234P - Faster turnaround time for circulating tumor cell results by CTC rating of hotspots

Date 10 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Breast Cancer
Presenter Mikkel Nielsen
Citation Annals of Oncology (2016) 27 (6): 68-99. 10.1093/annonc/mdw365
Authors M.T. Nielsen1, H. Stender2, T. Glückstadt3, J. Kraan4, J. Smith5, T. Hillig6, G. Sölétormos6
  • 1Ctc Center Of Excellence, CytoTrack, 2800 - Lyngby/DK
  • 2Ctc Center Of Excellence, CytoTrack, Lyngby/DK
  • 3Ctc Center Of Excellence, CytoTrack, 2800 Lyngby - Lyngby/DK
  • 4Department Of Medical Oncology, Erasmus University Medical Center, Rotterdam/NL
  • 5Faculty Of Health And Technology, Metropolitan University College, 2200-Kbh N - Copenhagen/DK
  • 6Department Of Clinical Biochemstry, Ctc Center Of Excellence, Hillerod Hospital, 3400 - Hillerod/DK



Detection and enumeration of circulating tumor cells (CTC) in patients with metastatic cancer offers important prognostic information and may assist in patient management and therapy. CTC are cytokeratin-positive, CD45-negative nucleated >4 um diameter cells where identification with current methods relies on automated scanning for presumptive identification as hotspots followed by final identification by manual review of images of each hotspot randomly presented to the operator. Often hundreds to thousands of images are manually reviewed making the process time-consuming and laborious. As an alternative to random review of images of hotspots a concept for CTC rating of hotspots based on the scanning measurement to determine their likelihood of being CTC has been developed and in this study validated on clinical specimens.


29 blood samples from metastatic breast cancer patients (Erasmus Medical Ctr, Rotterdam, NL) were analyzed using the CytoTrack system. CTC were identified by random manual review of each hotspot. Subsequently, the CTC rating concept was applied and the number of CTC present among the CTC rated hotspots was determined.


29 blood samples had a total of 21129 hotspots ranging from 93 - 2246 per sample. 15 of 29 samples contained CTC ranging from 1 - 104 CTC per sample. Of the 15 CTC-positive samples, 100% had CTC among the CTC rated hotspots ranging from 50 - 100% of the total number of CTC. In summary, the negative predictive value of CTC rating is 100% whereas the presence of CTC correlates with 81% (50-100%) of the total number of CTC. In the present study CTC rating of hotspots could avoid imaging of a total of 14224 hotspots ranging from 43 - 2000 hotspots per sample.


The high negative predictive value using CTC rating of hotspots offers the potential for 67% (14224/21129) reduction in the number of images to be reviewed to determine the presence or absence of CTC. For samples with the presence of at least 1 CTC the remaining images may optionally be reviewed to detect all CTC in the sample.

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M.T. Nielsen, H. Stender, T. Glückstadt: Employed by CytoTrack. All other authors have declared no conflicts of interest.