The emerging application of semi-quantitative and quantitative capillaroscopy in systemic sclerosis

Mihai, Carina; Smith, Vanessa; Dobrotă, Rucsandra; Gheorghiu, Ana Maria; Cutolo, Maurizio; Distler, Oliver

doi:10.1016/j.mvr.2018.03.004

Cited by 25 publications

(23 citation statements)

References 62 publications

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“…Several studies have demonstrated correlations between microvascular damage extent and the severity of internal organ involvement, showing that NVC abnormalities correlate with disease activity and severity and may be also predictive for disease worsening [510]. Furthermore, successful treatments have been shown to reduce NVC abnormalities in SSc cases, and these findings support the importance of NVC in monitoring SSc patients and also suggest its possible role as an outcome measure for microangiopathy in clinical trials [2,1114].…”

Section: Introductionmentioning

confidence: 94%

Progression of nailfold capillaroscopic patterns and correlation with organ involvement in systemic sclerosis: a 12 year study

et al. 2019

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Objective The aim of this observational study was to investigate the evolution of scleroderma microangiopathy throughout different nailfold videocapillaroscopy (NVC) patterns (‘early’, ‘active’, ‘late’) as well as the prevalence of organ involvement in SSc patients during a 12-year follow-up. Methods Thirty-four SSc patients showing at baseline (first capillaroscopic analysis) the ‘early’ NVC pattern of microangiopathy were enrolled and followed for 12 years (s.d. 2). Complete NVC analysis and clinical and serological findings were collected. Patients were in a standard therapeutic care setting. Statistical analysis was carried out by non-parametric tests. Results After a 12-year follow-up, the ‘early’ NVC pattern changed from baseline in 76% of the patients. The NVC pattern was found to be ‘active’ in 9 patients (26%), ‘late’ in 13 (38%) and characterized by non-specific capillary abnormalities in 4 (12%). In the subgroup whose microangiopathy progressed from the ‘early’ to the ‘late’ NVC pattern, the median time of progression from the ‘early’ to the ‘active’ pattern was significantly shorter (11 months) when compared with patients who progressed from the ‘early’ to the ‘active’ NVC pattern (55 months) (P = 0.002). The median time of progression between NVC patterns was significantly shorter in SSc patients showing either a nucleolar ANA pattern or Scl70 autoantibodies (P = 0.048). Organ involvement was progressively greater in SSc patients with ‘early’, ‘active’ and ‘late’ NVC patterns, respectively. Conclusions This longitudinal study confirms over a 12-year follow-up the evolution of specific NVC patterns associated with the progressive severity of organ involvement in SSc patients in a standard clinical care setting.

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Section: Introductionmentioning

confidence: 94%

Progression of nailfold capillaroscopic patterns and correlation with organ involvement in systemic sclerosis: a 12 year study

et al. 2019

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“…For all frequencies the vascular volumes [mean ± standard deviation] between groups was 0.216 ± 0.085 mm 3 www.nature.com/scientificreports/ (patients with SSc) and 0.337 ± 0.110 mm 3 (healthy controls); p < 0.0005. For the smaller frequency threshold (larger structures), the volumes were 0.050 ± 0.020 mm 3 (patients with SSc) and 0.072 ± 0.025 mm 3 (controls); p = 0.0031. For the higher frequency (fine structures) the volumes were 0.061 ± 0.031 mm 3 (patients with SSc) and 0.088 ± 0.022 mm 3 (controls); p = 0.0037.…”

Section: Resultsmentioning

confidence: 94%

“…Microvascular alteration is responsible for much of the morbidity of SSc, including Raynaud's phenomenon and digital ulcers 1 . These microvascular changes are most easily observed in the skin at the nailfold; characteristic SSc patterns are observed as decreased capillary density, increased capillary width and angiogenesis 2,3 . As such, nailfold capillaroscopy (green or white light microscopy of the capillaries) has been used widely as a research tool for SSc.…”

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confidence: 99%

Three-dimensional optoacoustic imaging of nailfold capillaries in systemic sclerosis and its potential for disease differentiation using deep learning

Nitkunanantharajah

Haedicke

Moore

et al. 2020

Sci Rep

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The autoimmune disease systemic sclerosis (SSc) causes microvascular changes that can be easily observed cutaneously at the finger nailfold. Optoacoustic imaging (OAI), a combination of optical and ultrasound imaging, specifically raster-scanning optoacoustic mesoscopy (RSOM), offers a non-invasive high-resolution 3D visualization of capillaries allowing for a better view of microvascular changes and an extraction of volumetric measures. In this study, nailfold capillaries of patients with SSc and healthy controls are imaged and compared with each other for the first time using OAI. The nailfolds of 23 patients with SSc and 19 controls were imaged using RSOM. The acquired images were qualitatively compared to images from state-of-the-art imaging tools for SSc, dermoscopy and high magnification capillaroscopy. The vascular volume in the nailfold capillaries were computed from the RSOM images. The vascular volumes differ significantly between both cohorts (0.216 ± 0.085 mm3 and 0.337 ± 0.110 mm3; p < 0.0005). In addition, an artificial neural network was trained to automatically differentiate nailfold images from both cohorts to further assess whether OAI is sensitive enough to visualize anatomical differences in the capillaries between the two cohorts. Using transfer learning, the model classifies images with an area under the ROC curve of 0.897, and a sensitivity of 0.783 and specificity of 0.895. In conclusion, this study demonstrates the capabilities of RSOM as an imaging tool for SSc and establishes it as a modality that facilitates more in-depth studies into the disease mechanisms and progression.

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“…The quantitative analysis of the morphological changes observed at NVC today is widely validated and even automatic systems for the count of capillaries are available [24][25][26][27].…”

Section: The Scleroderma Pattern In Systemic Sclerosismentioning

confidence: 99%

Nailfold capillaroscopy in rheumatology: ready for the daily use but with care in terminology

2019

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The emerging application of semi-quantitative and quantitative capillaroscopy in systemic sclerosis

Cited by 25 publications

References 62 publications

Progression of nailfold capillaroscopic patterns and correlation with organ involvement in systemic sclerosis: a 12 year study

Progression of nailfold capillaroscopic patterns and correlation with organ involvement in systemic sclerosis: a 12 year study

Three-dimensional optoacoustic imaging of nailfold capillaries in systemic sclerosis and its potential for disease differentiation using deep learning

Nailfold capillaroscopy in rheumatology: ready for the daily use but with care in terminology

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