Abstract
BackgroundKaposi’s sarcoma (KS) is the most frequently occurring cancer in Mozambique among men and the second most frequently occurring cancer among women. Effective therapeutic treatments for KS are poorly understood in this area. There is an unmet need to develop a simple but accurate tool for improved monitoring and diagnosis in a resource-limited setting. Standardized clinical photographs have been considered to be an essential part of the evaluation.MethodsWhen a therapeutic response is achieved, nodular KS often exhibits a reduction of the thickness without a change in the base area of the lesion. To evaluate the vertical space along with other characters of a KS lesion, we have created an innovative imaging system with a consumer light-field camera attached to a miniature “photography studio” adaptor. The image file can be further processed by computational methods for quantification.ResultsWith this novel imaging system, each high-quality 3D image was consistently obtained with a single camera shot at bedside by minimally trained personnel. After computational processing, all-focused photos and measurable 3D parameters were obtained. More than 80 KS image sets were processed in a semi-automated fashion.ConclusionsIn this proof-of-concept study, the feasibility to use a simple, low-cost and user-friendly system has been established for future clinical study to monitor KS therapeutic response. This 3D imaging system can be also applied to obtain standardized clinical photographs for other diseases.
Highlights
Kaposi’s sarcoma (KS) is the most frequently occurring cancer in Mozambique among men and the second most frequently occurring cancer among women
In 1989, The AIDS Clinical Trial Group (ACTG) proposed a KS staging system using a three-tiered system that classified the extent of tumor (T) involvement, the status of a patient’s immune system (I) assessed by CD4 cell count, and the severity of their systemic illness (S) as “good risk” or “poor risk” [3]
It would be difficult to generate informative images without knowing where to focus. To overcome this dilemma and to ease the technical hurdles, we have developed an innovative approach by taking advantage of the light-field photography in conjunction with a design of a miniaturized “photography studio” to control environment and standardize the image presentation
Summary
Kaposi’s sarcoma (KS) is the most frequently occurring cancer in Mozambique among men and the second most frequently occurring cancer among women. Standardized clinical photographs have been considered to be an essential part of the evaluation. It cannot be over-emphasized that high-quality images are critical for clinical decisions. The ACTG staging system and variants that are used to assess KS therapeutic response may include lesion counts, assessment of lesion color, nodularity, ulceration and associated edema, measurement of sum of the product of the diameters of 5 marker lesions, and evaluation for oral KS and secondary effects of KS [3,4,5,6]. The color and degree of nodularity of KS lesions are difficult to quantify, but often provide important information about response to treatment [3]. While conventional photography is probably the single most useful technique for imaging KS, it does not provide enough information about tumor nodularity and other important characteristics
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