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Automated thresholding algorithms outperform manual thresholding in macular optical coherence tomography angiography image analysis

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  • Jan Henrik Terheyden
  • Maximilian W M Wintergerst
  • Peyman Falahat
  • Moritz Berger
  • Frank G Holz
  • Robert P Finger

Abstract

Introduction: For quantification of Optical Coherence Tomography Angiography (OCTA) images, Vessel Density (VD) and Vessel Skeleton Density (VSD) are well established parameters and different algorithms are in use for their calculation. However, comparability, reliability and ability to discriminate healthy and impaired macular perfusion of different algorithms are unclear, yet, of potential high clinical relevance. Hence, we assessed comparability and test-retest reliability of the most common approaches. Materials and methods: Two consecutive 3×3mm OCTA en face images of the superficial and deep retinal layer were acquired with swept-source OCTA. VD and VSD were calculated with manual thresholding and six automated thresholding algorithms (Huang, Li, Otsu, Moments, Mean, Percentile) using ImageJ and compared in terms of intra-class correlation coefficients, measurement differences and repeatability coefficients. Receiver operating characteristic analyses (healthy vs. macular pathology) were performed and Area Under the Curve (AUC) values were calculated. Results: Twenty-six eyes (8 female, mean age: 47 years) of 15 patients were included (thereof 15 eyes with macular pathology). Binarization thresholds, VD and VSD differed significantly between the algorithms and compared to manual thresholding (p

Suggested Citation

  • Jan Henrik Terheyden & Maximilian W M Wintergerst & Peyman Falahat & Moritz Berger & Frank G Holz & Robert P Finger, 2020. "Automated thresholding algorithms outperform manual thresholding in macular optical coherence tomography angiography image analysis," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-12, March.
    • Handle: RePEc:plo:pone00:0230260
    DOI: 10.1371/journal.pone.0230260
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    References listed on IDEAS

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    1. Alessandro Rabiolo & Francesco Gelormini & Riccardo Sacconi & Maria Vittoria Cicinelli & Giacinto Triolo & Paolo Bettin & Kouros Nouri-Mahdavi & Francesco Bandello & Giuseppe Querques, 2018. "Comparison of methods to quantify macular and peripapillary vessel density in optical coherence tomography angiography," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-20, October.
    2. Sharmila Vaz & Torbjörn Falkmer & Anne Elizabeth Passmore & Richard Parsons & Pantelis Andreou, 2013. "The Case for Using the Repeatability Coefficient When Calculating Test–Retest Reliability," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.
    3. Khan BahadarKhan & Amir A Khaliq & Muhammad Shahid, 2016. "A Morphological Hessian Based Approach for Retinal Blood Vessels Segmentation and Denoising Using Region Based Otsu Thresholding," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-19, July.
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