Automatic assessment of nailfold capillaroscopy software: a pilot study

Abstract

IntroductionCapillaroscopy is a simple method of nailfold capillary imaging, used to diagnose diseases from the systemic sclerosis spectrum. However, the assessment of the capillary image is time-consuming and subjective. This makes it difficult to use for a detailed comparison of studies assessed by various physicians. This pilot study aimed to validate software used for automatic capil­lary counting and image classification as normal or pathological.Material and methodsThe study was based on the assessment of 200 capillaroscopic images obtained from patients suffering from systemic sclerosis or scleroderma spectrum diseases and healthy people. Dinolite MEDL4N Pro was used to perform capillaroscopy. Each image was analysed manually and described using working software. The neural network was trained using the fast.ai library (based on PyTorch). The ResNet-34 deep residual neural network was chosen; 10-fold cross-validation with the validation and test set was performed, using the Darknet-YoloV3 state of the art neural network in a GPU-optimized (P5000 GPU) environment. For the calculation of 1 mm capillaries, an additional detection mechanism was designed.ResultsThe results obtained under neural network training were compared to the results obtained in manual analysis. The sensitivity of the automatic tool relative to manual assessment in classification of correct vs. pathological images was 89.0%, specificity 89.4% for the training group, in validation 89.0% and 86.9% respectively. For the average number of capillaries in 1 mm the precision of real images detected within the region of interest was 96.48%.ConclusionsThe pilot software for fully automatic capillaroscopic image assessment can be a useful tool for the rapid classification of a normal and altered capillaroscopy pattern. In addition, it allows one to quickly calculate the number of capillaries. In the future, the tool will be developed and will make it possible to obtain full imaging characteristics independent of the experience of the examiner.