INTRODUCTION In osteosarcoma, the most significant indicator of prognosis is the histologic changes related to tumor response to preoperative chemotherapy, such as necrosis. We have developed a method to measure the osteosarcoma treatment effect using whole slide image (WSI) with an open-source digital image analytical software Qupath. MATERIALS AND METHODS In Qupath, each osteosarcoma case was treated as a project. All H&E slides from the entire representative slice of osteosarcoma were scanned into WSIs and imported into a project in Qupath. The regions of tumor and tumor necrosis were annotated, and their areas were measured in Qupath. In order to measure the osteosarcoma treatment effect, we needed to calculate the percentage of total necrosis area over total tumor area. We developed a tool that can automatically extract all values of tumor and necrosis areas from a Qupath project into an Excel file, sum these values for necrosis and whole tumor respectively, and calculate necrosis/tumor percentage. CONCLUSION Our method that combines WSI with Qupath can provide an objective measurement to facilitate pathologist's assessment of osteosarcoma response to treatment. The proposed approach can also be used for other types of tumors that have clinical need for post-treatment response assessment.

中文翻译：

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使用全切片图像和 Qupath 手动和半自动测量和计算骨肉瘤治疗效果。

简介 在骨肉瘤中，最重要的预后指标是与肿瘤对术前化疗的反应相关的组织学变化，例如坏死。我们开发了一种使用全幻灯片图像（WSI）和开源数字图像分析软件 Qupath 来测量骨肉瘤治疗效果的方法。材料和方法 在 Qupath 中，每个骨肉瘤病例都被视为一个项目。来自骨肉瘤整个代表性切片的所有 H&E 幻灯片都被扫描到 WSI 中并导入到 Qupath 的项目中。对肿瘤和肿瘤坏死的区域进行注释，并在 Qupath 中测量它们的面积。为了衡量骨肉瘤的治疗效果，我们需要计算总坏死面积占肿瘤总面积的百分比。我们开发了一种工具，可以自动从 Qupath 项目中提取肿瘤和坏死区域的所有值到 Excel 文件中，分别对坏死和整个肿瘤的这些值求和，并计算坏死/肿瘤百分比。结论 我们将 WSI 与 Qupath 相结合的方法可以提供客观的测量，以促进病理学家评估骨肉瘤对治疗的反应。所提出的方法也可用于临床需要进行治疗后反应评估的其他类型的肿瘤。