An Expert System for Analysis and Standardization of Bladder Carcinoma Grading

Correct evaluation of a urinary cytologic preparation is a matter of the cytologist’s experience and precise visual assessment. Up to now, the necessary skills could only be learned through regular, intensive training at the microscope and, in a very limited form, from the literature, whereby the most serious problem is a lack of standardized criteria for grading urothelial carcinoma (see Chap. 7). This causes a high rate of diagnoses of grade 2 carcinoma of the bladder, which is clinically an inhomogeneous group with respect to prognosis and clinical outcome (Jordan et al. 1987). The necessity for an analysis and a better standardization of criteria for grading bladder carcinoma is thus evident.