TY - JOUR
T1 - Semi-automatic standardized analysis method to objectively evaluate near-infrared fluorescent dyes in image-guided surgery
AU - Dijkhuis, Tom H.
AU - Bijlstra, Okker D.
AU - Warmerdam, Mats I.
AU - Faber, Robin A.
AU - Linders, Daan G. J.
AU - Galema, Hidde A.
AU - Broersen, Alexander
AU - Dijkstra, Jouke
AU - Kuppen, Peter J. K.
AU - Vahrmeijer, Alexander L.
AU - Mieog, Jan Sven David
N1 - Publisher Copyright: © 2024 SPIE. All rights reserved.
PY - 2024/2/1
Y1 - 2024/2/1
N2 - Significance: Near-infrared fluorescence imaging still lacks a standardized, objective method to evaluate fluorescent dye efficacy in oncological surgical applications. This results in difficulties in translation between preclinical to clinical studies with fluorescent dyes and in the reproduction of results between studies, which in turn hampers further clinical translation of novel fluorescent dyes. Aim: Our aim is to develop and evaluate a semi-automatic standardized method to objectively assess fluorescent signals in resected tissue. Approach: A standardized imaging procedure was designed and quantitative analysis methods were developed to evaluate non-targeted and tumor-targeted fluorescent dyes. The developed analysis methods included manual selection of region of interest (ROI) on white light images, automated fluorescence signal ROI selection, and automatic quantitative image analysis. The proposed analysis method was then compared with a conventional analysis method, where fluorescence signal ROIs were manually selected on fluorescence images. Dice similarity coefficients and intraclass correlation coefficients were calculated to determine the inter- and intraobserver variabilities of the ROI selections and the determined signal- and tumor-to-background ratios. Results: The proposed non-targeted fluorescent dyes analysis method showed statistically significantly improved variabilities after application on indocyanine green specimens. For specimens with the targeted dye SGM-101, the variability of the background ROI selection was statistically significantly improved by implementing the proposed method. Conclusion: Semi-automatic methods for standardized quantitative analysis of fluorescence images were successfully developed and showed promising results to further improve the reproducibility and standardization of clinical studies evaluating fluorescent dyes.
AB - Significance: Near-infrared fluorescence imaging still lacks a standardized, objective method to evaluate fluorescent dye efficacy in oncological surgical applications. This results in difficulties in translation between preclinical to clinical studies with fluorescent dyes and in the reproduction of results between studies, which in turn hampers further clinical translation of novel fluorescent dyes. Aim: Our aim is to develop and evaluate a semi-automatic standardized method to objectively assess fluorescent signals in resected tissue. Approach: A standardized imaging procedure was designed and quantitative analysis methods were developed to evaluate non-targeted and tumor-targeted fluorescent dyes. The developed analysis methods included manual selection of region of interest (ROI) on white light images, automated fluorescence signal ROI selection, and automatic quantitative image analysis. The proposed analysis method was then compared with a conventional analysis method, where fluorescence signal ROIs were manually selected on fluorescence images. Dice similarity coefficients and intraclass correlation coefficients were calculated to determine the inter- and intraobserver variabilities of the ROI selections and the determined signal- and tumor-to-background ratios. Results: The proposed non-targeted fluorescent dyes analysis method showed statistically significantly improved variabilities after application on indocyanine green specimens. For specimens with the targeted dye SGM-101, the variability of the background ROI selection was statistically significantly improved by implementing the proposed method. Conclusion: Semi-automatic methods for standardized quantitative analysis of fluorescence images were successfully developed and showed promising results to further improve the reproducibility and standardization of clinical studies evaluating fluorescent dyes.
KW - fluorescence-guided surgery
KW - image analysis
KW - image-guided surgery
KW - quantitative fluorescence imaging
KW - standardization
UR - http://www.scopus.com/inward/record.url?scp=85184111388&partnerID=8YFLogxK
U2 - 10.1117/1.JBO.29.2.026001
DO - 10.1117/1.JBO.29.2.026001
M3 - Article
C2 - 38312853
SN - 1083-3668
VL - 29
JO - Journal of biomedical optics
JF - Journal of biomedical optics
IS - 2
M1 - 026001
ER -