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      OCT-angiography: A qualitative and quantitative comparison of 4 OCT-A devices

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          Abstract

          Purpose

          To compare the quality of four OCT-angiography(OCT-A) modules.

          Method

          The retina of nineteen healthy volunteers were scanned with four OCT-devices (Topcon DRI-OCT Triton Swept-source OCT, Optovue RTVue-XR, a prototype Spectralis OCT2, Heidelberg-Engineering and Zeiss Cirrus 5000-HD-OCT). The device-software generated en-face OCT-A images of the superficial (SCP) and deep capillary plexuses (DCP) were evaluated and scored by 3 independent retinal imaging experts. The SCP vessel density was assessed using Angiotool-software. After the inter-grader reliability assessment, a consensus grading was performed and the modules were ranked based on their scoring.

          Results

          There was no significant difference in the vessel density among the modules (Zeiss 48.7±4%, Optovue 47.9±3%, Topcon 48.3±2%, Heidelberg 46.5±4%, p = 0.2). The numbers of discernible vessel-bifurcations differed significantly on each module (Zeiss 2±0.9 bifurcations, Optovue 2.5±1.2, Topcon 1.3±0.7 and Heidelberg 0.5±0.6, p≤0.001). The ranking of each module differed depending on the evaluated parameter. In the overall ranking, the Zeiss module was superior and in 90% better than the median (Bonferroni corrected p-value = 0.04). Optovue was better than the median in 60%, Topcon in 40% and Heidelberg module in 10%, however these differences were not statistically significant.

          Conclusion

          Each of the four evaluated OCT-A modules had particular strengths, which differentiated it from their competitors.

          Related collections

          Most cited references 21

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          Split-spectrum amplitude-decorrelation angiography with optical coherence tomography

          Amplitude decorrelation measurement is sensitive to transverse flow and immune to phase noise in comparison to Doppler and other phase-based approaches. However, the high axial resolution of OCT makes it very sensitive to the pulsatile bulk motion noise in the axial direction. To overcome this limitation, we developed split-spectrum amplitude-decorrelation angiography (SSADA) to improve the signal-to-noise ratio (SNR) of flow detection. The full OCT spectrum was split into several narrower bands. Inter-B-scan decorrelation was computed using the spectral bands separately and then averaged. The SSADA algorithm was tested on in vivo images of the human macula and optic nerve head. It significantly improved both SNR for flow detection and connectivity of microvascular network when compared to other amplitude-decorrelation algorithms.
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            A Computational Tool for Quantitative Analysis of Vascular Networks

            Angiogenesis is the generation of mature vascular networks from pre-existing vessels. Angiogenesis is crucial during the organism' development, for wound healing and for the female reproductive cycle. Several murine experimental systems are well suited for studying developmental and pathological angiogenesis. They include the embryonic hindbrain, the post-natal retina and allantois explants. In these systems vascular networks are visualised by appropriate staining procedures followed by microscopical analysis. Nevertheless, quantitative assessment of angiogenesis is hampered by the lack of readily available, standardized metrics and software analysis tools. Non-automated protocols are being used widely and they are, in general, time - and labour intensive, prone to human error and do not permit computation of complex spatial metrics. We have developed a light-weight, user friendly software, AngioTool, which allows for quick, hands-off and reproducible quantification of vascular networks in microscopic images. AngioTool computes several morphological and spatial parameters including the area covered by a vascular network, the number of vessels, vessel length, vascular density and lacunarity. In addition, AngioTool calculates the so-called “branching index” (branch points / unit area), providing a measurement of the sprouting activity of a specimen of interest. We have validated AngioTool using images of embryonic murine hindbrains, post-natal retinas and allantois explants. AngioTool is open source and can be downloaded free of charge.
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              Optical Coherence Tomography Angiography

              Optical coherence tomography angiography (OCTA) is a noninvasive approach that can visualize blood vessels down to the capillary level. With the advent of high-speed OCT and efficient algorithms, practical OCTA of ocular circulation is now available to ophthalmologists. Clinical investigations that used OCTA have increased exponentially in the past few years. This review will cover the history of OCTA and survey its most important clinical applications. The salient problems in the interpretation and analysis of OCTA are described, and recent advances are highlighted.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                10 May 2017
                2017
                : 12
                : 5
                Affiliations
                [1 ]Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Switzerland
                [2 ]Bern Photographic Reading Center, University of Bern, Switzerland
                [3 ]Department of Clinical Research, Inselspital Bern University Hospital, University of Bern, Switzerland
                [4 ]Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
                Justus Liebig Universitat Giessen, GERMANY
                Author notes

                Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: Sebastian Wolf is a consultant for Heidelberg Engineering and Zeiss. Martin S Zinkernagel is a consultant for Heidelberg Engineering. The remaining authors have no financial/proprietary interests relevant to this paper. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                • Conceptualization: MRM SW MSZ.

                • Data curation: MRM HGZ LB WH AE.

                • Formal analysis: WH MRM.

                • Funding acquisition: SW MSZ.

                • Investigation: MRM HGZ LB.

                • Methodology: MRM SW MSZ.

                • Project administration: MRM.

                • Resources: SW MSZ AE.

                • Software: WH AE.

                • Supervision: MRM MSZ SW.

                • Validation: WH MRM HGZ LB.

                • Visualization: MRM.

                • Writing – original draft: MRM.

                • Writing – review & editing: MRM HGZ LB WH AE SW MSZ.

                Article
                PONE-D-17-10099
                10.1371/journal.pone.0177059
                5425250
                28489918
                a1d3ae18-ac79-4da0-8353-4448cbfd5744
                © 2017 Munk et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 5, Tables: 2, Pages: 14
                Product
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Engineering and Technology
                Signal Processing
                Image Processing
                Engineering and Technology
                Technology Development
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                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Tomography
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
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                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
                Tomography
                Biology and Life Sciences
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                Medicine and Health Sciences
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                Ocular System
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                Anatomy
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                Retina
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                Anatomy
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                Cardiovascular Medicine
                Cardiovascular Imaging
                Angiography
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