to guide health care decision-making .

Laboratory Test Funding – Working with Ministry Partners in Challenging Times

Aaron Pollett, University of Toronto

 

Learning Objectives:

At the end of this presentation participants will be able to:

  • Discuss the issues which impact ministry funding decisions.
  • Outline the approach and successes Cancer Care Ontario has had in obtaining funding for molecular biomarkers.
  • Discuss how to present evidence to ministry regarding biomarker.

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Humanities and International Health Section Symposium: Pathology: An Essential Core Element to Successful Cancer Care in Low and Middle Income Countries (LMICs)
Tuesday July 10, 1015-1215

 

Dan Milner, American Society for Clinical Pathology

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Describe the current status of cancer care and pathology in LMICs.
  • Discuss the challenges facing pathology services in LMICs.
  • Compare current solutions being applied to pathology and cancer in LMICs.
  • Identify volunteer opportunities to assist LMICs (as possible).

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Workshop: Glandular Lesions of the Cervix, Endometrium and Ovary: an Update for the Practicing Pathologist
Tuesday July 10, 1015-1215

 

Bojana Djordjevic, Sunnybrook Health Sciences Centre

Mary Kinloch, Saskatoon City Hospital

Carlos Parra-Herran, Sunnybrook Health Sciences Centre

 

Learning Objectives:

At the end of this workshop participants will be able to:

  • Utilize current morphologic (including pattern-based assessment), immunohistochemical and molecular tools used in the interpretation and classification of in-situ and invasive endocervical glandular neoplasia.
  • Review the strengths and limitations of morphology, immunohistochemistry and molecular testing in the classification of endometrial carcinoma, and the appropriate role of these elements in endometrial carcinoma work-up including Lynch syndrome screening.
  • Assess the response of endometrial hyperplasia and neoplasia to progestin therapy in a systematic and organized manner and make recommendations with respect to patient follow-up.
  • Apply the concept of site assignment in high-grade serous carcinoma using International Collaboration on Cancer Reporting (ICCR) nomenclature and formulate a plan for using immunohistochemistry to distinguish primary ovarian from metastatic tumors.
  • Describe recent insights into synchronous and metachronous endometrial and ovarian tumors with resulting changes to diagnostic practice and clinical management.

This course will address a variety of emerging concepts in cervical, endometrial and tubo-ovarian carcinoma pathology and how they pertain to daily clinical practice.

On the subject of cervical glandular neoplasia (Dr. Parra-Herran), topics will include the application of the pattern-based assessment of stromal invasion by endocervical adenocarcinoma, distinction of in-situ from invasive endocervical adenocarcinoma, and an overview of the wide spectrum of non-HPV mediated cervical adenocarcinomas (gastric-type, clear cell, mesonephric).

Regarding endometrial carcinoma (Dr. Djordjevic), discussion will cover recent insights into endometrial tumor biology and what currently available ancillary testing may help with endometrial carcinoma classification, approach to interpretation of endometrial hyperplasia and low grade carcinoma treated with progestins, and adoption of endometrial tumor testing for Lynch Syndrome in the pathology laboratory.

In the field of tubo-ovarian carcinoma (Dr. Kinloch), the course will address current paradigms and tools for the histologic classification of ovarian carcinoma and assignment of site of origin, the diagnostic challenge and clinical implications of metachronous and synchronous ovarian and endometrial carcinomas, and a practical immunohistochemical approach to the distinction between primary and metastatic ovarian neoplasms.

This course is designed for general pathologists and pathology residents and will assume a case-based approach. Pre-meeting materials will be available to the participants prior to the commencement of the course. Audience participation and questions will be encouraged at the end of each course segment.

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Joint CAP-ACP/CAMB Symposium: Application of Liquid Biopsy
Tuesday July 10, 1015-1215

 

Co-Chairs:

CAP-ACP: Jimin (Nancy) Liu, Halton Healthcare

CAMB: Brian M. Gilfix, McGill University

 

1015-1055

NGS Analysis of Circulating Cell-free DNA for Prenatal Screening of Fetal Chromosomal Anomalies and Potential Non-oncologic Applications

Francois Rousseau, CHU de Québec-université Laval

 

1055-1135

Droplet Digital PCR in Molecular Pathology: Liquid Biopsy Applications in Solid Tumors Diagnosis and Patient’s Management

Philippe Joubert, Institut universitaire de cardiologie et de pneumologie de Québec; Université Laval

 

1135-1215

Liquid Biopsy by Massively Parallel Sequencing: Ready for Prime Time?

Harriet Feilotter, Queen’s University

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Education Section Symposium: Health Care is a Team Sport: Moving Beyond Individual Competence to Collective Competence
Tuesday July 10, 1345-1515

 

1345-1515 PART I

 

Bridging the Gap Between Individual and Collective Competence in Pathology and Health Care

Stefanie Sebok-Syer, Western University

 

Learning Objectives:

At the end of this symposium participants will be able to:

  • Describe the concept of collective competence and recognize its significance in medical education.
  • Identify the role of collective competence as it applies to pathology training and clinical practice.
  • Examine how collective competence is enacted in various pathology and laboratory medicine settings.

Residents-as-Leaders Presentation: Delineating Individual Trainee Competence from the Overall Collective Competence of the Health Care Team

Matt Cecchini, London Health Sciences Centre

 

1515-1545 Refreshment Break

 

1545-1715 PART II

 

Residents-as-Leaders presentation: Delineating individual trainee competence from the overall collective competence of the health care team

Andrew Brack, Calgary Laboratory Services

Linton (David) Sellen, University of Manitoba

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General Pathology Section Symposium
Tuesday July 10, 1345-1715

 

1345-1515 PART I

 

Current Updates on Serum Protein Electrophoresis: Challenges and Barriers to Harmonizing Reporting Practices

Pak-Cheung Chan, Sunnybrook Health Sciences Centre

 

Competency by Design: The Changing Landscape of General Pathology

Heidi Paulin, University of Calgary, Red Deer Regional Hospital

 

When Opportunity Knocks – Aspects of a Business Case for the Busy Lab Director

Katherine Chorneyko, Brant Community Healthcare System

 

1515-1545 Refreshment Break

 

1545-1645 PART II

 

An Approach to Haemoglobinopathy Investigations

Elaine Leung, Children’s Hospital of Eastern Ontario

 

Integration of General Pathology and Anatomic Pathology in Daily Practice: Case-based Discussion in Autopsy, Gastrointestinal and Liver Pathology

Ipshita Kak, Mount Sinai Hospital

Linda Kocovski, Hamilton Regional Forensic Pathology Unit

Jimin (Nancy) Liu, Halton Healthcare

 

1645-1715 PART III

 

CAP-ACP General Pathology Section Annual General Meeting

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Workshop: Diagnostic Devils and Rogue Results in Molecular Pathology, OMPRN
Tuesday July 10, 1345-1715

 

Chair: David LeBrun, Queen’s University

 

1345-1515 PART I

 

1515-1545 Refreshment Break

 

1545-1715 PART II

 

This workshop, developed through the Ontario Molecular Pathology Research Network, will focus on technical and interpretive challenges that arise in the application of molecular assays that are used broadly and increasingly in diagnostic cancer pathology. The session will be divided into three sections as follows:

  1. PCR-based assays for the detection of sequence variants and the quantification of aberrant transcripts
    • 1330-1430
    • Session Leader:
      Tracy Stockley, University Health Network
  2. Fluorescence in situ hybridization for the detection of gene copy number variation or rearrangement in routine histology sections
    • 1430-1530
    • Session Leaders:
      John Bartlett, Ontario Institute for Cancer Research
      Susan Crocker, Queen’s University
  3. Targeted gene sequencing with multi-gene panels
    • 1600-1700
    • Session Leaders:
      John Bartlett, Ontario Institute for Cancer Research
      Harriet Feilotter, Queen’s University

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Informatics, Digital Resources & Social Media Special Interest Group Symposium: Evolving Era of Digital Medicine: Impact on Pathologist’s Daily Practice
Tuesday July 10, 1345-1515

 

Learning Objectives:

At the end of this presentation attendants will be able to:

  • List ways digital resources can directly benefit your practice and career.
  • Describe a variety of educational pathology related applications for digital resources and social media.
  • Discuss adoption of telepathology in clinical practice with its requirements and challenges.
  • Develop lab informatics collaboration applications.

Any laboratory physician or trainee with an interest in using social media, digital resources and informatics as professional tools will benefit from this symposium. We will discuss how technology has changed the landscape of pathology practice, research, and education. Attendees will get a sense of various niche applications of technology in their careers, such as pathology education, adoption of technology in routine clinical use and nationwide collaborations.

 

1345-1405

Interactive OSCE Module for Anatomical Pathology Competency Assessment

George M. Yousef, University of Toronto, St. Michael’s Hospital

 

1405-1425

The Canadian Laboratory Informatics Collaboration

Christopher Naugler, University of Calgary, Calgary Laboratory Services

 

1425-1445

Telepathology in Routine Pathology Practice

Andrew Evans, University Health Network

 

1445-1500

Clinician Driven Web Based Pathology Module for Nonpathologists

Adriana Krizova, St. Michael’s Hospital

 

1500-1515

Panel Discussion: The Next Steps: An Action Plan to Push Forward a Digital Pathology Agenda in Canada

Andrew Evans, University Health Network

Adriana Krizova, St. Michael’s Hospital

Christopher Naugler, University of Calgary, Calgary Laboratory Services

George M. Yousef, University of Toronto, St. Michael’s Hospital

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Workshop: Practice Approach to Mismatch Repair Testing
Tuesday July 10, 1545-1715

 

Lien Hoang, Vancouver General Hospital

Mary Kinloch, Saskatoon City Hospital

David Schaeffer, Vancouver General Hospital

 

The purpose of this in-session course is to provide a practical approach to Mismatch Repair (MMR) testing in gastrointestinal and gynecologic tumours. The scope of the session will include issues ranging from pre-analytic considerations, analytic interpretation and post-analytic communicative and consultative topics. The course is intended for pathology residents and practicing pathologists and will serve as a complete guide for navigating MMR testing.

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Closing Plenary: The Evolving Role of Pathology in Multidisciplinary Teams
Tuesday July 10, 1730-1815

 

Judith Hugh, University of Alberta

 

Learning Objectives:

At the end of this presentation attendants will be able to:

  • Discuss the evolving role of pathologists in health care teams.
  • Describe the importance of leadership skills to the current practice of pathology.

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