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Rikke Riber-Hansen

Digital image analysis as a catalyst for applied stereology


Stereology, the science of extracting quantitative information about 3D structures from 2D planar sections, is the gold standard of immunohistochemistry quantification. It is based on the fundamental principles of geometry and statistics, and plays an important role in biological research.
However, most traditional stereological methods, such as point counting are best suited for small-scale cohorts and estimation of single markers, because the process of stereological estimation is often laborious and time-consuming.
Digital image analysis, the extracting of meaningful information from digital images, is on the rise in multiple areas of medical research, and shows great promise in pathology, especially in immunohistochemical quantification. However, as we implement this new technique in our daily routines, we must pay close attention to the quantification methods used, and assure that these new digital measurements will be solidly based on stereological principles.
This lecture will give an overview of the current status using digital stereological methods in pathology with special emphasis on immunohistochemical evaluation.


Nielsen PS, Riber-Hansen R, Jensen TO, Schmidt H, Steiniche T. Proliferation indices of phosphohistone H3 and Ki67: strong prognostic markers in a consecutive cohort with stage I/II melanoma. Mod Pathol. 2012 Nov 23. doi: 10.1038/modpathol.2012.188. [Epub ahead of print] PubMed PMID: 23174936.

Nielsen PS, Riber-Hansen R, Raundahl J, Steiniche T. Automated quantification of MART1-verified Ki67 indices by digital image analysis in melanocytic lesions. Arch Pathol Lab Med. 2012 Jun;136(6):627-34. doi: 10.5858/arpa.2011-0360-OA. PubMed PMID: 22646269.

Nielsen PS, Riber-Hansen R, Steiniche T. Immunohistochemical double stains against Ki67/MART1 and HMB45/MITF: promising diagnostic tools in melanocytic lesions. Am J Dermatopathol. 2011 Jun;33(4):361-70. doi: 10.1097/DAD.0b013e3182120173. PubMed PMID: 21610457.

Riber-Hansen R, Hastrup N, Clemmensen O, Behrendt N, Klausen S, Ramsing M, Spaun E, Hamilton-Dutoit SJ, Steiniche T. Treatment influencing down-staging in EORTC Melanoma Group sentinel node histological protocol compared with complete step-sectioning: a national multicentre study. Eur J Cancer. 2012 Feb;48(3):347-52. doi: 10.1016/j.ejca.2011.08.019. Epub 2011 Oct 22. PubMed PMID:  22023888.

Riber-Hansen R, Nyengaard JR, Hamilton-Dutoit SJ, Sjoegren P, Steiniche T. Automated digital volume measurement of melanoma metastases in sentinel nodes predicts disease recurrence and survival. Histopathology. 2011 Sep;59(3):433-40.  doi: 10.1111/j.1365-2559.2011.03960.x. PubMed PMID: 22034883.

Riber-Hansen R, Nyengaard JR, Hamilton-Dutoit SJ, Sjoegren P, Steiniche T. Metastatic melanoma volume in sentinel nodes: objective stereology-based measurement predicts disease recurrence and survival. Histopathology. 2009 Jun;54(7):796-803. doi: 10.1111/j.1365-2559.2009.03312.x. Epub 2009 Jun 1. PubMed PMID: 19635098.

Riber-Hansen R, Vainer B, Steiniche T. Digital image analysis: a review of reproducibility, stability and basic requirements for optimal results. APMIS. 2012 Apr;120(4):276-89. doi: 10.1111/j.1600-0463.2011.02854.x. Epub 2011 Dec 19. Review. PubMed PMID: 22429210.


Rikke Riber-Hansen, MD, PhD, Aarhus University Hospital, EORTC melanoma group member.

Dr. Riber-Hansen received her medical training at Aarhus University, where she completed her PhD thesis in 2009. She does her residency, with expected completion May 2013, in pathology at Aarhus University Hospital. In 2006, she joined Dr. Torben Steiniche’s melanoma research group to investigate prognostic markers in melanoma. Dr. Riber-Hansen’s contributions include the description of melanoma metastasis location in sentinel lymph nodes, the problems arising when using semi-quantitative estimates of metastasis size, and the use of digital image analysis to overcome these problems. She has received several awards for her research and is a valued lecturer. Dr. Riber-Hansen continues her research and clinical efforts at Aarhus University Hospital and participates in the care of patients with skin disease.

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