Automated quantification of choroidal neovascularization on Optical Coherence Tomography Angiography images. (November 2019) - Taibouni, Kawther
Abstract: Objectives: To report the design of an automated quantification algorithm for choroidal neovascularization (CNV) in the context of neovascular age-related macular degeneration (AMD), based on Optical Coherence Tomography Angiography (OCTA) images. Material and methods: In this study, 54 patients (mean age 75.80 ± 14.29 years) with neovascular AMD (type 1 and type 2 CNV) were included retrospectively and separated into two groups (Group 1–24 images; Group 2–30 images), according to the lesion topology. All patients underwent a 3 × 3 mm OCTA examination (AngioVue, Optovue, Freemont, California). The proposed algorithm is based on segmentation and enhancement methods including Frangi filter, Gabor wavelets and Fuzzy-C-Means Classification. Our results were compared to the manual quantifications given by the embedded quantification software "AngioAnalytics". Results: Automated CNV segmentation and quantification of three neovascular AMD biomarkers: the total vascular area (TVA), the total area (TA) and the vascular density (VD) were possible in all cases. Automated versus manual quantification comparison revealed a statistically significant difference for TVA and VD measurements for both groups (p = 0.00036 for Group 1 TVA, p < 0.0001 for Group 1 VD and Group 2 TVA and VD). The difference in TA measurements was not significant in Group 2 (p = 0.143). Bland-Altman analysis revealed low inter-method bias for TA measurements and higher bias for TVA and VD. Conclusion: This paper presents a method for segmenting and quantifying CNV that constitutes a valid option for clinicians. Complementary validations have to be carried out to compare our method's accuracy to "AngioAnalytics". Highlights: Automated CNV segmentation using enhancement filters and Fuzzy-C-Means. Two segmentation algorithms adapted to the lesions topologies. Quantification of three biomarkers of neovascular AMD on OCTA images. Comparison to AngioVue software measures, the new gold standard in OCTA imaging. Comparable results to expert delineation are achieved for the total area measure.