Automatic quantification of tumor infiltrating lymphocytes in standard immunohistochemical slides. Free non-profit medical software.
Ver. 06.01 - January 20, 2021
The quantitative evaluation of tumor infiltrating lymphocytes (TILs) can provide useful data on tumor prognosis, but few surgical pathology laboratories have a specific image analysis system for computer-aided quantification of TILs in standard immunohistochemical slides. However, almost all laboratories are potentially able to perform such an analysis, having slide scanners and/or microscopes capable of capturing images on a computer. On the other hand, the microscopic quantification of TILs in routine hematoxylin and eosin (H&E) slides, although carefully standardized, will hardly achieve the same objectivity and reproducibility of a computerized analysis of immunohistochemical stains that can also quantify specific populations of lymphocytes involved in infiltration (CD4, CD8 and so on) considering the heterogeneity of TILs. For these reasons we developed OncoImmunoQuantifier (OIQ), a non-profit free Windows app to automatically quantify TILs in standard digital images of immunohistochemical slides, allowing the spread of this evaluation without costs. Furthermore, it is possible to use OIQ even if the image capture system is based on a computer with an operating system different from Windows, since the app can also work on MacOS, Linux or other operating systems by installing Windows on Oracle VM VirtualBox, or using Boot Camp, Wine or Parallels Desktop.
OIQ manages sequences of standard digital images captured from immunohistochemical slides by you with the software of your system (keep in mind that the app doesn't capture images by itself). Therefore, you are not tied to a particular hardware. All you need is a slide scanner or a microscope equipped with a digital camera. OIQ gets automatically the density of TILs (number of TILs per mm square of tissue) saving the results in Excel or Text file format. Moreover, the app can score density according to mean, median, tertiles, and quartiles. If a slide scanner is used, the scanner software must allow to select areas of fixed or variable size within the entire slide image and save them in standard graphics files. A useful feature of the app is the ability to process captured images using low microscopic magnification (4x or 5x) to evaluate large areas of the slide in order to obtain more significant results. Moreover, the use of low magnification reduces the possibility of sampling errors. In any case, it is recommended that the choice of fields to be analyzed be performed by a pathologist. In addition, the latest version of the program allows you to quickly check whether immunohistochemical images are suitable for analysis without wasting time configuring the app. This mode also allows you to perform a first quantitative evaluation of the positive areas.