Characterizing primary refractory neuroblastoma: Prediction of outcome by microscopic image analysis

M. Khalid Khan Niazi, Daniel A. Weiser, Bruce R. Pawel, Metin N. Gurcan

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Scopus citations


Neuroblastoma is a childhood cancer that starts in very early forms of nerve cells found in an embryo or fetus. It is a highly lethal cancer of sympathetic nervous system that commonly affects children of age five or younger. It accounts for a disproportionate number of childhood cancer deaths and remains a difficult cancer to eradicate despite intensive treatment that includes chemotherapy, surgery, hematopoietic stem cell transplantation, radiation therapy and immunotherapy. A poorly characterized group of patients are the 15% with primary refractory neuroblastoma (PRN) which is uniformly lethal due to de novo chemotherapy resistance. The lack of response to therapy is currently assessed after multiple months of cytotoxic therapy, driving the critical need to develop pretreatment clinic-biological biomarkers that can guide precise and effective therapeutic strategies. Therefore, our guiding hypothesis is that PRN has distinct biological features present at diagnosis that can be identified for prediction modeling. During a visual analysis of PRN slides, stained with hematoxylin and eosin, we observed that patients who survived for less than three years contained large eosin-stained structures as compared to those who survived for greater than three years. So, our hypothesis is that the size of eosin stained structures can be used as a differentiating feature to characterize recurrence in neuroblastoma. To test this hypothesis, we developed an image analysis method that performs stain separation, followed by the detection of large structures stained with Eosin. On a set of 21 PRN slides, stained with hematoxylin and eosin, our image analysis method predicted the outcome with 85.7% accuracy.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2015
Subtitle of host publicationDigital Pathology
EditorsMetin N. Gurcan, Anant Madabhushi
ISBN (Electronic)9781628415100
StatePublished - Jan 1 2015
EventMedical Imaging 2015: Digital Pathology - Orlando, United States
Duration: Feb 25 2015Feb 26 2015

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


OtherMedical Imaging 2015: Digital Pathology
Country/TerritoryUnited States


  • Filtering
  • Image segmentation
  • Outcome prediction
  • Refractory neuroblastoma
  • Stroma
  • Texture analysis

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Atomic and Molecular Physics, and Optics
  • Biomaterials
  • Radiology Nuclear Medicine and imaging


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