Dynamic optical contrast imaging (DOCI): system theory for rapid, wide-field, multispectral optical imaging using fluorescence lifetime contrast mechanism," ABSTRACT Dynamic Optical Contrast Imaging (DOCI) is an imaging technique that generates image contrast through ratiometric measurements of the autofluorescence decay rates of aggregate fluorophores in tissue. This method enables better tissue characterization by utilizing wide-field signal integration, eliminating constraints of uniform illumination, and reducing time-intensive computations that are bottlenecks in the clinical translation of traditional fluorescence lifetime imaging. Previous works have demonstrated remarkable tissue contrast between tissue types in clinical human pilot studies. However, there are still challenges in the development of several subsystems, which results in existing works to use relative models. A comprehensive mathematical framework is presented to describe the contrast mechanism of the DOCI system to allow intraoperative quantitative imaging, which merits consideration for evaluation in measuring tissue characteristics in several important clinical settings.
Purpose
To review existing classification systems for degenerative spondylolisthesis (DS), propose a novel classification designed to better address clinically relevant radiographic and clinical features of disease, and determine the inter- and intraobserver reliability of this new system for classifying DS.
Methods
The proposed classification system includes four components: 1) segmental dynamic instability, 2) location of spinal stenosis, 3) sagittal alignment, and 4) primary clinical presentation. To establish the reliability of this system, 12 observers graded 10 premarked test cases twice each. Kappa values were calculated to assess the inter- and intraobserver reliability for each of the four components separately.
Results
Interobserver reliability for dynamic instability, location of stenosis, sagittal alignment, and clinical presentation was 0.94, 0.80, 0.87, and 1.00, respectively. Intraobserver reliability for dynamic instability, location of stenosis, sagittal alignment, and clinical presentation were 0.91, 0.88, 0.87, and 0.97, respectively.
Conclusion
The UCSF DS classification system provides a novel framework for assessing DS based on radiographic and clinical parameters with established implications for surgical treatment. The almost perfect interobserver and intraobserver reliability observed for all components of this system demonstrates that it is simple and easy to use. In clinical practice, this classification may allow subclassification of similar patients into groups that may benefit from distinct treatment strategies, leading to the development of algorithms to help guide selection of an optimal surgical approach. Future work will focus on the clinical validation of this system, with the goal of providing for more evidence-based, standardized approaches to treatment and improved outcomes for patients with DS.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.