title: Computer-assisted quantification of CD3+ T cells in follicular lymphoma.
abstract: The advance of high resolution digital scans of pathology slides allowed development of computer based image analysis algorithms that may help pathologists in IHC stains quantification. While very promising, these methods require further refinement before they are implemented in routine clinical setting. Particularly critical is to evaluate algorithm performance in a setting similar to current clinical practice. In this article, we present a pilot study that evaluates the use of a computerized cell quantification method in the clinical estimation of CD3 positive (CD3+) T cells in follicular lymphoma (FL). Our goal is to demonstrate the degree to which computerized quantification is comparable to the practice of estimation by a panel of expert pathologists. The computerized quantification method uses entropy based histogram thresholding to separate brown (CD3+) and blue (CD3-) regions after a color space transformation. A panel of four board-certified hematopathologists evaluated a database of 20 FL images using two different reading methods: visual estimation and manual marking of each CD3+ cell in the images. These image data and the readings provided a reference standard and the range of variability among readers. Sensitivity and specificity measures of the computer's segmentation of CD3+ and CD- T cell are recorded. For all four pathologists, mean sensitivity and specificity measures are 90.97 and 88.38%, respectively. The computerized quantification method agrees more with the manual cell marking as compared to the visual estimations. Statistical comparison between the computerized quantification method and the pathologist readings demonstrated good agreement with correlation coefficient values of 0.81 and 0.96 in terms of Lin's concordance correlation and Spearman's correlation coefficient, respectively. These values are higher than most of those calculated among the pathologists. In the future, the computerized quantification method may be used to investigate the relationship between the overall architectural pattern (i.e., interfollicular vs. follicular) and outcome measures (e.g., overall survival, and time to treatment). © 2017 International Society for Advancement of Cytometry.
authors.affiliation: Center for e-Health, Faculty of Engineering and Technology, Multimedia University, Melaka, Malaysia.
authors.forename: Fazly S
authors.initials: FS
authors.lastname: Abas
authors.affiliation: Department of Pathology, The Ohio State University, Columbus, Ohio.
authors.forename: Arwa
authors.initials: A
authors.lastname: Shana'ah
authors.affiliation: Department of Internal Medicine, The Ohio State University, Columbus, Ohio.
authors.forename: Beth
authors.initials: B
authors.lastname: Christian
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Robert
authors.initials: R
authors.lastname: Hasserjian
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Abner
authors.initials: A
authors.lastname: Louissaint
authors.affiliation: Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio.
authors.forename: Michael
authors.initials: M
authors.lastname: Pennell
authors.affiliation: Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland.
authors.forename: Berkman
authors.initials: B
authors.lastname: Sahiner
authors.affiliation: Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland.
authors.forename: Weijie
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio.
authors.forename: Muhammad Khalid Khan
authors.initials: MKK
authors.lastname: Niazi
authors.affiliation: Department of Pathology, The Ohio State University, Columbus, Ohio.
authors.forename: Gerard
authors.initials: G
authors.lastname: Lozanski
authors.affiliation: Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio.
authors.forename: Metin
authors.initials: M
authors.lastname: Gurcan
mesh_terms: D000465:Algorithms; D057205:Automation, Laboratory; D017252:CD3 Complex / Q000235:genetics; D019277:Entropy; D015870:Gene Expression; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data*; D007150:Immunohistochemistry / Q000379:methods; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000648:ultrastructure; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013194:Staining and Labeling / Q000379:methods; D013601:T-Lymphocytes / Q000473:pathology* / Q000648:ultrastructure
chemical_list: D017252:CD3 Complex
keywords: CD3; cell quantification; follicular lymphoma