Image analysis Uncovers associations between immune landscape, collagen structure, and neoadjuvant chemotherapy in high-grade serous ovarian carcinomas.

ABSTRACT

Background: The changes in the tumor microenvironment of high-grade serous ovarian carcinomas following neoadjuvant chemotherapy are a complex area of study. Previous research underscores the importance of investigating the immune and collagen components within the tumor microenvironment for prognostic implications. Methods: In this study, we utilized computational pathology techniques with Hematoxylin and Eosin-stained images to quantitatively characterize the immune and collagen architecture within the tumor microenvironment of patients with high-grade serous ovarian carcinoma. Results: Our analysis of 12 pre- and post-neoadjuvant chemotherapy images revealed an increase in immune infiltrate, primarily within the epithelial region. Additionally, post-neoadjuvant chemotherapy images exhibited chaotic collagen architecture compared to pre-neoadjuvant chemotherapy images. Importantly, features extracted from post-neoadjuvant chemotherapy images showed associations with overall survival, potentially aiding in the selection of patients for immunotherapy trials. Conclusions: These findings offer critical insights into the changes in the tumor microenvironment of high-grade serous ovarian carcinomas following neoadjuvant chemotherapy and their potential implications for clinical outcomes.