An image analysis method for analyzing an IHC tissue sample, the method comprising: - storing, for each of one or more sets (112; 113) of digital images (106.1-106-4; 106.5-106.7), a set-ID in a spatial database of a spatial DBMS, the digital images of each digital image set depicting the same or adjacent layers (102; 110; 108) of the IHC tissue sample; - storing, for each of the digital images, a plurality of spatial data objects in the spatial database in association with the set-ID, each spatial data object being a point, a line, a polygon or a combination thereof and representing a biomedical feature of the tissue sample, the biomedical features of the tissue sample represented by the data objects belonging to at least two different types of biomedical features; - creating, by the spatial DBMS, at least one spatial index covering the spatial data objects of the digital images contained in the one or more sets, wherein for each of the at least two different types of biomedical features of each of the one or more sets of digital images, a respective spatial index or a partition of the at least one spatial index is created; - selecting one of the one or more sets of digital images; - applying, by the spatial DBMS, a spatial database operation on the at least one spatial index for determining the relative positions of spatial data objects of two or more digital images of the selected digital image set; - providing the relative positions as input for determining the distance and/or relative position of the biomedical features of the tissue sample represented by the spatial data objects of the two or more digital images. - storing, for each of one or more sets (112; 113) of digital images (106.1-106-4; 106.5-106.7), a set-ID in a spatial database of a spatial DBMS, the digital images of each digital image set depicting the same or adjacent layers (102; 110; 108) of the IHC tissue sample; - storing, for each of the digital images, a plurality of spatial data objects in the spatial database in association with the set-ID, each spatial data object being a point, a line, a polygon or a combination thereof and representing a biomedical feature of the tissue sample, the biomedical features of the tissue sample represented by the data objects belonging to at least two different types of biomedical features; - creating, by the spatial DBMS, at least one spatial index covering the spatial data objects of the digital images contained in the one or more sets, wherein for each of the at least two different types of biomedical features of each of the one or more sets of digital images, a respective spatial index or a partition of the at least one spatial index is created; - selecting one of the one or more sets of digital images; - applying, by the spatial DBMS, a spatial database operation on the at least one spatial index for determining the relative positions of spatial data objects of two or more digital images of the selected digital image set; - providing the relative positions as input for determining the distance and/or relative position of the biomedical features of the tissue sample represented by the spatial data objects of the two or more digital images.