title: Mathematical morphologic segmentation dedicated to quantitative immunohistochemistry.
abstract: OBJECTIVE
  To develop automatic segmentation sequences for fully automated quantitative immunohistochemistry of cancer cell nuclei by image analysis.
  
  
  METHODS
  The study focused on the automated delineation of cancer cell lobules and nuclei, taking breast carcinoma as an example. A hierarchic segmentation was developed, employing mainly the chaining of mathematical morphology operators. The proposed sequence was tested on 22 images of various situations, collected from 18 different cases of breast carcinoma. A quality control procedure was applied, comparing the automated method with manual outlining of cancer cell foci and with manual pricking of cancer cell nuclei.
  
  
  RESULTS
  Good concordance was found between automated and manual segmentation procedures (90% for cancer cell clumps, 97% for cancer cell nuclei on average), but the rate of false positive nuclei (small regions labeled as nuclei by the segmentation procedure) could be relatively high (11% on average, with a maximum of 35%) and can result in underestimation of the immunostaining ratio.
  
  
  CONCLUSIONS
  This study examined a preliminary approach to automated immunoquantification, limited to automated segmentation without any color characterization. The automated hierarchic segmentation presented here leads to good discrimination of cancer cell nuclei at the chosen magnification.
authors.affiliation: Department of Pathology, University of Caen, France.
authors.forename: S
authors.initials: S
authors.lastname: Schüpp
authors.forename: A
authors.initials: A
authors.lastname: Elmoataz
authors.forename: P
authors.initials: P
authors.lastname: Herlin
authors.forename: D
authors.initials: D
authors.lastname: Bloyet
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology; D018275:Carcinoma, Lobular / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007150:Immunohistochemistry / Q000379:methods*; D008433:Mathematics; D010865:Pilot Projects