Use of Image Transformation to Track the Natural History of Diseases

Albert Shar, Vice President of Information Technology at the Robert Wood Johnson Foundation, has patented a technique for creating more accurate images of lesions inside the body; several trials have used the technique to track changes over time in the size of lesions.

Measuring the surface area of a lesion is integral to detecting changes in the lesion. Endoscopy— a standard imaging technique used to measure the size of gastrointestinal lesions— tends to distort the structure surrounding the lesion, making it difficult to accurately measure the lesion itself.

In this article, Mr. Shar presents his process of “flattening” images of tubular structures. In the "Shar process," an endoscope moves up or down the tubular structure (e.g., the esophagus), capturing a series of images; a mathematical formula knits together these images so that the interior surface of the tube can be “flattened.”

In this installment of Original Research, from Pragmatic and Observational Research, Mr. Shar describes three clinical trials that have implemented his technique. He includes single eodoscopic photos and final, “flattened” images from each trial.

Key Findings:

  • The Shar technique applies to any hollow cylindrical structure into which a camera can be placed and aligned.
  • The technique allowed for quantitative measurement of the surface area of Barrett’s esophagus in Chemoprevention for Barrett’s Esophagus Trial.
  • One study used the Shar process to measure the shape and size of excised tissue.

The technique will help detect changes in the surface area of lesions inside the body.