{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:47:13Z","timestamp":1790272033173,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T00:00:00Z","timestamp":1720915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study evaluated the diagnostic effectiveness of the AIxURO platform, an artificial intelligence\u2013based tool, to support urine cytology for bladder cancer management, which typically requires experienced cytopathologists and substantial diagnosis time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One cytopathologist and two cytotechnologists reviewed 116 urine cytology slides and corresponding whole\u2010slide images (WSIs) from urology patients. They used three diagnostic modalities: microscopy, WSI review, and AIxURO, per The Paris System for Reporting Urinary Cytology (TPS) criteria. Performance metrics, including TPS\u2010guided and binary diagnosis, inter\u2010 and intraobserver agreement, and screening time, were compared across all methods and reviewers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>AIxURO improved diagnostic accuracy by increasing sensitivity (from 25.0%\u201330.6% to 63.9%), positive predictive value (PPV; from 21.6%\u201324.3% to 31.1%), and negative predictive value (NPV; from 91.3%\u201391.6% to 95.3%) for atypical urothelial cell (AUC) cases. For suspicious for high\u2010grade urothelial carcinoma (SHGUC) cases, it improved sensitivity (from 15.2%\u201327.3% to 33.3%), PPV (from 31.3%\u201347.4% to 61.1%), and NPV (from 91.6%\u201392.7% to 93.3%). Binary diagnoses exhibited an improvement in sensitivity (from 77.8%\u201382.2% to 90.0%) and NPV (from 91.7%\u201393.4% to 95.8%). Interobserver agreement across all methods showed moderate consistency (\u03ba\u00a0=\u00a00.57\u20130.61), with the cytopathologist demonstrating higher intraobserver agreement than the two cytotechnologists across the methods (\u03ba\u00a0=\u00a00.75\u20130.88). AIxURO significantly reduced screening time by 52.3%\u201383.2% from microscopy and 43.6%\u201386.7% from WSI review across all reviewers. Screening\u2010positive (AUC+) cases required more time than negative cases across all methods and reviewers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AIxURO demonstrates the potential to improve both sensitivity and efficiency in bladder cancer diagnostics via urine cytology. Its integration into the cytopathological screening workflow could markedly decrease screening times, which would improve overall diagnostic processes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncy.22884","type":"journal-article","created":{"date-parts":[[2024,7,14]],"date-time":"2024-07-14T10:26:27Z","timestamp":1720952787000},"page":"686-695","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Evaluating artificial intelligence\u2013enhanced digital urine cytology for bladder cancer diagnosis"],"prefix":"10.1002","volume":"132","author":[{"given":"Tien\u2010Jen","family":"Liu","sequence":"first","affiliation":[{"name":"AIxMed, Inc.  Santa Clara California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Chi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Post\u2010Baccalaureate Medicine College of Medicine National Chung Hsing University  Taichung Taiwan"},{"name":"Department of Pathology Show Chwan Memorial Hospital  Changhua Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin\u2010Min","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pathology Show Chwan Memorial Hospital  Changhua Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010Lei","family":"Yang","sequence":"additional","affiliation":[{"name":"AIxMed, Inc.  Santa Clara California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsing\u2010Ju","family":"Wu","sequence":"additional","affiliation":[{"name":"Research Assistant Center Show Chwan Memorial Hospital  Changhua Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui Wen","family":"Ho","sequence":"additional","affiliation":[{"name":"Research Assistant Center Show Chwan Memorial Hospital  Changhua Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Wen","family":"Hsu","sequence":"additional","affiliation":[{"name":"AIxMed, Inc.  Santa Clara California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010Hung","family":"Yeh","sequence":"additional","affiliation":[{"name":"AIxMed, Inc.  Santa Clara California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"AIxMed, Inc.  Santa Clara California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Ting","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Statistics National Taipei University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010Yi","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Post\u2010Baccalaureate Medicine College of Medicine National Chung Hsing University  Taichung Taiwan"},{"name":"Department of Pathology Show Chwan Memorial Hospital  Changhua Taiwan"},{"name":"School of Medicine College of Medicine Fu Jen Catholic University  New Taipei City Taiwan"},{"name":"National Institute of Cancer Research National Health Research Institutes  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,14]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Cancer Stat Facts: Bladder Cancer. Surveillance Epidemiology and End Results Program National Institutes of Health. Accessed December 15 2020.https:\/\/seer.cancer.gov\/statfacts\/html\/urinb.html"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2018\u20100329\u2010ra"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21253"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2022\u20100509\u2010RA"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000333938"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ppr\/114.1.s59"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(20000825)90:4<222::aid\u2010cncr4>3.0.co;2\u2010a"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23656"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22725"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22732"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15382"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.13173"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22615"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.901586"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22633"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-88686-8"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2021.12.003"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpi.2023.100346"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2016.05.028"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acuroe.2019.03.014"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/cytojournal.cytojournal_12_17"},{"issue":"9","key":"e_1_2_8_23_1","first-page":"882","article-title":"Accuracy of grading of urothelial carcinoma on urine cytology: an analysis of interobserver and intraobserver agreement","volume":"5","author":"Reid MD","year":"2012","journal-title":"Int J Clin Exp Pathol"}],"container-title":["Cancer Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncy.22884","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T18:50:36Z","timestamp":1760295036000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncy.22884"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,14]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1002\/cncy.22884"],"URL":"https:\/\/doi.org\/10.1002\/cncy.22884","archive":["Portico"],"relation":{},"ISSN":["1934-662X","1934-6638"],"issn-type":[{"value":"1934-662X","type":"print"},{"value":"1934-6638","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,14]]},"assertion":[{"value":"2024-04-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}