ArticleLaboratory investigation; a journal of technical methods and pathology2019
Ki67 reproducibility using digital image analysis: an inter-platform and inter-operator study.
Article in Laboratory investigation; a journal of technical methods and pathology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 2 of them syntheses that pooled it.
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Who cites it
70 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Ki67 in Breast Cancer Assay: An Ad Hoc Testing Recommendation from the Canadian Association of Pathologists Task Force.Current oncology (Toronto, Ont.) · 2023Guideline
- Evaluation of the Suitability of RNAscope as a Technique to Measure Gene Expression in Clinical Diagnostics: A Systematic Review.Molecular diagnosis & therapy · 2022Pooled it
- Neoadjuvant palbociclib and endocrine therapy versus chemotherapy in ER + /HER2- breast cancer: a randomized phase II trial.Nature communications · 2026Trial
- AI-Assisted Scoring Improves Interobserver Agreement in Breast Cancer Biomarker Evaluation.Cancers · 2026Article
- Tumor slice cultures enable rapid ex vivo profiling of patient-specific drug sensitivity in pancreatic ductal adenocarcinoma.NPJ precision oncology · 2026Article
- Low KIF4A expression is associated with gastric cancer progression and aggressive phenotypes.Scientific reports · 2026Article
- Article
- Evaluating the Impact of a Ki-67 Decision Support Algorithm on Pathology Residents' Scoring Accuracy.Journal of imaging informatics in medicine · 2026Article
- Prognostic relevance of MIB-1 labeling index in VHL-associated and sporadic spinal hemangioblastomas: a subgroup analysis from a multicentric study.Acta neuropathologica communications · 2025Article
- Early-stage lung adenocarcinoma affects DNA methylation and gene expression in adjacent tissues.EMBO reports · 2025Article
- Comparison of QuPath and HALO Platforms for Analysis of the Tumor Microenvironment in Prostate Cancer.Laboratory investigation; a journal of technical methods and pathology · 2025Article
- Reproducibility of Ki67 Haralick entropy as a prognostic marker in estrogen receptor-positive HER2-negative breast cancer.American journal of clinical pathology · 2025Article
- The case for homebrew AI in diagnostic pathology.The Journal of pathology · 2025Article
- Digital pathology in tau research: A comparison of QuPath and HALO.Journal of neuropathology and experimental neurology · 2025Article
- Comparing non-machine learning vs. machine learning methods for Ki67 scoring in gastrointestinal neuroendocrine tumors.Scientific reports · 2025Article
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- Article
- A deep learning model to predict Ki-67 positivity in oral squamous cell carcinoma.Journal of pathology informatics · 2024Article
- Biomarkers in breast cancer 2024: an updated consensus statement by the Spanish Society of Medical Oncology and the Spanish Society of Pathology.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024Article
- Flow cytometric analysis for Ki67 assessment in formalin-fixed paraffin-embedded breast cancer tissue.BMC biology · 2024Article
10 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ki67 expression has been a valuable prognostic variable in breast cancer, but has not seen broad adoption due to lack of standardization between institutions. Automation could represent a solution. Here we investigate the reproducibility of Ki67 measurement between three image analysis platforms with supervised classifiers performed by the same operator, by multiple operators, and finally we compare their accuracy in prognostic potential. Two breast cancer patient cohorts were used for this study. The standardization was done with the 30 cases of ER+ breast cancer that were used in phase 3 of International Ki67 in Breast Cancer Working Group initiatives where blocks were centrally cut and stained for Ki67. The outcome cohort was from 149 breast cancer cases from the Yale Pathology archives. A tissue microarray was built from representative tissue blocks with median follow-up of 120 months. The Mib-1 antibody (Dako) was used to detect Ki67 (dilution 1:100). HALO (IndicaLab), QuantCenter (3DHistech), and QuPath (open source software) digital image analysis (DIA) platforms were used to evaluate Ki67 expression. Intraclass correlation coefficient (ICC) was used to measure reproducibility. Between-DIA platform reproducibility was excellent (ICC: 0.933, CI: 0.879-0.966). Excellent reproducibility was found between all DIA platforms and the reference standard Ki67 values of Spectrum Webscope (QuPath-Spectrum Webscope ICC: 0.970, CI: 0.936-0.986; HALO-Spectrum Webscope ICC: 0.968, CI: 0.933-0.985; QuantCenter-Spectrum Webscope ICC: 0.964, CI: 0.919-0.983). All platforms showed excellent intra-DIA reproducibility (QuPath ICC: 0.992, CI: 0.986-0.996; HALO ICC: 0.972, CI: 0.924-0.988; QuantCenter ICC: 0.978, CI: 0.932-0.991). Comparing each DIA against outcome, the hazard ratios were similar. The inter-operator reproducibility was particularly high (ICC: 0.962-0.995). Our results showed outstanding reproducibility both within and between-DIA platforms, including one freely available DIA platform (QuPath). We also found the platforms essentially indistinguishable with respect to prediction of breast cancer patient outcome. Results justify multi-institutional DIA studies to assess clinical utility.
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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.