Charlotte Hoogstins1,2, Jan Jaap Burggraaf1, Marjory Koller3, Henricus Handgraaf1, Leonora Boogerd1, Gooitzen van Dam3, Alexander Vahrmeijer1, Jacobus Burggraaf4,5. 1. Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands. 2. Centre for Human Drug Research and Leiden Center for Academic Drug Research, Zernikedreef 8, 2333, CL, Leiden, the Netherlands. 3. Department of Surgery, Nuclear Medicine and Molecular Imaging, and Intensive Care, University Medical Center, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands. 4. Centre for Human Drug Research and Leiden Center for Academic Drug Research, Zernikedreef 8, 2333, CL, Leiden, the Netherlands. kb@chdr.nl. 5. Leiden Academic Center for Drug Research, Rapenburg 70, 2311 EZ, Leiden, the Netherlands. kb@chdr.nl.
Abstract
PURPOSE: Intraoperative fluorescence imaging (FI) is a promising technique that could potentially guide oncologic surgeons toward more radical resections and thus improve clinical outcome. Despite the increase in the number of clinical trials, fluorescent agents and imaging systems for intraoperative FI, a standardized approach for imaging system performance assessment and post-acquisition image analysis is currently unavailable. PROCEDURES: We conducted a systematic, controlled comparison between two commercially available imaging systems using a novel calibration device for FI systems and various fluorescent agents. In addition, we analyzed fluorescence images from previous studies to evaluate signal-to-background ratio (SBR) and determinants of SBR. RESULTS: Using the calibration device, imaging system performance could be quantified and compared, exposing relevant differences in sensitivity. Image analysis demonstrated a profound influence of background noise and the selection of the background on SBR. CONCLUSIONS: In this article, we suggest clear approaches for the quantification of imaging system performance assessment and post-acquisition image analysis, attempting to set new standards in the field of FI.
PURPOSE: Intraoperative fluorescence imaging (FI) is a promising technique that could potentially guide oncologic surgeons toward more radical resections and thus improve clinical outcome. Despite the increase in the number of clinical trials, fluorescent agents and imaging systems for intraoperative FI, a standardized approach for imaging system performance assessment and post-acquisition image analysis is currently unavailable. PROCEDURES: We conducted a systematic, controlled comparison between two commercially available imaging systems using a novel calibration device for FI systems and various fluorescent agents. In addition, we analyzed fluorescence images from previous studies to evaluate signal-to-background ratio (SBR) and determinants of SBR. RESULTS: Using the calibration device, imaging system performance could be quantified and compared, exposing relevant differences in sensitivity. Image analysis demonstrated a profound influence of background noise and the selection of the background on SBR. CONCLUSIONS: In this article, we suggest clear approaches for the quantification of imaging system performance assessment and post-acquisition image analysis, attempting to set new standards in the field of FI.
Entities:
Keywords:
Fluorescence; Image analysis; Optical imaging; Phantom; Quantification; Signal-to-noise ratio
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