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Open Access Research article

Clinical map document based on XML (cMDX): document architecture with mapping feature for reporting and analysing prostate cancer in radical prostatectomy specimens

Okyaz Eminaga1*, Reemt Hinkelammert1, Axel Semjonow1, Joerg Neumann2, Mahmoud Abbas2, Thomas Koepke1, Olaf Bettendorf3, Elke Eltze4 and Martin Dugas5

Author Affiliations

1 Prostate Center, Dept. of Urology, University Hospital Muenster, Albert-Schweitzer-Str. 33, D-48149 Muenster, Germany

2 Prostate Center, Gerhard-Domagk Institute for Pathology, University Hospital Muenster, Domagkstr. 17, D-48149 Muenster, Germany

3 Institute of Pathology and Cytology, Technikerstrasse 14, D-48465 Schüttorf, Germany

4 Institute for Pathology, Saarbrücken-Rastpfuhl, Rheinstrasse 2, D-66113 Saarbrücken, Germany

5 Department of Medical Informatics and Biomathematics, University of Muenster, Domagkstr. 9, D-48149 Muenster, Germany

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BMC Medical Informatics and Decision Making 2010, 10:71  doi:10.1186/1472-6947-10-71

Published: 15 November 2010



The pathology report of radical prostatectomy specimens plays an important role in clinical decisions and the prognostic evaluation in Prostate Cancer (PCa). The anatomical schema is a helpful tool to document PCa extension for clinical and research purposes. To achieve electronic documentation and analysis, an appropriate documentation model for anatomical schemas is needed. For this purpose we developed cMDX.


The document architecture of cMDX was designed according to Open Packaging Conventions by separating the whole data into template data and patient data. Analogue custom XML elements were considered to harmonize the graphical representation (e.g. tumour extension) with the textual data (e.g. histological patterns). The graphical documentation was based on the four-layer visualization model that forms the interaction between different custom XML elements. Sensible personal data were encrypted with a 256-bit cryptographic algorithm to avoid misuse. In order to assess the clinical value, we retrospectively analysed the tumour extension in 255 patients after radical prostatectomy.


The pathology report with cMDX can represent pathological findings of the prostate in schematic styles. Such reports can be integrated into the hospital information system. "cMDX" documents can be converted into different data formats like text, graphics and PDF. Supplementary tools like cMDX Editor and an analyser tool were implemented. The graphical analysis of 255 prostatectomy specimens showed that PCa were mostly localized in the peripheral zone (Mean: 73% ± 25). 54% of PCa showed a multifocal growth pattern.


cMDX can be used for routine histopathological reporting of radical prostatectomy specimens and provide data for scientific analysis.