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Image analysis as an adjunct to manual HER-2 immunohistochemical review: a diagnostic tool to standardize interpretation
Article first published online: 24 JUN 2010
© 2010 Blackwell Publishing Limited
Volume 57, Issue 1, pages 27–38, July 2010
How to Cite
Dobson, L., Conway, C., Hanley, A., Johnson, A., Costello, S., O’Grady, A., Connolly, Y., Magee, H., O’Shea, D., Jeffers, M. and Kay, E. (2010), Image analysis as an adjunct to manual HER-2 immunohistochemical review: a diagnostic tool to standardize interpretation. Histopathology, 57: 27–38. doi: 10.1111/j.1365-2559.2010.03577.x
- Issue published online: 9 JUL 2010
- Article first published online: 24 JUN 2010
- Date of submission 23 March 2009 Accepted for publication 6 October 2009
- fluorescence in situ hybridization;
- image analysis;
- virtual slides
Dobson L, Conway C, Hanley A, Johnson A, Costello S, O’Grady A, Connolly Y, Magee H, O’Shea D, Jeffers M & Kay E (2010) Histopathology 57, 27–38 Image analysis as an adjunct to manual HER-2 immunohistochemical review: a diagnostic tool to standardize interpretation
Aims: Accurate determination of HER-2 status is critical to identify patients for whom trastuzumab treatment will be of benefit. Although the recommended primary method of evaluation is immunohistochemistry, numerous reports of variability in interpretation have raised uncertainty about the reliability of results. Recent guidelines have suggested that image analysis could be an effective tool for achieving consistent interpretation, and this study aimed to assess whether this technology has potential as a diagnostic support tool.
Methods and results: Across a cohort of 275 cases, image analysis could accurately classify HER-2 status, with 91% agreement between computer-aided classification and the pathology review. Assessment of the continuity of membranous immunoreactivity in addition to intensity of reactivity was critical to distinguish between negative and equivocal cases and enabled image analysis to report a lower referral rate of cases for confirmatory fluorescence in situ hybridization (FISH) testing. An excellent concordance rate of 95% was observed between FISH and the automated review across 136 informative cases.
Conclusions: This study has validated that image analysis can robustly and accurately evaluate HER-2 status in immunohistochemically stained tissue. Based on these findings, image analysis has great potential as a diagnostic support tool for pathologists and biomedical scientists, and may significantly improve the standardization of HER-2 testing by providing a quantitative reference method for interpretation.