Somatostatin receptor immunohistochemistry in neuroendocrine tumors: Comparison between manual and automated evaluation

Kaemmerer Daniel, Athelogou Maria, Lupp Amelie, Lenhardt Isabell, Schulz Stefan, Peter Luisa, Hommann Merten, Prasad Vikas, Binnig Gerd, Baum Richard Paul

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Manual evaluation of somatostatin receptor (SSTR) immunohistochemistry (IHC) is a time-consuming and cost-intensive procedure. Aim of the study was to compare manual evaluation of SSTR subtype IHC to an automated software-based analysis, and to in-vivo imaging by SSTR-based PET/CT. Methods: We examined 25 gastroenteropancreatic neuroendocrine tumor (GEP-NET) patients and correlated their in-vivo SSTR-PET/CT data (determined by the standardized uptake values SUVmax,-mean) with the corresponding ex-vivo IHC data of SSTR subtype (1, 2A, 4, 5) expression. Exactly the same lesions were imaged by PET/CT, resected and analyzed by IHC in each patient. After manual evaluation, the IHC slides were digitized and automatically evaluated for SSTR expression by Definiens XD software. A virtual IHC score "BB1" was created for comparing the manual and automated analysis of SSTR expression. Results: BB1 showed a significant correlation with the corresponding conventionally determined Her2/neu score of the SSTR-subtypes 2A (rs: 0.57), 4 (rs: 0.44) and 5 (rs: 0.43). BB1 of SSTR2A also significantly correlated with the SUVmax (rs: 0.41) and the SUVmean (rs: 0.50). Likewise, a significant correlation was seen between the conventionally evaluated SSTR2A status and the SUVmax (rs: 0.42) and SUVmean (rs: 0.62).Conclusion: Our data demonstrate that the evaluation of the SSTR status by automated analysis (BB1 score), using digitized histopathology slides ("virtual microscopy"), corresponds well with the SSTR2A, 4 and 5 expression as determined by conventional manual histopathology. The BB1 score also exhibited a significant association to the SSTR-PET/CT data in accordance with the high affinity profile of the SSTR analogues used for imaging.

Original languageEnglish
Pages (from-to)4971-4980
Number of pages10
JournalInternational Journal of Clinical and Experimental Pathology
Issue number8
StatePublished - 2014


  • Immunohistochemistry
  • Molecular imaging
  • Neuroendocrine tumor
  • PET/CT
  • Somatostatin receptor


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