Submitted:
12 June 2025
Posted:
16 June 2025
You are already at the latest version
Abstract
Keywords:
1. Introduction
2. Materials and Methods
3. Results
3.1. Different Experimental Conditions Yielded Tissues Showing Varying Expression of the Marker

3.2. High Interobserver Variability Is Noted in Manual Annotation of Spots with Non-Uniform Marker Expression

3.3. Development of a Quantitative Tool To Analyze Immunofluorescence in Multicellular Spots


3.4. Automated Quantification of Immunofluorescence Intensity

4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
| DNA | Deoxyribonucleic acid |
| RNA | Ribonucleic acid |
| IF | Immunofluorescence |
| γH2AX | Phosphorylated Histone H2AX |
| RT | Radiation Treatment |
| IACUC | Institutional Animal Care and Use Committee |
Appendix A
Appendix A.1
| Setting | Default Value |
| Range for Cell Sweeping(a) | 5:10:250 |
| Average Cell Perimeter(b) | 80 |
| Intensity Lower Threshold(c) | 55 |
| Percent Positive Threshold(d) | 5 |
| Red Pixel Value (Lower Threshold) (e) | 55 |
| Blue Pixel Value (Lower Threshold) (e) | 50 |
| Green Pixel Value (Lower Threshold) (e) | 0 |
| Pixel Clean-up (f) | 20 |
References
- Lowe, R.; et al. Transcriptomics technologies. PLOS Computational Biology 2017, 13, e1005457. [Google Scholar] [CrossRef] [PubMed]
- Wang, Z.; Gerstein, M.; Snyder, M. RNA-Seq: a revolutionary tool for transcriptomics. Nature Reviews Genetics 2009, 10, 57–63. [Google Scholar] [CrossRef] [PubMed]
- Williams, C.G.; et al. An introduction to spatial transcriptomics for biomedical research. Genome Medicine 2022, 14. [Google Scholar] [CrossRef]
- Hahn, N.; et al. Protecting RNA quality for spatial transcriptomics while improving immunofluorescent staining quality. Frontiers in Neuroscience 2023, 17. [Google Scholar] [CrossRef]
- Holtz, A.; Basisty, N.; Schilling, B. Quantification and Identification of Post-Translational Modifications Using Modern Proteomics Approaches. In Methods in Molecular Biology; Springer US: 2021; p. 225-235.
- Xun, Z.; et al. Reconstruction of the tumor spatial microenvironment along the malignant-boundary-nonmalignant axis. Nat Commun 2023, 14, 933. [Google Scholar] [CrossRef]
- Bankhead, P.; et al. QuPath: Open source software for digital pathology image analysis. Scientific Reports 2017, 7. [Google Scholar] [CrossRef]
- Vrekoussis, T.; et al. Image analysis of breast cancer immunohistochemistry-stained sections using ImageJ: an RGB-based model. Anticancer Res 2009, 29, 4995–8. [Google Scholar]
- Schmid, R.S.; et al. Core pathway mutations induce de-differentiation of murine astrocytes into glioblastoma stem cells that are sensitive to radiation but resistant to temozolomide. Neuro Oncol 2016, 18, 962–73. [Google Scholar] [CrossRef]
- ER, P.; et al. Purine salvage promotes treatment resistance in H3K27M-mutant diffuse midline glioma - PubMed. Cancer & metabolism, 04/09/2024. 12(1).
- Li, M.; Gao, Q.; Yu, T. Kappa statistic considerations in evaluating inter-rater reliability between two raters: which, when and context matters. BMC Cancer 2023, 23. [Google Scholar] [CrossRef]
- Mah, L.-J.; El-Osta, A.; Karagiannis, T.C. γH2AX: a sensitive molecular marker of DNA damage and repair. Leukemia 2010, 24, 679–686. [Google Scholar] [CrossRef]
- Jung, C.; Kim, C. Impact of the accuracy of automatic segmentation of cell nuclei clusters on classification of thyroid follicular lesions. Cytometry Part A 2014, 85, 709–718. [Google Scholar] [CrossRef] [PubMed]
- Xing, F.; Yang, L. Robust Nucleus/Cell Detection and Segmentation in Digital Pathology and Microscopy Images: A Comprehensive Review. IEEE Reviews in Biomedical Engineering 2016, 9, 234–263. [Google Scholar] [CrossRef] [PubMed]
- Ronneberger, O.; et al. Spatial quantitative analysis of fluorescently labeled nuclear structures: Problems, methods, pitfalls. Chromosome Research 2008, 16, 523–562. [Google Scholar] [CrossRef]
- Stupp, R; et al. Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma. New England Journal of Medicine 2005, 352.
- Lakomy, R.; et al. Real-World Evidence in Glioblastoma: Stupp's Regimen After a Decade. Frontiers in Oncology 2020, 10. [Google Scholar] [CrossRef]
- Santosh, V.; Sravya, P.; Arivazhagan, A. Molecular Pathology of Glioblastoma- An Update. Advances in Biology and Treatment of Glioblastoma 2017.
- Zhou, W.; et al. Purine metabolism regulates DNA repair and therapy resistance in glioblastoma. Nature Communications 2020, 11, 1–14. [Google Scholar] [CrossRef]
- McHugh, M.L. , Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 2012, 22, 276–82. [Google Scholar] [CrossRef]
- Al-Holou, W.N.; et al. Subclonal evolution and expansion of spatially distinct THY1-positive cells is associated with recurrence in glioblastoma. Neoplasia (New York, N.Y.) 2023, 36.
- Arora, R.; et al. Spatial transcriptomics reveals distinct and conserved tumor core and edge architectures that predict survival and targeted therapy response. Nature Communications, 2023, 14.
- Suzuki, A.; et al. Identification of invasive subpopulations using spatial transcriptome analysis in thyroid follicular tumors. Journal of Pathology and Translational Medicine 2024, 58, 22–28. [Google Scholar] [CrossRef]
- Jhaveri, N.; et al. Mapping the Spatial Proteome of Head and Neck Tumors: Key Immune Mediators and Metabolic Determinants in the Tumor Microenvironment. GEN Biotechnology 2023, 2, 418–434. [Google Scholar] [CrossRef]
- Hickey, J.W.; et al. Spatial mapping of protein composition and tissue organization: a primer for multiplexed antibody-based imaging. Nature Methods 2022, 19, 284–295. [Google Scholar] [CrossRef] [PubMed]
- Van Bockstal, M.R.; et al. Interobserver variability in the assessment of stromal tumor-infiltrating lymphocytes (sTILs) in triple-negative invasive breast carcinoma influences the association with pathological complete response: the IVITA study. Modern Pathology 2021, 34, 2130–2140. [Google Scholar] [CrossRef] [PubMed]
- Robert, M.E.; et al. High Interobserver Variability Among Pathologists Using Combined Positive Score to Evaluate PD-L1 Expression in Gastric, Gastroesophageal Junction, and Esophageal Adenocarcinoma. Mod Pathol 2023, 36, 100154. [Google Scholar] [CrossRef]
- Van Bockstal, M.R.; et al. Interobserver Variability in Ductal Carcinoma In Situ of the Breast. American Journal of Clinical Pathology 2020, 154, 596–609. [Google Scholar] [CrossRef]
- Meevassana, J.; et al. 5-Methylcytosine immunohistochemistry for predicting cutaneous melanoma prognosis. Scientific Reports 2024, 14. [Google Scholar] [CrossRef]
- Asano, N.; et al. Immunohistochemistry for trimethylated H3K27 in the diagnosis of malignant peripheral nerve sheath tumours. Histopathology 2017, 70, 385–393. [Google Scholar] [CrossRef]
| Negative control (No RT) | Positive control (RT 30 min) | Critical Experimental condition (RT 6hrs) | |
| No. of spots annotated | 2785 | 1857 | 2424 |
| Agreement between observers 1 and 2 | 98.06% | 99.35% | 73.93% |
| Agreement between observers 2 and 3 | 99.21 | 100% | 57.47% |
| Agreement between observers 1 and 3 | 97.99% | 99.35% | 75.78% |
| Average pairwise agreement score | 98.42% | 99.57% | 69.06% |
| Fliess’ Kappa | 0.912 | 0.857 | 0.345 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).