[1593] Morphometric Analysis in the Diagnosis of Ductal (DCIS) and Lobular Carcinoma In Situ (LCIS)

Carlos Parra-Herran, Tyna Hope, Elzbieta Slodkowska, Fang-I Lu, Taha Rashed, Marko Katic, Guangming Han, Gina Clarke, Martin Yaffe, Sharon Nofech-Mozes. Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Centre for Imaging Technology Commercialization, Toronto, ON, Canada

Background: Distinction between DCIS and LCIS, while critical for margin assessment and further management (re-excision, radiation), is sometimes challenging. Immunohistochemistry for E-Cadherin and Catenin P120 has proven utility. However up to 15% of LCIS cases show E-Cadherin expression. We aim to identify quantifiable histologic features by digital image analysis that can differentiate between DCIS and LCIS as an adjunct diagnostic tool.
Design: Scanned images of 13 cases of DCIS and 14 cases of LCIS were analyzed. Three regions of solid intraductal proliferation were selected from each case and analyzed using Mercator Version 1.0 (ExploraNova, La Rochelle, France). The system detects structures based on optical density and analyzes them as closed objects.

We analyzed multiple morphometric variables.

Morphometric variables in DCIS and LCIS
VARIABLEFORMULA
Nuclear density (ND)NC/TSA
% Nuclear surface areaSNA/TSA*100
Mean nuclear area (MNA)SNA/NC
Mean nuclear form factor (MNFF)SNF/NC
% direct cytoplasm area (measured by the system)SCA/TSA*100
% indirect cytoplasm area (calculated)(TSA-SNA-SWS)/TSA*100)
NC = Nuclear count, TSA = Total Region Surface Area, SNA = Sum of all nuclear areas, SNF=Sum of nuclear form factors, SCA = Sum of all cytoplasmic areas, SWS = Sum of all white space areas. All areas in µm2.

Non-parametric Wilcoxon Mann Whitney test was used to evaluate the difference between the two groups.
Results: Four variables analyzed were significantly different between LCIS and DCIS. LCIS showed higher nuclear density (0.01301 vs 0.01003, p=0.0066), higher nuclei surface area (34.67049 vs 24.07501, p=0.008) and lower direct and indirect cytoplasm surface area (1.42364 vs 13.27139, p<0.0001; 64.9085 vs 75.33277, p=0.0084) compared to DCIS. Nuclear size and shape (given by the MNA and MMFF respectively) showed no significant difference.
Conclusions: Morphometric features related to nuclear density and amount of cytoplasm are different between DCIS and LCIS. This correlates with the standard qualitative criteria conventionally used. Our study underscores the potential of measurable variables using image analysis as adjunct diagnostic tools in the era of digital pathology.
Category: Informatics

Wednesday, March 6, 2013 1:00 PM

Poster Session VI # 278, Wednesday Afternoon

 

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