Independent Clinical Validation of the Automated Ki67 Scoring Guideline from the International Ki67 in Breast Cancer Working Group

Ki67 is an important biomarker with prognostic and potential predictive value in breast cancer. However, the lack of standardization hinders its clinical applicability. In this study, we aimed to investigate the reproducibility among pathologists following the guidelines of the International Ki67 in...

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Autores principales:	Ceren Boyaci, Wenwen Sun, Stephanie Robertson, Balazs Acs, Johan Hartman
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	Ki67 breast cancer QuPath digital image analysis validation reproducibility Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/8c9be16dc039410b9146f7c5b994c8a5
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spelling	oai:doaj.org-article:8c9be16dc039410b9146f7c5b994c8a52021-11-25T16:52:47ZIndependent Clinical Validation of the Automated Ki67 Scoring Guideline from the International Ki67 in Breast Cancer Working Group10.3390/biom111116122218-273Xhttps://doaj.org/article/8c9be16dc039410b9146f7c5b994c8a52021-10-01T00:00:00Zhttps://www.mdpi.com/2218-273X/11/11/1612https://doaj.org/toc/2218-273XKi67 is an important biomarker with prognostic and potential predictive value in breast cancer. However, the lack of standardization hinders its clinical applicability. In this study, we aimed to investigate the reproducibility among pathologists following the guidelines of the International Ki67 in Breast Cancer Working Group (IKWG) for Ki67 scoring and to evaluate the prognostic potential of this platform in an independent cohort. Four algorithms were independently built by four pathologists based on our study cohort using an open-source digital image analysis (DIA) platform (QuPath) following the detailed guideline of the IKWG. The algorithms were applied on an ER+ breast cancer study cohort of 157 patients with 15 years of follow-up. The reference Ki67 score was obtained by a DIA algorithm trained on a subset of the study cohort. Intraclass correlation coefficient (ICC) was used to measure reproducibility. High interobserver reliability was reached with an ICC of 0.938 (CI: 0.920–0.952) among the algorithms and the reference standard. Comparing each machine-read score against relapse-free survival, the hazard ratios were similar (2.593–4.165) and showed independent prognostic potential (<i>p</i> ≤ 0.018, for all comparisons). In conclusion, we demonstrate high reproducibility and independent prognostic potential using the IKWG DIA instructions to score Ki67 in breast cancer. A prospective study is needed to assess the clinical utility of the IKWG DIA Ki67 instructions.Ceren BoyaciWenwen SunStephanie RobertsonBalazs AcsJohan HartmanMDPI AGarticleKi67breast cancerQuPathdigital image analysisvalidationreproducibilityMicrobiologyQR1-502ENBiomolecules, Vol 11, Iss 1612, p 1612 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ki67 breast cancer QuPath digital image analysis validation reproducibility Microbiology QR1-502
spellingShingle	Ki67 breast cancer QuPath digital image analysis validation reproducibility Microbiology QR1-502 Ceren Boyaci Wenwen Sun Stephanie Robertson Balazs Acs Johan Hartman Independent Clinical Validation of the Automated Ki67 Scoring Guideline from the International Ki67 in Breast Cancer Working Group
description	Ki67 is an important biomarker with prognostic and potential predictive value in breast cancer. However, the lack of standardization hinders its clinical applicability. In this study, we aimed to investigate the reproducibility among pathologists following the guidelines of the International Ki67 in Breast Cancer Working Group (IKWG) for Ki67 scoring and to evaluate the prognostic potential of this platform in an independent cohort. Four algorithms were independently built by four pathologists based on our study cohort using an open-source digital image analysis (DIA) platform (QuPath) following the detailed guideline of the IKWG. The algorithms were applied on an ER+ breast cancer study cohort of 157 patients with 15 years of follow-up. The reference Ki67 score was obtained by a DIA algorithm trained on a subset of the study cohort. Intraclass correlation coefficient (ICC) was used to measure reproducibility. High interobserver reliability was reached with an ICC of 0.938 (CI: 0.920–0.952) among the algorithms and the reference standard. Comparing each machine-read score against relapse-free survival, the hazard ratios were similar (2.593–4.165) and showed independent prognostic potential (<i>p</i> ≤ 0.018, for all comparisons). In conclusion, we demonstrate high reproducibility and independent prognostic potential using the IKWG DIA instructions to score Ki67 in breast cancer. A prospective study is needed to assess the clinical utility of the IKWG DIA Ki67 instructions.
format	article
author	Ceren Boyaci Wenwen Sun Stephanie Robertson Balazs Acs Johan Hartman
author_facet	Ceren Boyaci Wenwen Sun Stephanie Robertson Balazs Acs Johan Hartman
author_sort	Ceren Boyaci
title	Independent Clinical Validation of the Automated Ki67 Scoring Guideline from the International Ki67 in Breast Cancer Working Group
title_short	Independent Clinical Validation of the Automated Ki67 Scoring Guideline from the International Ki67 in Breast Cancer Working Group
title_full	Independent Clinical Validation of the Automated Ki67 Scoring Guideline from the International Ki67 in Breast Cancer Working Group
title_fullStr	Independent Clinical Validation of the Automated Ki67 Scoring Guideline from the International Ki67 in Breast Cancer Working Group
title_full_unstemmed	Independent Clinical Validation of the Automated Ki67 Scoring Guideline from the International Ki67 in Breast Cancer Working Group
title_sort	independent clinical validation of the automated ki67 scoring guideline from the international ki67 in breast cancer working group
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8c9be16dc039410b9146f7c5b994c8a5
work_keys_str_mv	AT cerenboyaci independentclinicalvalidationoftheautomatedki67scoringguidelinefromtheinternationalki67inbreastcancerworkinggroup AT wenwensun independentclinicalvalidationoftheautomatedki67scoringguidelinefromtheinternationalki67inbreastcancerworkinggroup AT stephanierobertson independentclinicalvalidationoftheautomatedki67scoringguidelinefromtheinternationalki67inbreastcancerworkinggroup AT balazsacs independentclinicalvalidationoftheautomatedki67scoringguidelinefromtheinternationalki67inbreastcancerworkinggroup AT johanhartman independentclinicalvalidationoftheautomatedki67scoringguidelinefromtheinternationalki67inbreastcancerworkinggroup
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Independent Clinical Validation of the Automated Ki67 Scoring Guideline from the International Ki67 in Breast Cancer Working Group

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