Healthc Inform Res.  2014 Jul;20(3):191-198. 10.4258/hir.2014.20.3.191.

New Parametric Imaging Method with Fluorescein Angiograms for Detecting Areas of Capillary Nonperfusion

• Kim YJ
• Jeong CB
• Hwang JM
• Yang HK
• Lee SH
• Kim KG

• KMID: 2284582
• DOI: http://doi.org/10.4258/hir.2014.20.3.191

Abstract

OBJECTIVES
Fluorescein angiography (FAG) is currently the most useful diagnostic modality for examining retinal circulation, and it is frequently used for the evaluation of patients with diabetic retinopathy, occlusive diseases, such as retinal venous and arterial occlusions, and wet macular degeneration. This paper presents a method for objectively evaluating retinal circulation by quantifying circulation-related parameters.
METHODS
This method allows the semiautomatic preprocessing and registering of FAG images. The arterial input function is estimated from the registered set of FAG images using gamma-variate fitting. Then, the parameters can be computed by deconvolution on the basis of truncated singular value decomposition, and they can finally be presented as parametric color images in a combination of three colors, red, green, and blue.
RESULTS
After the estimation of arterial input function, the parameters of relative blood flow and mean transit time were computed using deconvolution analysis based on truncated singular value decomposition.
CONCLUSIONS
The parametric color image is helpful to interpret the status of retinal blood circulation and provides quantitative data on retina ischemia without interobserver variability. This system easily provides the status of retinal blood circulation both qualitatively and quantitatively. It also helps to standardize FAG interpretation and may contribute to network-based telemedicine systems in the future.

Keyword

Fluorescein Angiography; Ophthalmology; Eye Disease; Computer-Assisted Diagnosis; Biomedical Engineering

MeSH Terms

Biomedical Engineering
Blood Circulation
Capillaries*
Diabetic Retinopathy
Diagnosis, Computer-Assisted
Eye Diseases
Fluorescein Angiography
Fluorescein*
Humans
Ischemia
Observer Variation
Ophthalmology
Retina
Retinaldehyde
Telemedicine
Wet Macular Degeneration
Fluorescein
Retinaldehyde

Figure

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  Figure 1 Flow diagram for image registration. CLAHE: contrast-limited adaptive histogram equalization.

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  Figure 2 The result of image registration: (A) reference image, (B) moving image, (C) registered moving image, (D/E) difference image before/after registration.

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  Figure 3 (A) A red region of interest (ROI) at the artery area. (B) The result of gamma-variate curve fitting for estimation estimating of the arterial input function.

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  Figure 4 (A) Reference image, (B) moving image before registration, (C) moving image after registration, (D) difference image between (A) and (B), and (E) difference image between (A) and (C).

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  Figure 5 Fluorescein angiogram images (A, D, G), parametric images of blood flow (B, E, H) and mean transit time (C, F, I).

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