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Ben Vainer

Next generation image analysis for quantitation in IHC

Handout (pdf 31 p)

Handout (pdf 8 p)


Governmental guaranties for treatment and diagnosis have put focus on optimisation of procedures at Danish hospitals. Diagnostic pathology, where cancer diagnoses are made based on changes in cells and tissue, is a central element in these initiatives. Proper cancer diagnoses cannot be made without assessment of specific biomarker in the tissue, which most often is done by using conventional microscopes to evaluate immunohistochemical staining reactions. However, this method is subjective and carries a significant interobserver (and intraobserver!) variability that denies some patients the correct anti-cancer treatment. During the last couple of years, advanced software for analysis of specific components of the cancer cells have been introduced by digital image analysis developers.

For a variety of antibodies for immunohistochemical staining procedures, techniques have been developed that precisely can pinpoint the tumour cells in a mosaic of different cells and thereby make a standardized, automated and reproducible assessment without the need for a human, subjective assessment. Diagnosis of breast cancer has been leading within this area, and it is now possible to state the presence of oestrogen receptors, HER2 protein and the proliferation index (Ki67) by using digital image analysis. Studies have unequivocally demonstrated that this automated analysis is stable, objective and correct, and it therefore allows allocation of each individual patient to the correct treatment, avoiding infliction of potentially severe adverse reactions in patients, who would have no benefit from a specific anti-cancer drug. Other cancer types are increasingly included in studies attempting to demonstrate the usability of digital image analysis, including malignant melanoma, gastric cancer, prostate cancer, neuroendocrine carcinomas and sarcomas.

Next generation image analysis software is developed to use computers for time-consuming work that is difficult for the human brain to process, thereby freeing up valuable time that can be used by the pathologist to provide the correct diagnosis and to communicate this to the treating clinician. The aim of digitalization is not to let the computer assume the role of the pathologist, but to offer the pathologist a solid tool in the assessment of the specimen slides in a completely objective way. The talk will present studies comparing manual with digital biomarker assessment and discuss the implementation of automated biomarker analysis in routine diagnostic settings.


1995: MD from University of Copenhagen
2005: Board certification in surgical pathology, histopathology and cytopathology

1995-1997: Resident, depts. of internal medicine and surgery, Glostrup and Herlev hospitals
1997-2000: PhD, Dept. of Medicine, Glostrup Hospital and University of Copenhagen
2000-2001: Resident, Dept. of Internal Medicine, Glostrup Hospital
2001-2005: Resident at depts. of pathology at Herlev Hospital and Rigshospitalet
2005-2007: Junior consultant (liver and gastroenterological pathology), Dept. of Pathology, Rigshospitalet
2008-2013: Senior consultant (liver and urological pathology) and Director of Education, Dept. of Pathology, Rigshospitalet
2013-         : Clinical professor of pathology, Dept. of Pathology, Rigshospitalet. Administrative and research obligations: digitalization of the diagnostic process, implementation of digital methods in pathology research and education.

Teaching appointments:
1997-2001 : Clinical teacher at Dept. of Internal Medicine, Glostrup Hospital
1997-2004 : Teaching assistant, medical science theory and ethics, Univ. of Copenhagen
2005-          : Organiser of national postgraduate courses in liver and gastroenterological pathology in the pathology speciality training programme
2008-2013 : Associate Professor, Dept. of Biomedical Sciences, University of Copenhagen
2013-          : Professor of pathology, Dept. of Biomedical Sciences, Univ. of Copenhagen, and Dept. of Pathology, Rigshospitalet

As Professor and Associate Professor at University of Copenhagen, I have implemented digital methods in the teaching curriculum in the courses of pathology for medical students and students in odontology and human biomedicine, including virtual microscopy, lecture streaming, blogs, and remote education. Please visit

Scientific appointments:
External reviewer at several scientific journals, including Scand J Gastroenterol, Clin Exp Immunol, Virchows Archiv, Inflamm Res, Histol Histopathol and J Urol.

  • Member of the Advisory Board at Inflammation Research.

  • National editor at APMIS.

  • Member of the Advisory Board at World Journal of Hepatology

Scientific supervision and evaluation:
Presently, supervisor of 9 PhD students (4 as primary supervisor) and 6 pre-graduate student (topics: morphological and expressional characteristics of colorectal liver metastases; TMPRSS2/ERG fusion in prostate cancer; three-dimensional reconstruction of tumor growth, digital imaging and analysis of biomarker assessment, and implementation of digital methods in routine surgical pathology). Previous supervisor of 4 PhD and 12 pre-graduate students.

Publications etc.:

  • Gold medal, Univ. of Copenhagen, 1996, on a thesis on adhesion molecules in chronic inflammatory bowel disease

  • PhD, Univ. of Copenhagen, 2001, on a thesis on the chemotactic effect of ICAM-1 on neutrophils in ulcerative colitis

  • DMSc, Univ. of Copenhagen, 2010, on a doctoral thesis on morphologal studies of ICAM-1 in ulcerative colitis

  • Additional 101 publications, 20 as first author, 7 as senior author. Recent studies have included application of digital image analysis in research on human disease.

  • H-index: 26; citations: 2396.

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