ABSTRACT
PURPOSE: To provide a computer-aided visualization tool for accurate diagnosis and quantification of choroidal neovascularization (CNV) on the basis of fluorescence leakage characteristics. METHODS: All image frames of a fluorescein angiography (FA) sequence are first aligned and mapped to a global space. To automatically determine the severity of each pixel in the global space and hence the extent of CNV, the system matches the intensity variation of each set of spatially corresponding pixels across the sequence with the targeted leakage pattern, learned from a sampled population graded by a retina specialist. The learning strategy, known as the AdaBoost algorithm, has 12 classifiers for 12 features that summarize the variation in fluorescence intensity over time. Given a new sequence, the severity map image is generated using the contribution scores of the 12 classifiers. Initialized with points of low and high severity, regions of CNV are delineated using the random walk algorithm. RESULTS: A dataset of 33 FA sequences of classic CNV showed the average accuracy of CNV delineation to be 83.26%. In addition, the 30- to 60-second interval provided the most reliable information for differentiating CNV from the background. Using eight sequences of multiple visits of four patients for evaluation of the postphotodynamic therapy (PDT), the statistics derived from the segmented regions correlate closely with the clinical observed changes. CONCLUSIONS: The clinician can easily visualize the temporal characteristics of CNV fluorescence leakage using the severity map, which is a two-dimensional summary of a complete FA sequence. The computer-aided tool allows objective evaluation and computation of statistical data from the automatic delineation for surgical assessment.
