Semi-automatic standardized analysis method to objectively evaluate near-infrared fluorescent dyes in image-guided surgery

Tom H. Dijkhuis; Okker D. Bijlstra; Mats I. Warmerdam; Robin A. Faber; Daan G. J. Linders; Hidde A. Galema; Alexander Broersen; Jouke Dijkstra; Peter J. K. Kuppen; Alexander L. Vahrmeijer; Jan Sven David Mieog

doi:10.1117/1.JBO.29.2.026001

1 February 2024 Semi-automatic standardized analysis method to objectively evaluate near-infrared fluorescent dyes in image-guided surgery

Tom H. Dijkhuis, Okker D. Bijlstra, Mats I. Warmerdam, Robin A. Faber, Daan G. J. Linders, Hidde A. Galema, Alexander Broersen, Jouke Dijkstra, Peter J. K. Kuppen, Alexander L. Vahrmeijer, Jan Sven David Mieog

Author Affiliations +

Journal of Biomedical Optics, Vol. 29, Issue 2, 026001 (February 2024). https://doi.org/10.1117/1.JBO.29.2.026001

Abstract

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.

CC BY: © The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Tom H. Dijkhuis, Okker D. Bijlstra, Mats I. Warmerdam, Robin A. Faber, Daan G. J. Linders, Hidde A. Galema, Alexander Broersen, Jouke Dijkstra, Peter J. K. Kuppen, Alexander L. Vahrmeijer, and Jan Sven David Mieog "Semi-automatic standardized analysis method to objectively evaluate near-infrared fluorescent dyes in image-guided surgery," Journal of Biomedical Optics 29(2), 026001 (1 February 2024). https://doi.org/10.1117/1.JBO.29.2.026001

Received: 20 September 2023; Accepted: 20 December 2023; Published: 1 February 2024

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KEYWORDS

Fluorescence

Tumors

Dyes

Surgery

Fluorescence imaging

Statistical analysis

Analytical research

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