Relevant bibliographies by topics / Surgical margin delineation

Academic literature on the topic 'Surgical margin delineation'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "Surgical margin delineation"

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Debacker, Jens M., Vanessa Schelfhout, Lieve Brochez, David Creytens, Yves D’Asseler, Philippe Deron, Vincent Keereman, Koen Van de Vijver, Christian Vanhove, and Wouter Huvenne. "High-Resolution 18F-FDG PET/CT for Assessing Three-Dimensional Intraoperative Margins Status in Malignancies of the Head and Neck, a Proof-of-Concept." Journal of Clinical Medicine 10, no. 16 (August 22, 2021): 3737. http://dx.doi.org/10.3390/jcm10163737.

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The surgical treatment of head and neck malignancies relies on the complete removal of tumoral tissue, while inadequate margins necessitate the use of adjuvant therapy. However, most positive margins are identified postoperatively as deep margins, and intraoperative identification of the deep positive margins could help achieve adequate surgical margins and decrease adjuvant therapies. To improve deep-margin identification, we investigated whether the use of high-resolution preclinical PET and CT could increase certainty about the surgical margins in three dimensions. Patients with a malignancy of the head and neck planned for surgical resection were administered a clinical activity of 4MBq/kg 18F-FDG approximately one hour prior to surgical initiation. Subsequently, the resected specimen was scanned with a micro-PET-CT imaging device, followed by histopathological assessment. Eight patients were included in the study and intraoperative PET/CT-imaging of 11 tumoral specimens and lymph nodes of three patients was performed. As a result of the increased resolution, differentiation between inflamed and dysplastic tissue versus malignant tissue was complicated in malignancies with increased peritumoral inflammation. The current technique allowed the three-dimensional delineation of 18F-FDG using submillimetric PET/CT imaging. While further optimization and patient stratification is required, clinical implementation could enable deep margin assessment in head and neck resection specimens.
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Nagahama, Takashi, Kenshi Yao, Noriya Uedo, Hisashi Doyama, Tetsuya Ueo, Kunihisa Uchita, Hideki Ishikawa, et al. "Delineation of the extent of early gastric cancer by magnifying narrow-band imaging and chromoendoscopy: a multicenter randomized controlled trial." Endoscopy 50, no. 06 (February 13, 2018): 566–76. http://dx.doi.org/10.1055/s-0044-100790.

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Abstract Background Accurate delineation of tumor margins is necessary for curative resection of early gastric cancer (EGC). The objective of this multicenter, randomized, controlled study was to compare the accuracy with which magnifying narrow-band imaging (M-NBI) and indigo carmine chromoendoscopy delineate EGC margins. Methods Patients with EGC ≥ 10 mm undergoing endoscopic or surgical resection were enrolled. The oral-side margins of the lesions were first evaluated with conventional white-light endoscopy in both groups and then delineated by either chromoendoscopy or M-NBI. Biopsies were taken from noncancerous and cancerous mucosa, each at 5 mm from the margin. Accurate delineation was judged to have been achieved when the histological findings in all biopsy samples were consistent with endoscopic diagnoses. The primary end point was the difference in rate of accurate delineation between the two techniques. Results Data on 343 patients were analyzed. The accurate delineation rate (95 % confidence interval) was 85.7 % (80.4 – 91.0) in the chromoendoscopy group (n = 168), and 88.0 % (83.2 – 92.8) in the M-NBI group (n = 175; P = 0.63). Lower third tumor location (odds ratio [OR] 2.9; P = 0.01), nonflat macroscopic type (OR 4.4; P < 0.01), and high diagnostic confidence (OR 3.6; P < 0.001) were associated with accurate delineation, whereas use of M-NBI was not (OR 1.2; P = 0.39). Even after adjustment for identified confounders, the difference in accurate delineation between the groups was not significant (OR 1.0; P = 0.82). Conclusions M-NBI does not offer superior delineation of EGC margins compared with chromoendoscopy; the two methods appear to be clinically equivalent.
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Dika, Emi, Pier Alessandro Fanti, Alma Ismaili, Cosimo Misciali, Sabina Vaccari, Alessia Barisani, and Annalisa Patrizi. "Basal cell carcinoma margin delineation: is curettage useful? A surgical and histological study." Journal of Dermatological Treatment 24, no. 3 (February 24, 2013): 238–42. http://dx.doi.org/10.3109/09546634.2012.756572.

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DOUPLIK, ALEXANDRE, AZHAR ZAM, RALPH HOHENSTEIN, ANGELOS KALITZEOS, EMEKA NKENKE, and FLORIAN STELZLE. "LIMITATIONS OF CANCER MARGIN DELINEATION BY MEANS OF AUTOFLUORESCENCE IMAGING UNDER CONDITIONS OF LASER SURGERY." Journal of Innovative Optical Health Sciences 03, no. 01 (January 2010): 45–51. http://dx.doi.org/10.1142/s179354581000085x.

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Limitations of cancer margin delineation and surgical guidance by means of autofluorescence imaging under conditions of laser ablation were investigated and preliminary results are presented. PinPoint™ (Novadaq Technologies Inc., Canada) was used to capture digital images and Er:YAG laser (2.94 μm, Glissando, WaveLight™, Germany) was exploited to cause laser ablation on both normal and cancer sites of the specimen. It was shown that changes of the autofluorescence image after ablation extend beyond the actual sizes of the ablation loci. The tumor tissue after the laser ablation starts to emit fluorescent light within the green wavelength band (490–550 nm) similar to normal tissue stating that the current technology of in-process tissue classification fails. However, when the autofluorescence was collected in the red range (600–750 nm), then the abnormal/normal contrast was reduced, but still present even after the laser ablation. The present study highlights the importance of finding a proper technology for surgical navigation of cancer removal under conditions of high power effects in biological tissues.
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Edwards, Steven J., Ifigeneia Mavranezouli, George Osei-Assibey, Gemma Marceniuk, Victoria Wakefield, and Charlotta Karner. "VivaScope® 1500 and 3000 systems for detecting and monitoring skin lesions: a systematic review and economic evaluation." Health Technology Assessment 20, no. 58 (July 2016): 1–260. http://dx.doi.org/10.3310/hta20580.

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BackgroundSkin cancer is one of the most common cancers in the UK. The main risk factor is exposure to ultraviolet radiation from sunlight or the use of sunbeds. Patients with suspicious skin lesions are first examined with a dermoscope. After examination, those with non-cancerous lesions are discharged, but lesions that are still considered clinically suspicious are surgically removed. VivaScope®is a non-invasive technology designed to be used in conjunction with dermoscopy to provide a more accurate diagnosis, leading to fewer biopsies of benign lesions or to provide more accurate presurgical margins reducing the risk of cancer recurrence.ObjectivesTo evaluate the clinical effectiveness and cost-effectiveness of VivaScope®1500 (Caliber Imaging and Diagnostics, Rochester, NY, USA; Lucid Inc., Rochester, NY, USA; or Lucid Inc., MAVIG GmbH, Munich, Germany) and VivaScope®3000 (Caliber Imaging and Diagnostics, Rochester, NY, USA) in the diagnosis of equivocal skin lesions, and VivaScope 3000 in lesion margin delineation prior to surgical excision of lesions.Data sourcesDatabases (MEDLINE, EMBASE and The Cochrane Library) were searched on 14 October 2014, reference lists of included papers were assessed and clinical experts were contacted for additional information on published and unpublished studies.MethodsA systematic review was carried out to identify randomised controlled trials (RCTs) or observational studies evaluating dermoscopy plus VivaScope, or VivaScope alone, with histopathology as the reference test. A probabilistic de novo economic model was developed to synthesise the available data on costs and clinical outcomes from the UK NHS perspective. All costs were expressed as 2014 prices.ResultsSixteen studies were included in the review, but they were too heterogeneous to be combined in a meta-analysis. One of two diagnostic studies that were deemed most representative of UK clinical practice reported that dermoscopy plus VivaScope 1500 was significantly more sensitive than dermoscopy alone in the diagnosis of melanoma (97.8% vs. 94.6%;p = 0.043) and significantly more specific than dermoscopy alone in the diagnosis of non-melanoma (92.4% vs. 26.74%;p < 0.000001). The results of another study suggest 100% [95% confidence interval (CI) 86.16% to 100%] sensitivity for dermoscopy plus VivaScope 1500 versus 100% (95% CI 91.51% to 100%) for dermoscopy alone. Specificity varied from 51.77% to 80.2% depending on the analysis set used. In terms of margin delineation with VivaScope, one study found that 17 out of 29 patients with visible lentigo maligna (LM) had subclinical disease of > 5 mm beyond the dermoscopically identified margin. Using ‘optimistic’ diagnostic data, the economic model resulted in an incremental cost-effectiveness ratio (ICER) of £8877 per quality-adjusted life-year (QALY) (£9362 per QALY), while the ‘less favourable’ diagnostic data resulted in an ICER of £19,095 per QALY (£25,453 per QALY) in the diagnosis of suspected melanomas. VivaScope was also shown to be a dominant strategy when used for the diagnostic assessment of suspected basal cell carcinoma (BCC). Regarding margin delineation of LM, mapping with VivaScope was cost-effective, with an ICER of £10,241 per QALY (£11,651 per QALY). However, when VivaScope was used for diagnosis as well as mapping of LM, then the intervention cost was reduced and VivaScope became a dominant strategy.LimitationsThere is an absence of UK data in the included studies and, therefore, generalisability of the results to the UK population is unclear.ConclusionsThe use of VivaScope appears to be a cost-effective strategy in the diagnostic assessment of equivocal melanomas and BCCs, and in margin delineation of LM prior to surgical treatment.Future workHigh-quality RCTs are required in a UK population to assess the diagnostic accuracy of VivaScope in people with equivocal lesions.Study registrationThis study is registered as PROSPERO CRD42014014433.FundingThe National Institute for Health Research Health Technology Assessment programme.
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Makouei, Fatemeh, Caroline Ewertsen, Tina Klitmøller Agander, Mikkel Vestergaard Olesen, Bente Pakkenberg, and Tobias Todsen. "3D Ultrasound versus Computed Tomography for Tumor Volume Measurement Compared to Gross Pathology—A Pilot Study on an Animal Model." Journal of Imaging 8, no. 12 (December 19, 2022): 329. http://dx.doi.org/10.3390/jimaging8120329.

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The margin of the removed tumor in cancer surgery has an important influence on survival. Adjuvant treatments, prognostic complications, and financial costs are required when the pathologist observes a close/positive surgical margin. Ex vivo imaging of resected cancer tissue has been suggested for margin assessment, but traditional cross-sectional imaging is not optimal in a surgical setting. Instead, three-dimensional (3D) ultrasound is a portable, high-resolution, and low-cost method to use in the operation room. In this study, we aimed to investigate the accuracy of 3D ultrasound versus computed tomography (CT) to measure the tumor volume in an animal model compared to gross pathology assessment. The specimen was formalin fixated before systematic slicing. A slice-by-slice area measurement was performed to compare the accuracy of the 3D ultrasound and CT techniques. The tumor volume measured by pathological assessment was 980.2 mm3. The measured volume using CT was 890.4 ± 90 mm3, and the volume using 3D ultrasound was 924.2 ± 96 mm3. The correlation coefficient for CT was 0.91 and that for 3D ultrasound was 0.96. Three-dimensional ultrasound is a feasible and accurate modality to measure the tumor volume in an animal model. The accuracy of tumor delineation on CT depends on the soft tissue contrast.
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El Shafie, Rami, Eric Tonndorf-Martini, Daniela Schmitt, Dorothea Weber, Aylin Celik, Thorsten Dresel, Denise Bernhardt, et al. "Pre-Operative Versus Post-Operative Radiosurgery of Brain Metastases—Volumetric and Dosimetric Impact of Treatment Sequence and Margin Concept." Cancers 11, no. 3 (March 1, 2019): 294. http://dx.doi.org/10.3390/cancers11030294.

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Background: Pre-operative radiosurgery (SRS) preceding the resection of brain metastases promises to circumvent limitations of post-operative cavity SRS. It minimizes uncertainties regarding delineation and safety margins and could reduce dose exposure of the healthy brain (HB). Methods: We performed a systematic treatment plan comparison on 24 patients who received post-operative radiosurgery of the resection cavity at our institution. Comparative treatment plans were calculated for hypofractionated stereotactic radiotherapy (7 × 5 Gray (Gy)) in a hypothetical pre-operative (pre-op) and two post-operative scenarios, either with (extended field, post-op-E) or without the surgical tract (involved field, post-op-I). Detailed volumetric comparison of the resulting target volumes was performed, as well as dosimetric comparison focusing on targets and the HB. Results: The resection cavity was significantly smaller and different in morphology from the pre-operative lesion, yielding a low Dice Similarity Coefficient (DSC) of 53% (p = 0.019). Post-op-I and post-op-E targets showed high similarity (DSC = 93%), and including the surgical tract moderately enlarged resulting median target size (18.58 ccm vs. 22.89 ccm, p < 0.001). Dosimetric analysis favored the pre-operative treatment setting since it significantly decreased relevant dose exposure of the HB (Median volume receiving 28 Gy: 6.79 vs. 10.79 for pre-op vs. post-op-E, p < 0.001). Dosimetrically, pre-operative SRS is a promising alternative to post-operative cavity irradiation that could furthermore offer practical benefits regarding delineation and treatment planning. Comparative trials are required to evaluate potential clinical advantages of this approach.
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Onoe, Shunsuke, Yoshie Shimoyama, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Shigeo Nakamura, and Masato Nagino. "Prognostic delineation of papillary cholangiocarcinoma based on the invasive proportion." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 4119. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.4119.

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4119 Background: Intraductal papillary neoplasm of the bile duct (IPNB) is a presumed precursor lesion in biliary carcinogenesis, clinicopathologically overlapping with papillary cholangiocarcinoma (PCC); however, as IPNB has no standardized definition, this relationship remains equivocal. Here, we aimed to develop a new PCC prognostic model, focusing on the invasive proportion. Methods: Among 605 patients with surgically resected cholangiocarcinoma in Nagoya University Hospital between 2000 and 2011, 173 (29%) had intraductal exophytic papillary lesions. These were divided into four subsets based on the invasive component: non-invasive (PCC-1, n = 13), ≤10% (PCC-2, n = 30), 11-50% (PCC-3, n = 55), and >50% (PCC-4, n = 75). Results: Invasion beyond the ductal wall was observed in 83% of PCCs and 99% of non-papillary cholangiocarcinomas (NPCC, n = 432; P < 0.001). Regional lymph node metastases were more frequent in NPCC (48%) than PCC (32%; P < 0.001). Five-year survival was better for PCC (52%) than NPCC (37%; P < 0.001), indicating the papillary component to be a significant independent prognosticator. PCC-4 and NPCC had similar clinicopathological features and overlapping survival curves: 32% and 37% at 5 years (P = 0.877), both lower than those of PCC-1, PCC-2, and PCC-3 (respectively, 91%, 71%, and 60% at 5 years; P < 0.01 in all combinations). Multivariate analysis in PCC showed >50% invasive component, nodal metastasis, and positive surgical margin as independent predictors. Conclusions: The presence of an intraductal papillary component was an important determinant of better survival in cholangiocarcinoma. PCC exhibited a more aggressive histologic character and worse survival with progression of the invasive component. PCC with >50% invasive component was morphologically and prognostically similar to NPCC. Therefore, we propose that IPNB should be nosologically applied only for PCC cases with ≤50% invasive component.
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Whitson, Wesley J., Pablo A. Valdes, Brent T. Harris, Keith D. Paulsen, and David W. Roberts. "Confocal Microscopy for the Histological Fluorescence Pattern of a Recurrent Atypical Meningioma: Case Report." Neurosurgery 68, no. 6 (June 1, 2011): E1768—E1773. http://dx.doi.org/10.1227/neu.0b013e318217163c.

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Abstract BACKGROUND AND IMPORTANCE: Fluorescence-guided resection with 5-aminolevulinic acid (5-ALA), which has shown promising results in the resection of malignant gliomas, has been used for meningioma resection in an attempt to more clearly delineate the tumor margin. However, no article has investigated the fluorescence pattern of meningiomas on a histological level. Understanding the microscopic pattern of fluorescence could help assess the precision and utility of using 5-ALA for these tumors. We present the case of a recurrent atypical meningioma operated on with 5-ALA fluorescence-guided resection for delineation of tumor tissue from surrounding uninvolved dura. CLINICAL PRESENTATION: A 53-year-old woman presented with recurrent atypical meningioma of the falx. Prior treatment included surgical resection 6 years earlier with subsequent fractionated radiation therapy and radiosurgery for tumor progression. The patient was given 5-ALA 20 mg/kg body weight dissolved in 100 mL water 3 hours before induction of anesthesia. Intraoperative fluorescence was coregistered with preoperative imaging. Neuropathological analysis of the resected falx with confocal microscopy enabled correlation of fluorescence with the extent of tumor on a histological level. CONCLUSION: Fluorescence guidance allowed clear intraoperative delineation of tumor tissue from adjacent, uninvolved dura. On a microscopic level, there was a very close correlation of fluorescence with tumor, but some tumor cells did not fluoresce.
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Halip, Ioana-Alina, Dan Vâţă, Laura Statescu, Paul Salahoru, Adriana Ionela Patraşcu, Doinita Temelie Olinici, Bogdan Tarcau, et al. "Assessment of Basal Cell Carcinoma Using Dermoscopy and High Frequency Ultrasound Examination." Diagnostics 12, no. 3 (March 18, 2022): 735. http://dx.doi.org/10.3390/diagnostics12030735.

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Basal cell carcinoma (BCC) is the most common form of cutaneous neoplasia in humans, and dermoscopy may provide valuable information for histopathological classification of BCC, which allows for the choice of non-invasive topical or surgical therapy. Similarly, dermoscopy may allow for the identification of incipient forms of BCC that cannot be detected in clinical examination. The importance of early diagnosis using the dermoscopy of superficial BCC forms is proven by the fact that despite their indolent clinical appearance, they can be included in high-risk BCC forms due to the rate of postoperative recurrence. Nodular pigmentary forms of BCCs present ovoid gray-blue nests or multiple gray-blue dots/globules associated with arborized vessels, sometimes undetectable on clinical examination. The management of BCC depends on this, as pigmentary forms have been shown to have a poor response to photodynamic therapy. High frequency ultrasound examination (HFUS) aids in the diagnosis of BCC with hypoechoic tumour masses, as well as in estimating tumour size (thickness and diameter), presurgical margin delineation, and surgical planning. The examination is also useful for determining the invasion of adjacent structures and for studying local recurrences. The use of dermoscopy in combination with HFUS allows for optimisation of the management of the oncological patient.
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Book chapters on the topic "Surgical margin delineation"

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Ferrari, Marco, Nausica Montalto, and Piero Nicolai. "Novel Approaches in Surgical Management: How to Assess Surgical Margins." In Critical Issues in Head and Neck Oncology, 95–110. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63234-2_7.

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AbstractThe concept of surgical margins was born a long time ago but still lacks a univocal and sound understanding. The current biological rationale behind the recommendations on margins management relies on two pillars: (1) the observation that groups of cancer cells can leave the macroscopic tumor and disseminate throughout adjacent tissues with different degrees of aggressiveness; (2) the belief that removal of all (or most of) cancer cells can cure the patient. However, this background is undermined by some pieces of evidence. For instance, it has been proven that tissues surrounding cancer often bear precancerous traits, which means that cutting through non-cancerous tissues does not equate to cut through healthy tissues. The head and neck exquisitely poses a number of challenges in the achievement of negative margins, with special reference to anatomical complexity, high density in relevant structures, and unique histological heterogeneity of cancers. Currently, intraoperative margins evaluation relies on surgeons’ sight, palpation, ability to map tumor extension on imaging, and knowledge of anatomy, with some optical imaging technologies aiding the delineation of the mucosal margins of excision. Frozen sections are currently used to intraoperatively evaluate margins, yet with debate on whether and how this practice should be performed. Future perspectives on improvement of margins control are threefold: research is oriented towards refinements of understanding of cancers local progression, implementation of technologies to intraoperatively render tumor extension, and employment of optical imaging modalities capable of detecting foci of residual tumor in the surgical bed.
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Conference papers on the topic "Surgical margin delineation"

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Horgan, Conor C., Mads S. Bergholt, Isaac J. Pence, Anika Nagelkerke, and Molly M. Stevens. "Computer vision-based spatial co-registration of spectroscopic measurements for tumour margin delineation (Conference Presentation)." In Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XVII, edited by Anita Mahadevan-Jansen. SPIE, 2019. http://dx.doi.org/10.1117/12.2507851.

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Pardo, Arturo, Samuel S. Streeter, Benjamin W. Maloney, José M. López-Higuera, Brian W. Pogue, and Olga M. Conde. "Scatter signatures in SFDI data enable breast surgical margin delineation via ensemble learning." In Biomedical Applications of Light Scattering X, edited by Adam Wax and Vadim Backman. SPIE, 2020. http://dx.doi.org/10.1117/12.2546945.

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Lu, Guolan, Luma Halig, Dongsheng Wang, Zhuo G. Chen, and Baowei Fei. "Hyperspectral imaging for cancer surgical margin delineation: registration of hyperspectral and histological images." In SPIE Medical Imaging, edited by Ziv R. Yaniv and David R. Holmes. SPIE, 2014. http://dx.doi.org/10.1117/12.2043805.

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Weyers, Brent W., Tianchen Sun, Jakob Unger, Hanna Kim, Julien Bec, Michael G. Moore, Arnaud F. Bewley, Gregory D. Farwell, and Laura Marcu. "Real-time delineation of cancer margins in otolaryngologic applications using multispectral FLIm (Conference Presentation)." In Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XVII, edited by Anita Mahadevan-Jansen. SPIE, 2019. http://dx.doi.org/10.1117/12.2506795.

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