Evaluation of the scars’ vascularization using computer processing of the digital images

Abstract

Background: The application of new techniques of the scars’ correction requires the objective evaluation of their vascularization. Objective: To evaluate the effectiveness of digital program ImageJ in assessing neovascularization of pathologic scars. Material and methods: In this cross-sectional study, a total of 25 patients with pathologic scars were enrolled. Vessel selection in the first set of digital images of their scars was performed by computer processing started from thresholding with subsequent manual correction. In the second set of the same pictures, Vessel Analysis plugin was used. Comparison of both approaches was performed by three independent investigators. The time required for images processing was measured. Results: The average time that image processing and calculation have taken in the first group (753.3 ± 88.02 seconds) was statistically longer (P < 0.0001) than in the second one (358.1 ± 105.91 seconds). Independent investigators scored the precision of vessel selection in the first group as 80.4 ± 9.82, in the second group as 72.6 ± 10.53 (P < 0.0001). Kolmogorov-Smirnov test demonstrated higher precision of vessel selection by method that involves manual correction (P < 0.001). The results of Vascular Density measurements were obviously overestimated in the second group. More expedient looks calculation of the Vascular Length Density: ratio of skeletonized vasculature area to total area. Skeletonization avoids overestimation of Vascular Density, but the density of the vessel mesh can be determined. Conclusions: Computer processing of the scars’ digital photographs using ImageJ software gives cheap, technically easy and not cumbersome way of superficial scars’ vascularization objectifying. Vessel selection with subsequent manual correction has advantage of higher precision.