Patient-derived cancer organoids (PDCOs) are valuable for patient management and drug development. Label-free widefield optical redox ratio (WF-ORR) imaging measures organoid-level treatment response using the autofluorescence intensity of the metabolic co-enzymes NAD(P)H and FAD. We have developed WF-ORR imaging and analysis tools to maximize the accessibility, speed, sensitivity, and reproducibility of drug response measurements in PDCOs. These tools include leading-edge segmentation methods that isolate ORR changes within the proliferating zone of PDCOs, and single organoid tracking that reduces variability within drug screens. Overall, this approach enables rapid, sensitive, and reproducible measurements of treatment response and heterogeneity in PDCOs.
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