Ann Lab Med.  2020 Jul;40(4):312-316. 10.3343/alm.2020.40.4.312.

Development of an Automated Image Analyzer for Microvessel Density Measurement in Bone Marrow Biopsies

• Chung Y
• Shin S
• Shim H
• Sohn JY
• Lee DE
• Lee H
• Eom HS
• Kim KG
• Kong SY

• KMID: 2470327
• DOI: http://doi.org/10.3343/alm.2020.40.4.312

Abstract

Angiogenesis is important for the proliferation and survival of multiple myeloma (MM) cells. Bone marrow (BM) microvessel density (MVD) is a useful marker of angiogenesis and an increase in MVD can be used as a marker of poor prognosis in MM patients. We developed an automated image analyzer to assess MVD from images of BM biopsies stained with anti-CD34 antibodies using two color models. MVD was calculated by merging images from the red and hue channels after eliminating non-microvessels. The analyzer results were compared with those obtained by two experienced hematopathologists in a blinded manner using the 84 BM samples of MM patients. Manual assessment of the MVD by two hematopathologists yielded mean±SD values of 19.4±11.8 and 20.0±11.8. The analyzer generated a mean±SD of 19.5±11.2. The intraclass correlation coefficient (ICC) and Bland-Altman plot of the MVD results demonstrated very good agreement between the automated image analyzer and both hematopathologists (ICC=0.893 [0.840-0.929] and ICC=0.906 [0.859-0.938]). This automated analyzer can provide time- and labor-saving benefits with more objective results in hematology laboratories.

Keyword

Multiple myeloma; Bone marrow; Microvessel density; Analyzer; Development; Automation

MeSH Terms

Antibodies
Automation
Biopsy*
Bone Marrow*
Hematology
Humans
Microvessels*
Multiple Myeloma
Prognosis
Antibodies

Figure

• 

  Fig. 1 MVD being calculated by the automated image analyzer using an image (×400) of a hot spot from BM section stained with anti-CD34 antibodies. Microvessels are marked by a pink box and the MVD count is displayed at the right upper corner. Abbreviations: MVD, microvessel density; BM, bone marrow.

• 

  Fig. 2 Comparison of MVD between manual counting and the automated image analyzer for 84 BM biopsy samples from multiple myeloma patients. (A) intraclass correlation coefficient. (B) Bland-Altman plot. Abbreviations: MVD, microvessel density; BM, bone marrow; CI, confidence interval.

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