title: Clinical usefulness of the free web-based image analysis application ImmunoRatio for assessment of Ki-67 labelling index in breast cancer.
abstract: OBJECTIVE
  Ki-67 is a prognostic marker in breast cancer; however, the use of the Ki-67 labelling index (LI) in clinical practice requires a consistent and easily accessible scoring method. The present study evaluated the use of the free internet-based image analysis program ImmunoRatio to score Ki-67 LI in breast cancer in comparison with manual counting.
  
  
  METHODS
  Ki-67 immunohistochemical detection was performed in 577 breast cancer cases, and the Ki-67 LI was determined by ImmunoRatio and manual counting.
  
  
  RESULTS
  The Ki-67 LI determined by ImmunoRatio correlated well with that obtained by manual counting. The concordance rate between ImmunoRatio and manual counting was excellent (κ coefficient of 0.881) at a Ki-67 LI cut-off value of 20%. Cases with high Ki-67 LI by ImmunoRatio were associated with poor overall survival, in particular in the hormone receptor positive group.
  
  
  CONCLUSIONS
  The web-based automated image analysis program ImmunoRatio is an attractive alternative to manual counting to determine the Ki-67 LI in breast cancer.
authors.affiliation: Department of Hospital Pathology, The Catholic university of Korea, College of Medicine, Seoul, Republic of Korea.|Department of Pathology, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
authors.forename: Min-Kyung
authors.initials: MK
authors.lastname: Yeo
authors.affiliation: Department of Hospital Pathology, The Catholic university of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Hee Eun
authors.initials: HE
authors.lastname: Kim
authors.affiliation: Department of Radiology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
authors.forename: Sung Hun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
authors.forename: Byung Joo
authors.initials: BJ
authors.lastname: Chae
authors.affiliation: Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
authors.forename: Byung Joo
authors.initials: BJ
authors.lastname: Song
authors.affiliation: Department of Hospital Pathology, The Catholic university of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Ahwon
authors.initials: A
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D018567:Breast Neoplasms, Male / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry; D020407:Internet; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055815:Young Adult
chemical_list: D019394:Ki-67 Antigen
keywords: BREAST CANCER; DIGITAL PATHOLOGY; PROLIFERATION