Abstract

BackgroundDiagnosis of pulmonary thromboembolism (PTE) in dogs relies on computed tomography pulmonary angiography (CTPA), but detailed interpretation of CTPA images is demanding for the radiologist and only large vessels may be evaluated. New approaches for better detection of smaller thrombi include dual energy computed tomography (DECT) as well as computer assisted diagnosis (CAD) techniques. The purpose of this study was to investigate the performance of quantitative texture analysis for detecting dogs with PTE using grey-level co-occurrence matrices (GLCM) and multivariate statistical classification analyses.CT images from healthy (n = 6) and diseased (n = 29) dogs with and without PTE confirmed on CTPA were segmented so that only tissue with CT numbers between −1024 and −250 Houndsfield Units (HU) was preserved. GLCM analysis and subsequent multivariate classification analyses were performed on texture parameters extracted from these images.ResultsLeave-one-dog-out cross validation and receiver operator characteristic (ROC) showed that the models generated from the texture analysis were able to predict healthy dogs with optimal levels of performance. Partial Least Square Discriminant Analysis (PLS-DA) obtained a sensitivity of 94% and a specificity of 96%, while Support Vector Machines (SVM) yielded a sensitivity of 99% and a specificity of 100%. The models, however, performed worse in classifying the type of disease in the diseased dog group: In diseased dogs with PTE sensitivities were 30% (PLS-DA) and 38% (SVM), and specificities were 80% (PLS-DA) and 89% (SVM). In diseased dogs without PTE the sensitivities of the models were 59% (PLS-DA) and 79% (SVM) and specificities were 79% (PLS-DA) and 82% (SVM).ConclusionThe results indicate that texture analysis of CTPA images using GLCM is an effective tool for distinguishing healthy from abnormal lung. Furthermore the texture of pulmonary parenchyma in dogs with PTE is altered, when compared to the texture of pulmonary parenchyma of healthy dogs. The models’ poorer performance in classifying dogs within the diseased group, may be related to the low number of dogs compared to texture variables, a lack of balanced number of dogs within each group or a real lack of difference in the texture features among the diseased dogs.

Highlights

  • Diagnosis of pulmonary thromboembolism (PTE) in dogs relies on computed tomography pulmonary angiography (CTPA), but detailed interpretation of CTPA images is demanding for the radiologist and only large vessels may be evaluated

  • The results indicate that texture analysis of CTPA images using grey-level cooccurrence matrices (GLCM) is an effective tool for distinguishing healthy from abnormal lung

  • The present study was performed at University of Copenhagen utilizing CTPA scans that were generated in a prospective study on the haemostatic and inflammatory changes in dogs suspected of PTE, where CTPA was used to determine presence or absence of emboli

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Summary

Introduction

Diagnosis of pulmonary thromboembolism (PTE) in dogs relies on computed tomography pulmonary angiography (CTPA), but detailed interpretation of CTPA images is demanding for the radiologist and only large vessels may be evaluated. The purpose of this study was to investigate the performance of quantitative texture analysis for detecting dogs with PTE using grey-level cooccurrence matrices (GLCM) and multivariate statistical classification analyses. Since the detection rate for clots decreases with size, clots distal to segmental vessels may be beyond the resolution limits of the technique and go undetected. This issue of resolution limits the use of CTPA for identification of minor clots in the pulmonary circulation [8]. Based on the limitations of CTPA, it is obvious that tools for better identification of both large and small pulmonary thrombi as well as parenchymateous changes related to these would increase the applicability of CTPA for correct identification of PTE in dogs

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