A Simple Sign for Recognizing Off–Axis OCT Measurement Beam Placement in the Context of Multicentre Studies
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{"title"=>"A Simple Sign for Recognizing Off-Axis OCT Measurement Beam Placement in the Context of Multicentre Studies", "type"=>"journal", "authors"=>[{"first_name"=>"Lisanne J.", "last_name"=>"Balk", "scopus_author_id"=>"35200468000"}, {"first_name"=>"Willemien A E J", "last_name"=>"de Vries-Knoppert", "scopus_author_id"=>"6603658213"}, {"first_name"=>"Axel", "last_name"=>"Petzold", "scopus_author_id"=>"7006826396"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"84869061392", "doi"=>"10.1371/journal.pone.0048222", "issn"=>"19326203", "pui"=>"366041820", "isbn"=>"1932-6203", "pmid"=>"23144857", "scopus"=>"2-s2.0-84869061392"}, "id"=>"4330aa83-3854-3a89-8cb7-fe4ea2ac6ed2", "abstract"=>"PURPOSE: Optical coherence tomography (OCT) allows quantification of the thickness of the retinal nerve fibre layer (RNFL) thickness, a potential biomarker for neurodegeneration. The estimated annual RNFL loss in multiple sclerosis amounts to 2 μm using time domain OCT. The recognition of measurement artifacts exceeding this limit is relevant for the successful use of OCT as a secondary outcome measure in clinical trials.\\n\\nMETHODS: Prospective study design. An exploratory pilot study (ring and volume scans) followed by a cohort study (1,980 OCT ring scans). The OCT measurement beam was placed off-axis to the left, right, top and bottom of the subjects pupil and RNFL thickness of these scans were compared to the centrally placed reference scans.\\n\\nRESULTS: Off-axis placement of the OCT measurement beam resulted in significant artifacts in RNFL thickness measurements (95%CI 9μm, maximal size of error 42μm). Off-axis placement gave characteristic patterns of the OCT live images which are not necessarily saved for review. Off-axis placement also causes regional inhomogeneity of reflectivity in the outer nuclear (ONL) and outer plexiform layers (OPL) which remains visible on scans saved for review.\\n\\nCONCLUSION: Off-axis beam placement introduces measurement artifacts at a magnitude which may mask recognition of RNFL loss due to neurodegeneration in multiple sclerosis. The resulting pattern in the OCT live image can only be recognised by the technician capturing the scans. Once the averaged scans have been aligned this pattern is lost. Retrospective identification of this artifact is however possible by presence of regional inhomogeneity of ONL/OPL reflectivity. This simple and robust sign may be considered for quality control criteria in the setting of multicentre OCT studies. The practical advice of this study is to keep the OCT image in the acquisition window horizontally aligned whenever possible.", "link"=>"http://www.mendeley.com/research/simple-sign-recognizing-offaxis-oct-measurement-beam-placement-context-multicentre-studies", "reader_count"=>17, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Researcher"=>6, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Student > Master"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Researcher"=>6, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Student > Master"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Engineering"=>3, "Medicine and Dentistry"=>7, "Neuroscience"=>1, "Sports and Recreations"=>1, "Physics and Astronomy"=>1, "Psychology"=>2, "Computer Science"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>3}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>7}, "Neuroscience"=>{"Neuroscience"=>1}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Psychology"=>{"Psychology"=>2}, "Computer Science"=>{"Computer Science"=>1}, "Unspecified"=>{"Unspecified"=>1}}, "reader_count_by_country"=>{"United Kingdom"=>1}, "group_count"=>1}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/291652", "https://ndownloader.figshare.com/files/291720", "https://ndownloader.figshare.com/files/291776"], "description"=>"<div><h3>Purpose</h3><p>Optical coherence tomography (OCT) allows quantification of the thickness of the retinal nerve fibre layer (RNFL) thickness, a potential biomarker for neurodegeneration. The estimated annual RNFL loss in multiple sclerosis amounts to 2 <em>μ</em>m using time domain OCT. The recognition of measurement artifacts exceeding this limit is relevant for the successful use of OCT as a secondary outcome measure in clinical trials.</p> <h3>Methods</h3><p>Prospective study design. An exploratory pilot study (ring and volume scans) followed by a cohort study (1,980 OCT ring scans). The OCT measurement beam was placed off–axis to the left, right, top and bottom of the subjects pupil and RNFL thickness of these scans were compared to the centrally placed reference scans.</p> <h3>Results</h3><p>Off–axis placement of the OCT measurement beam resulted in significant artifacts in RNFL thickness measurements (95%CI 9<em>μ</em>m, maximal size of error 42<em>μ</em>m). Off–axis placement gave characteristic patterns of the OCT live images which are not necessarily saved for review. Off–axis placement also causes regional inhomogeneity of reflectivity in the outer nuclear (ONL) and outer plexiform layers (OPL) which remains visible on scans saved for review.</p> <h3>Conclusion</h3><p>Off–axis beam placement introduces measurement artifacts at a magnitude which may mask recognition of RNFL loss due to neurodegeneration in multiple sclerosis. The resulting pattern in the OCT live image can only be recognised by the technician capturing the scans. Once the averaged scans have been aligned this pattern is lost. Retrospective identification of this artifact is however possible by presence of regional inhomogeneity of ONL/OPL reflectivity. This simple and robust sign may be considered for quality control criteria in the setting of multicentre OCT studies. The practical advice of this study is to keep the OCT image in the acquisition window horizontally aligned whenever possible.</p> </div>", "links"=>[], "tags"=>["recognizing", "oct", "multicentre", "studies"], "article_id"=>117417, "categories"=>["Information And Computing Sciences", "Physiology", "Neuroscience", "Medicine"], "users"=>["Lisanne J. Balk", "Willemien A. E. J. de Vries–Knoppert", "Axel Petzold"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0048222.s001", "https://dx.doi.org/10.1371/journal.pone.0048222.s002", "https://dx.doi.org/10.1371/journal.pone.0048222.s003"], "stats"=>{"downloads"=>11, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/A_Simple_Sign_for_Recognizing_Off_Axis_OCT_Measurement_Beam_Placement_in_the_Context_of_Multicentre_Studies__/117417", "title"=>"A Simple Sign for Recognizing Off–Axis OCT Measurement Beam Placement in the Context of Multicentre Studies", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2012-11-08 02:03:37"}
  • {"files"=>["https://ndownloader.figshare.com/files/545113"], "description"=>"<p>(<b>A</b>) All averaged ONH ring scan images are of high signal strength and quality (ART 25, signal >35 dB) taken for large temporal and nasal off–axis beam placement from subject #1 (OD) are shown (note the 10 additional scans with only small off-axis placement are of comparable quality). (<b>B</b>) The ring scan RNFL data was separately analyzed for the nasal and temporal sectors. The direction and size of the resulting measurement error compared to the reference scan (vertical dashed reference line) are shown as a histogram for the nasal and temporal sectors. The inlay indicates direction of off-axis beam placement in each case. The overlaid Gaussian curve illustrates the mirror pattern of the resulting over-/underestimation of the RNFL thickness in this subject. The y-axis gives the percentage of scans for the range of measurement error in µm shown on the x-axis.</p>", "links"=>[], "tags"=>["changes", "rnfl"], "article_id"=>215610, "categories"=>["Information And Computing Sciences", "Physiology", "Neuroscience", "Medicine"], "users"=>["Lisanne J. Balk", "Willemien A. E. J. de Vries–Knoppert", "Axel Petzold"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0048222.g004", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Scan_quality_and_direction_of_changes_in_RNFL_thickness_/215610", "title"=>"Scan quality and direction of changes in RNFL thickness.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-11-08 01:33:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/545285"], "description"=>"<p>Female  =  f, male  = m, MD  =  mean field deviation, VF  =  visual field.</p>", "links"=>[], "tags"=>["ophthalmology", "physiology", "computer science", "neurological disorders"], "article_id"=>215782, "categories"=>["Information And Computing Sciences", "Physiology", "Neuroscience", "Medicine"], "users"=>["Lisanne J. Balk", "Willemien A. E. J. de Vries–Knoppert", "Axel Petzold"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0048222.t002", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Subject_characteristics_/215782", "title"=>"Subject characteristics.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-11-08 01:36:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/545341"], "description"=>"<p>The pilot study shows that quantification of the RNFL thickness depends on placement of the measurement beam. The mean±standard deviation are shown. Group comparisons were done using the Kruskal–Wallis test.</p><p>PMB =  papillomacular bundle.</p>", "links"=>[], "tags"=>["rnfl"], "article_id"=>215842, "categories"=>["Information And Computing Sciences", "Physiology", "Neuroscience", "Medicine"], "users"=>["Lisanne J. Balk", "Willemien A. E. J. de Vries–Knoppert", "Axel Petzold"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0048222.t001", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Quantification_of_RNFL_thickness_/215842", "title"=>"Quantification of RNFL thickness.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-11-08 01:37:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/545045"], "description"=>"<p>(<b>A</b>) The averaged summary scan obtained from the correctly, horizontally orientated live images of the reference scan shown in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0048222#pone-0048222-g002\" target=\"_blank\">Figure 2A</a>. This images shows a homogeneous reflectivity of the outer ONL (black arrow). The automated segmentation identifies the borders of the RNFL (red/gray lines). Note, this is the image which is send to the reading centre and used for automated calculation of the RNFL thickness shown in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0048222#pone-0048222-t001\" target=\"_blank\">Table 1</a>. (<b>B</b>) temporal off-axis placement results in a inhomogeneous outer ONL reflectivity. The ONL reflectivity is increased for the centrally elevated part in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0048222#pone-0048222-g002\" target=\"_blank\">Figure 2B</a> (white arrows) and decreased in the periphery (gray arrows). (<b>C</b>) nasal off–axis placement (<b>D</b>) superior off-axis placement (<b>E</b>) inferior off–axis placement.</p>", "links"=>[], "tags"=>["reflectivity", "onl", "indicates", "centre", "oct"], "article_id"=>215535, "categories"=>["Information And Computing Sciences", "Physiology", "Neuroscience", "Medicine"], "users"=>["Lisanne J. Balk", "Willemien A. E. J. de Vries–Knoppert", "Axel Petzold"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0048222.g003", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Inhomogeneous_reflectivity_of_the_outer_part_of_the_ONL_indicates_off_centre_placement_of_the_OCT_measurement_beam_/215535", "title"=>"Inhomogeneous reflectivity of the outer part of the ONL indicates off centre placement of the OCT measurement beam.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-11-08 01:32:15"}
  • {"files"=>["https://ndownloader.figshare.com/files/544823"], "description"=>"<p>(<b>A</b>) The OCT measurement beam is focused on the dilated right eye of subject #1, (<b>B</b>) temporal off–axis placement of the measurement beam results in a shorter light path to the temporal part of the optic nerve head (dotted line) and a longer pathway from the nasal part of the optic nerve head (dotted-dashed line). The difference in path length results in a tilted appearance of the B–scan. (<b>C</b>) Nasal off–axis placement of themeasurement beam results in a mirror pattern. The resulting averaged OCT image is of good quality (ART 25, signal strength 35 dB) for both (<b>D</b>) temporal off–axis placement and (<b>E</b>) nasal off–axis placement. The quantification of the RNFL thickness by the algorithm is however clearly different (Global average OD with temporal off-axis placement 106 μm and nasal off–axis placement 103 μm).</p>", "links"=>[], "tags"=>["centre"], "article_id"=>215320, "categories"=>["Information And Computing Sciences", "Physiology", "Neuroscience", "Medicine"], "users"=>["Lisanne J. Balk", "Willemien A. E. J. de Vries–Knoppert", "Axel Petzold"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0048222.g001", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Off_centre_placement_of_the_measurement_beam_/215320", "title"=>"Off centre placement of the measurement beam.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-11-08 01:28:40"}
  • {"files"=>["https://ndownloader.figshare.com/files/545316"], "description"=>"<p>Values are reported as mean±standard deviation.</p><p>PMB =  papillomacular bundle.</p>", "links"=>[], "tags"=>["artifacts", "caused", "off-centre", "compared"], "article_id"=>215813, "categories"=>["Information And Computing Sciences", "Physiology", "Neuroscience", "Medicine"], "users"=>["Lisanne J. Balk", "Willemien A. E. J. de Vries–Knoppert", "Axel Petzold"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0048222.t003", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_mean_measurement_artifacts_caused_by_small_and_large_off_centre_beam_placement_compared_to_central_beam_placement_are_shown_/215813", "title"=>"The mean measurement artifacts caused by small and large off-centre beam placement compared to central beam placement are shown.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-11-08 01:36:53"}
  • {"files"=>["https://ndownloader.figshare.com/files/545204"], "description"=>"<p>In about 78% of all measurements there is an error of ≥|0| μm, in 5% ≥|9| μm with a maximum error of |42| μm. An accurate measurement (0 μm error) is indicated by the dashed vertical reference line. The size of the measurement error demonstrates a Gaussian distribution to both sides of the vertical reference line (gray shaded curve). The y-axis gives the percentage of scans for the range of measurement error in µm shown on the x-axis.</p>", "links"=>[], "tags"=>["caused"], "article_id"=>215698, "categories"=>["Information And Computing Sciences", "Physiology", "Neuroscience", "Medicine"], "users"=>["Lisanne J. Balk", "Willemien A. E. J. de Vries–Knoppert", "Axel Petzold"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0048222.g005", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Measurement_error_in_956_m_caused_by_off_8211_axis_beam_placement_/215698", "title"=>"Measurement error in μm caused by off–axis beam placement.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-11-08 01:34:58"}
  • {"files"=>["https://ndownloader.figshare.com/files/544964"], "description"=>"<p>Here we show the OCT live image obtained by the optic nerve head ring scan. (<b>A</b>) The reference scan with the measurement beam (yellow dot) being placed centrally in the pupil (black circle). This results in a correct, horizontal OCT live image. Note, the live image will not be visible to the reading centre (note the live image was taken as a screen shot during the imaging and appears in print in lower quality than in reality. Please see the video in the supplementary material for a live coverage image acquisition). (<b>B</b>) Temporal off–axis placement of the measurement beam results in a centrally convex live image. (<b>C</b>) Nasal off–axis placement results in a centrally concave OCT live image. (<b>D</b>) Superior off–axis placement results in a rising wave which is mirrored by (<b>E</b>) inferior off–axis placement (a falling wave). Please note that for didactic purposes the off–axis placement of the measurement beam is shown for an idealized situation with a central fixation target for a perfectly aligned right subject's eye from the OCT operators point of view.</p>", "links"=>[], "tags"=>["centre", "oct", "tilted"], "article_id"=>215455, "categories"=>["Information And Computing Sciences", "Physiology", "Neuroscience", "Medicine"], "users"=>["Lisanne J. Balk", "Willemien A. E. J. de Vries–Knoppert", "Axel Petzold"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0048222.g002", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Off_centre_placement_of_the_OCT_measurement_beam_results_in_tilted_images_/215455", "title"=>"Off centre placement of the OCT measurement beam results in tilted images.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-11-08 01:30:55"}

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Relative Metric

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