Clinical evaluation of a device providing simultaneous white-light and fluorescence video streams as well as panoramic imaging during fluorescence assisted-transurethral resection of bladder cancer.

The current clinical study is aimed at evaluating the clinical relevance of an innovative device (called CyPaM2 device) that for the first time provides urologists with (i) a panoramic image of the bladder inner wall within the surgery time, and with (ii) a simultaneous (bimodal) display of fluorescence and white-light video streams during the fluorescence assisted-transurethral resection of bladder cancers procedure. The clinical relevance of this CyPaM2 device was evaluated on 10 patients according to three criteria (image quality, fluorescent lesions detection relevance, and ergonomics) compared with a reference medical device. Innovative features displayed by the CyPaM2 device were evaluated without any possible comparison: (i) simultaneous bimodal display of white-light and fluorescence video streams, (ii) remote light control, and (iii) time delay for the panoramic image building. The results highlight the progress to achieve in order to obtain a fully mature device ready for commercialization and the relevance of the innovative features proposed by the CyPaM2 device confirming their interest.

Assessment of a Monte-Carlo simulation of SPECT recordings from a new-generation heart-centric semiconductor camera: from point sources to human images.

Geant4 application for tomographic emission (GATE), a Monte-Carlo simulation platform, has previously been used for optimizing tomoscintigraphic images recorded with scintillation Anger cameras but not with the new-generation heart-centric cadmium-zinc-telluride (CZT) cameras. Using the GATE platform, this study aimed at simulating the SPECT recordings from one of these new CZT cameras and to assess this simulation by direct comparison between simulated and actual recorded data, ranging from point sources to human images. Geometry and movement of detectors, as well as their respective energy responses, were modeled for the CZT 'D.SPECT' camera in the GATE platform. Both simulated and actual recorded data were obtained from: (1) point and linear sources of (99m)Tc for compared assessments of detection sensitivity and spatial resolution, (2) a cardiac insert filled with a (99m)Tc solution for compared assessments of contrast-to-noise ratio and sharpness of myocardial borders and (3) in a patient with myocardial infarction using segmented cardiac magnetic resonance imaging images. Most of the data from the simulated images exhibited high concordance with the results of actual images with relative differences of only: (1) 0.5% for detection sensitivity, (2) 6.7% for spatial resolution, (3) 2.6% for contrast-to-noise ratio and 5.0% for sharpness index on the cardiac insert placed in a diffusing environment. There was also good concordance between actual and simulated gated-SPECT patient images for the delineation of the myocardial infarction area, although the quality of the simulated images was clearly superior with increases around 50% for both contrast-to-noise ratio and sharpness index. SPECT recordings from a new heart-centric CZT camera can be simulated with the GATE software with high concordance relative to the actual physical properties of this camera. These simulations may be conducted up to the stage of human SPECT-images even if further refinement is needed in this setting.