ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2016
Digital image analysis outperforms manual biomarker assessment in breast cancer.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
77 citing papers in PubMed, 179 citations in OpenAlex.
- Artificial intelligence-supported segmentation of cardiac anatomy in open-heart surgery videos.Journal of robotic surgery · 2026Article
- Low KIF4A expression is associated with gastric cancer progression and aggressive phenotypes.Scientific reports · 2026Article
- Estimating tumour immune infiltration: methodological convergence across histology and spatial technologies.Briefings in bioinformatics · 2026Review
- MicroRNA-Directed Biomarkers and Breast Cancer Therapeutics-Potential to Advance Personalised Approaches in Clinical Trials.International journal of molecular sciences · 2026Review
- Machine Learning in Biomarker-Driven Precision Oncology: Automated Immunohistochemistry Scoring and Emerging Directions in Genitourinary Cancers.Current oncology (Toronto, Ont.) · 2026Review
- Reliability of stromal markers multiplex immunofluorescent staining: pathologist assessment compared to quantitative image analysis.American journal of cancer research · 2026Article
- Artificial Intelligence as an Assistive Tool in Breast Cancer Screening and Diagnosis in the Digital Era.International journal of breast cancer · 2026Article
- AI-powered spatial cell phenomics enhances risk stratification in non-small cell lung cancer.Nature communications · 2025Article
- Use of AI Histopathology in Breast Cancer Diagnosis.Medicina (Kaunas, Lithuania) · 2025Review
- Can mutation abundance assess the biological behavior of BRAFJournal of translational medicine · 2025Article
- Immunohistochemical expression of smoothened in periocular basal cell, squamous cell and sebaceous carcinomas.Scientific reports · 2025Article
- Innovative approach for the qualitative-quantitative assessment of neurodevelopment biomarkers research in placenta tissue using immunohistochemistry digital image analysis.Biology methods & protocols · 2025Article
- Computational pathology in the identification of HER2-low breast cancer: Opportunities and challenges.Journal of pathology informatics · 2024Review
- The Performance and Clinical Applicability of HER2 Digital Image Analysis in Breast Cancer: A Systematic Review.Cancers · 2024Review
- The Ki67 dilemma: investigating prognostic cut-offs and reproducibility for automated Ki67 scoring in breast cancer.Breast cancer research and treatment · 2024Article
- Digital Validation in Breast Cancer Needle Biopsies: Comparison of Histological Grade and Biomarker Expression Assessment Using Conventional Light Microscopy, Whole Slide Imaging, and Digital Image Analysis.Journal of personalized medicine · 2024Article
- Quantitative immunohistochemistry analysis of breast Ki67 based on artificial intelligence.Open life sciences · 2024Article
- Digital pathology systems enabling quality patient care.Genes, chromosomes & cancer · 2023Review
- Artificial intelligence in diagnostic pathology.Diagnostic pathology · 2023Review
- Use of a Novel Deep Learning Open-Source Model for Quantification of Ki-67 in Breast Cancer Patients in Pakistan: A Comparative Study between the Manual and Automated Methods.Diagnostics (Basel, Switzerland) · 2023Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In the spectrum of breast cancers, categorization according to the four gene expression-based subtypes 'Luminal A,' 'Luminal B,' 'HER2-enriched,' and 'Basal-like' is the method of choice for prognostic and predictive value. As gene expression assays are not yet universally available, routine immunohistochemical stains act as surrogate markers for these subtypes. Thus, congruence of surrogate markers and gene expression tests is of utmost importance. In this study, 3 cohorts of primary breast cancer specimens (total n=436) with up to 28 years of survival data were scored for Ki67, ER, PR, and HER2 status manually and by digital image analysis (DIA). The results were then compared for sensitivity and specificity for the Luminal B subtype, concordance to PAM50 assays in subtype classification and prognostic power. The DIA system used was the Visiopharm Integrator System. DIA outperformed manual scoring in terms of sensitivity and specificity for the Luminal B subtype, widely considered the most challenging distinction in surrogate subclassification, and produced slightly better concordance and Cohen's κ agreement with PAM50 gene expression assays. Manual biomarker scores and DIA essentially matched each other for Cox regression hazard ratios for all-cause mortality. When the Nottingham combined histologic grade (Elston-Ellis) was used as a prognostic surrogate, stronger Spearman's rank-order correlations were produced by DIA. Prognostic value of Ki67 scores in terms of likelihood ratio χ(2) (LR χ(2)) was higher for DIA that also added significantly more prognostic information to the manual scores (LR-Δχ(2)). In conclusion, the system for DIA evaluated here was in most aspects a superior alternative to manual biomarker scoring. It also has the potential to reduce time consumption for pathologists, as many of the steps in the workflow are either automatic or feasible to manage without pathological expertise.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.