Overview of established and emerging immunohistochemical biomarkers and their role in correlative studies in MRI

Abstract

Clinical practice in radiology and pathology requires professional expertise and many years of training to visually evaluate and interpret abnormal phenotypic features in medical images and tissue sections to generate diagnoses that guide patient management and treatment. Recent advances in digital image analysis methods and machine learning have led to significant interest in extracting additional information from medical and digital whole‐slide images in radiology and pathology, respectively. This has led to significant interest and research in radiomics and pathomics to correlate phenotypic features of disease with image analytics in order to identify image‐based biomarkers. The expanding role of big data in radiology and pathology parallels the development and role of immunohistochemistry (IHC) in the daily practice of pathology. IHC methods were initially developed to provide additional information to help classify tumors and then transformed into an indispensable tool to guide treatment in many types of cancer. IHC markers are used in daily practice to identify specific types of cells and highlight their distributions in tissues in order to distinguish benign from neoplastic cells, determine tumor origin, subclassify neoplasms, and support and confirm diagnoses. In this regard, radiomics, pathomics, and IHC methods are very similar since they enable the extraction of image‐based features to characterize various properties of diseases. Due to the dramatic advancements in recent radiomics research, we provide a brief overview of the role of established and emerging IHC biomarkers in various tumor types that have been correlated with radiologic biomarkers to improve diagnostic accuracy, predict prognosis, guide patient management, and select treatment strategies. Level of Evidence: 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;51:341–354.

Radio-pathomic approaches in pediatric neuro-oncology: Opportunities and challenges

“…Although traditional techniques continue to be regularly utilized, the expanding role of immunohistochemistry, and multiplex antibody-based imaging, is a promising modality to improve phenotypic characterization of the local microenvironment. 61 Utilizing novel staining and imaging techniques, including variations of antibody conjugation, direct insights into cellular and sub-cellular tissue domains can be elucidated. 62 , 63 Such methods have the potential to be directly associated with emerging theranostic PET imaging methods, which can capture molecular properties, such as metabolic activity, and are becoming increasingly relevant in imaging of tumor burden and response assessment.…”

Artificial Intelligence in Pathology: From Prototype to Product

“…They provide valuable information about the course of cancer or the likelihood of response to therapy. [ 123 ] Computer assistance enables the automatic quantification of protein expression and thus makes the analysis of IHC biomarkers more accurate and reproducible. [ 124 ]…”

<p>Application of Radiomics for Personalized Treatment of Cancer Patients</p>

“…In prostate cancer IHC the most widely used markers are prostate-specific antigen (PSA), prostate-specific acid phosphatase (PSAP), Prostate-specific membrane antigen (PSMA), and p63; all are commonly used as a part of prostate radioimaging. 60 Despite the initial lack of correlation, the study also aimed to combine serum and urine biomarkers with diffusion-weighted imaging (DWI)-MRI to predict prostate cancer with vascular IHC markers and assess microvessel density in large prospective cohorts. In the future, the correlation between integrated radiology and IHC expression will provide clinicians with more diagnostic information and evidence to predict clinical outcomes and formulate a treatment response, which should significantly improve the quality and efficiency of medical services.…”