Background

Globally prostatic adenocarcinoma is the second most frequent malignancy after lung cancer in men worldwide, about 1 400 000 cases and causing about 375 000 deaths. Consequently accurate histological diagnosis of prostatic adenocarcinoma is an important issue worldwide.

Organized screening for prostatic adenocarcinoma is not introduced but middle aged and older men are often recommended screening for prostatic adenocarcinoma by performing blood sampling for analysis of PSA (Prostatic Specific Antigen). Elevated levels of PSA indicate an increased risk for prostatic adenocarcinoma. Males with elevated levels of PSA are recommended to attain a reception in urological surgery to obtain biopsies from the prostatic gland.

Prostatic adenocarcinoma is the most prevalent type of male cancer in Sweden, with over 10 000 new cases diagnosed every year. It constitutes around 30% of all male cancer cases and it occurs mainly in older men. Accordingly, 70% of the tumors are diagnosed in men 70 years of age and older. Over 2 000 males die due to prostatic cancer every year and prostatic adenocarcinoma is the most common cause of death due to a malignant tumor among males in Sweden.

Over one million men undergo sampling of prostate biopsies each year in the United States. More than 20 million prostate tissue samples are examined annually in Europé and the United States.

In Sweden biopsies of the prostatic gland from around 20 000 men are performed every year and since 12 biopsies mostly are collected in each male around 240 000 histological sections from prostatic glands are examined each year by light microscopy performed by doctors in surgical pathology.

These biopsies constitute the ultimate bases for the diagnosis of prostatic adenocarcinoma even if other visual methods as ultrasound and data tomography are adjuncts in that respect.

Image analysis focuses on digital pathology and computer assisted analysis of tissue sections with human cancer. The aim is to obtain reproducible, correct and objective histo-pathological diagnoses without subjective microscopic examination, which may occur by surgical pathologists.

The method will shorten the process from symptoms to therapy in individuals with malignant tumours. It will also be cost effective, automatic and decrease workload. By applying series of immuno-histochemical staining, human tissues can easily be analysed by automatic examination of digital images using tumour specific computer algorithms.

Healthcare has a great shortage of pathologists and financial resources. Pathologists today work with manual cancer diagnosis. A diagnostic method based on computerized image analysis of prostate biopsies can reduce waiting times and reduce healthcare costs.