Abstract

Raynaud’s phenomenon (RP) is a microvessels’ disorder resulting in transient ischemia. It can be either primary or secondary to connective tissue diseases, such as systemic sclerosis. The differentiation between primary and secondary to systemic sclerosis is of paramount importance to set the proper therapeutic strategy. Thus far, thermal infrared imaging has been employed to accomplish this task by monitoring the finger temperature response to a controlled cold challenge. A completely automated methodology based on deep convolutional neural network is here introduced with the purpose of being able to differentiate systemic sclerosis from primary RP patients by relying uniquely on thermal images of the hands acquired at rest. The classification performance of such a method was compared to that of a three-dimensional convolutional neural network model implemented to classify thermal images of the hands recorded during rewarming from a cold challenge. No significant differences were found between the two procedures, thus ensuring the possibility to avoid the cold challenge. Moreover, the convolutional neural network models were compared with standard feature-based approaches and showed higher performances, thus overcoming the limitations related to the feature extraction (e.g., biases introduced by the operator). Such automated procedures can constitute promising tools for large scale screening of primary RP and secondary to systemic sclerosis in clinical practice.

Highlights

  • Raynaud’s phenomenon (RP) is a common vascular disorder consisting of recurrent, long-lasting, and episodic vasospasm of the fingers and toes often manifesting as discoloration and pain [1]

  • RP is classified as primary RP (PRP) if there is no known underlying illness and secondary when associated with a disorder detected upon assessment [5]

  • An innovative automatic procedure to differentiate PRP from systemic sclerosis (SSc) and healthy controls (HC) based on machine learning algorithms and IR images of the hands was presented

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Summary

Introduction

Raynaud’s phenomenon (RP) is a common vascular disorder consisting of recurrent, long-lasting, and episodic vasospasm of the fingers and toes often manifesting as discoloration and pain [1]. RP is typically induced by cold exposure and emotional stress [2]. It affects approximately 5–10% of the population (prevalently females) [3], with a worldwide distribution, its prevalence is elevated in cold climates where the risk of exposure to low ambient temperatures is greater [4]. RP is classified as primary RP (PRP) if there is no known underlying illness and secondary when associated with a disorder detected upon assessment [5]. Secondary RP can be associated with many systemic rheumatic diseases. The most frequent association is with systemic sclerosis (SSc) [7]

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