Email updates

Keep up to date with the latest news and content from BMC Clinical Pathology and BioMed Central.

Open Access Open Badges Technical advance

DNA index determination with Automated Cellular Imaging System (ACIS) in Barrett's esophagus: Comparison with CAS 200

Qin Huang12, Chenggong Yu1, Michael Klein2, James Fang1 and Raj K Goyal1*

Author affiliations

1 Center for Swallowing and Motility Disorders, Departments of Medicine & Pathology and Laboratory Medicine, VA Boston Healthcare System and Harvard Medical School, 1400 VFW Parkway, West Roxbury, MA 02132, USA

2 Department of Pathology and Laboratory Medicine, Providence VA Medical Center and Brown Medical School, Providence, RI 02908, USA

For all author emails, please log on.

Citation and License

BMC Clinical Pathology 2005, 5:7  doi:10.1186/1472-6890-5-7

Published: 12 August 2005



For solid tumors, image cytometry has been shown to be more sensitive for diagnosing DNA content abnormalities (aneuploidy) than flow cytometry. Image cytometry has often been performed using the semi-automated CAS 200 system. Recently, an Automated Cellular Imaging System (ACIS) was introduced to determine DNA content (DNA index), but it has not been validated.


Using the CAS 200 system and ACIS, we compared the DNA index (DI) obtained from the same archived formalin-fixed and paraffin embedded tissue samples from Barrett's esophagus related lesions, including samples with specialized intestinal metaplasia without dysplasia, low-grade dysplasia, high-grade dysplasia and adenocarcinoma.


Although there was a very good correlation between the DI values determined by ACIS and CAS 200, the former was 25% more sensitive in detecting aneuploidy. ACIS yielded a mean DI value 18% higher than that obtained by CAS 200 (p < 0.001; paired t test). In addition, the average time required to perform a DNA ploidy analysis was shorter with the ACIS (30–40 min) than with the CAS 200 (40–70 min). Results obtained by ACIS gave excellent inter-and intra-observer variability (coefficient of correlation >0.9 for both, p < 0.0001).


Compared with the CAS 200, the ACIS is a more sensitive and less time consuming technique for determining DNA ploidy. Results obtained by ACIS are also highly reproducible.