Ann Lab Med 2020; 40(4): 312-316
Development of an Automated Image Analyzer for Microvessel Density Measurement in Bone Marrow Biopsies
Yousun Chung, M.D.1*, Seungwon Shin, Ph.D.2*, Hyoeun Shim, MD, Ph.D.3, Ji Yeon Sohn, M.D.4, Dong-eun Lee, M.S.5, Hyewon Lee, M.D., Ph.D.6, Hyeon-Seok Eom, M.D., Ph.D.6, Kwang Gi Kim, Ph.D.7, and Sun-Young Kong, M.D., Ph.D.3
1Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea; 2Optical Research Team, Magok R&D Campus, Z-tec Co., Ltd., Seoul, Korea; 3Department of Laboratory Medicine, Center for Diagnostic Oncology, Hospital and Research Institute, National Cancer Center, Goyang, Korea; 4Department of Laboratory Medicine, Eone Laboratories, Incheon, Korea; 5Biostatistics Collaboration Team, Research Institute, National Cancer Center, Goyang, Korea; 6Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, Korea; 7Department of Medical Engineering, Gachon University, Incheon, Korea
Corresponding author: Sun-Young Kong, M.D., Ph.D.
Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea
Tel: +82-31-920-1507 Fax: +82-31-920-1268 E-mail:

Kwang Gi Kim, Ph.D.
Department of Medical Engineering, Gachon University, 191 Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Korea
Tel: +82-32-460-2177 Fax: +82-32-460-2361 E-mail:

*These authors equally contributed to this study.
Received: August 8, 2019; Revised: October 30, 2019; Accepted: January 14, 2020; Published online: July 1, 2020.
© Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Angiogenesis is important for the proliferation and survival of multiple myeloma (MM) cells. Bone marrow (BM) microvessel density (MVD) is a useful marker of angiogenesis and an increase in MVD can be used as a marker of poor prognosis in MM patients. We developed an automated image analyzer to assess MVD from images of BM biopsies stained with anti-CD34 antibodies using two color models. MVD was calculated by merging images from the red and hue channels after eliminating non-microvessels. The analyzer results were compared with those obtained by two experienced hematopathologists in a blinded manner using the 84 BM samples of MM patients. Manual assessment of the MVD by two hematopathologists yielded mean±SD values of 19.4±11.8 and 20.0±11.8. The analyzer generated a mean±SD of 19.5±11.2. The intraclass correlation coefficient (ICC) and Bland-Altman plot of the MVD results demonstrated very good agreement between the automated image analyzer and both hematopathologists (ICC=0.893 [0.840–0.929] and ICC=0.906 [0.859–0.938]). This automated analyzer can provide time- and labor-saving benefits with more objective results in hematology laboratories.
Keywords: Multiple myeloma, Bone marrow, Microvessel density, Analyzer, Development, Automation

This Article



Indexed/Covered by