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Jeffrey W. Berger, Jonathan Yoken; Computer-Assisted Quantitation of Choroidal Neovascularization for Clinical Trials. Invest. Ophthalmol. Vis. Sci. 2000;41(8):2286-2295.
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purpose. To develop a computer-assisted method for the quantitation of choroidal
neovascularization (CNV) for the support of clinical trials.
methods. Fluorescein angiographic images were selected from 5 patients enrolled
in a clinical trial for which three follow-up visits were available.
Thirty- and 600-second images were digitized at 1000 dots/in
and registered (aligned) with polynomial warping algorithms.
Custom-developed software allowed for coarse, automated identification
of CNV. An easy-to-use graphical user interface facilitated supervision
and refinement of the lesion boundaries by a skilled reader based on
standard stereoscopic viewing of the fluorescein angiography study.
Capabilities for boundary delineation in both early and late phases,
and animation to allow for image correlation and evaluation of temporal
changes in fluorescence of spatially corresponding pixels, were
included. Two metrics for CNV characterization were generated. First,
the lesion area based on the lesion boundaries was identified after
supervision. Second, an integrated lesion intensity (ILI)
reflecting the integrated, normalized lesion hyperfluorescence was
results. Area and ILI measures were calculated for each of 5 patients for three
or more visits. Facile supervision based on the stereoscopic angiogram
permitted arbitrarily close concordance with CNV identification using
standard methods. Changes in area and ILI measurements between visits
correlated closely with clinically observed changes in each case.
conclusions. Interactive image processing permits efficient, accurate,
computer-assisted CNV quantitation that may be useful for the support
of clinical trials and preclinical studies.
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