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Updated: May 30, 2026
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Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma
Published on: January 9, 2019
Quantitative image analysis in the assessment of diffuse large B-cell lymphoma
Devon S Chabot-Richards1, David R Martin, Orrin B Myers
1Department of Pathology, University of New Mexico, Albuquerque, NM, USA.
Summary
Pathologist assessment of Ki-67 proliferation rates in diffuse large B-cell lymphoma showed a trend toward poorer survival, unlike quantitative image analysis. Pathologist estimates may be more clinically relevant despite good correlation with automated methods.
Area of Science:
- Oncology
- Pathology
- Biomedical Engineering
Background:
- Proliferation rates in diffuse large B-cell lymphoma (DLBCL) are linked to patient outcomes, but estimates vary.
- Traditionally, Ki-67 immunohistochemistry assessed by pathologists determines proliferation, yet its prognostic value is debated.
- Quantitative image analysis offers a potential alternative for precise proliferation assessment.
Purpose of the Study:
- To compare Ki-67 proliferation rate estimation between pathologists and a quantitative image analysis algorithm in DLBCL.
- To evaluate the association of both estimation methods with patient survival outcomes.
- To determine if quantitative image analysis provides superior prognostic information compared to pathologist assessment.
Main Methods:
- Eighty-four DLBCL cases were analyzed using WHO criteria.
- Ki-67 percentage positivity was recorded from original pathologist reports.
- The same slides underwent quantitative image analysis using a validated algorithm.
- Survival data was collected via chart review.
Main Results:
- Pathologist and quantitative image analysis Ki-67 estimates were significantly correlated (P<0.001).
- Pathologist Ki-67 percentages were significantly higher than quantitative analysis (P=0.021), with less agreement at lower percentages.
- Neither method showed a statistically significant association with survival, though a trend of worse survival with higher pathologist-estimated Ki-67 was observed.
Conclusions:
- Pathologist assessment of Ki-67 may hold greater prognostic significance for DLBCL survival than quantitative image analysis, despite good correlation between methods.
- Pathologists might excel at identifying prognostically relevant tumor areas.
- Further studies with larger cohorts are needed to confirm the statistical significance of these findings and the clinical utility of quantitative image analysis in DLBCL.
