One of the more recent approaches to Ki-67 scoring is the hot spot scoring method, which has been implemented to multiple scoring guidelines, e.g. the Swedish guidelines for breast cancer, see [1], and the Danish guidelines for breast cancer, see [2]. However, this scoring method lacks standardization and is often found to be subjective and prone to both intra- and inter-observer variability, see [3]. Using the Hot spot APP a standardized method for scoring in hot spots can be obtained.
The APP is independent on biomarker and tissue type, and may be used for analysis of biomarkers different from Ki-67 and on indications different from breast cancer. The APP can be configured in numerous ways, and can be customized for different use cases. The default Hot Spot APP configuration is the same as used in article [4], where it was shown that digital image analysis of Ki-67 in hot spots is superior to both manual Ki-67 and mitotic counts in breast cancer.