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Elliptical Broken Line Method for Calculating Capillary Density in Nailfold Capillaroscopy: Proposal and Evaluation Publisher Pubmed



Karbalaie A1 ; Abtahi F2, 5 ; Fatemi A3 ; Etehadtavakol M4 ; Emrani Z4 ; Erlandsson BE1
Authors
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Authors Affiliations
  1. 1. School of Technology and Health, Royal Institute of Technology (KTH), Stockholm, SE-100 44, Sweden
  2. 2. Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
  3. 3. Department of Rheumatology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden

Source: Microvascular Research Published:2017


Abstract

Nailfold capillaroscopy is a practical method for identifying and obtaining morphological changes in capillaries which might reveal relevant information about diseases and health. Capillaroscopy is harmless, and seems simple and repeatable. However, there is lack of established guidelines and instructions for acquisition as well as the interpretation of the obtained images; which might lead to various ambiguities. In addition, assessment and interpretation of the acquired images are very subjective. In an attempt to overcome some of these problems, in this study a new modified technique for assessment of nailfold capillary density is introduced. The new method is named elliptic broken line (EBL) which is an extension of the two previously known methods by defining clear criteria for finding the apex of capillaries in different scenarios by using a fitted elliptic. A graphical user interface (GUI) is developed for pre-processing, manual assessment of capillary apexes and automatic correction of selected apexes based on 90° rule. Intra- and inter-observer reliability of EBL and corrected EBL is evaluated in this study. Four independent observers familiar with capillaroscopy performed the assessment for 200 nailfold videocapillaroscopy images, form healthy subject and systemic lupus erythematosus patients, in two different sessions. The results show elevation from moderate (ICC = 0.691) and good (ICC = 0.753) agreements to good (ICC = 0.750) and good (ICC = 0.801) for intra- and inter-observer reliability after automatic correction of EBL. This clearly shows the potential of this method to improve the reliability and repeatability of assessment which motivates us for further development of automatic tool for EBL method. © 2017 Elsevier Inc.
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