Validation of a deep learning-based image analysis system to diagnose subclinical endometritis in dairy cows

PLoS One. 2022 Jan 28;17(1):e0263409. doi: 10.1371/journal.pone.0263409. eCollection 2022.

Abstract

The assessment of polymorphonuclear leukocyte (PMN) proportions (%) of endometrial samples is the hallmark for subclinical endometritis (SCE) diagnosis. Yet, a non-biased, automated diagnostic method for assessing PMN% in endometrial cytology slides has not been validated so far. We aimed to validate a computer vision software based on deep machine learning to quantify the PMN% in endometrial cytology slides. Uterine cytobrush samples were collected from 116 postpartum Holstein cows. After sampling, each cytobrush was rolled onto three different slides. One slide was stained using Diff-Quick, while a second was stained using Naphthol (golden standard to stain PMN). One single observer evaluated the slides twice at different days under light microscopy. The last slide was stained with a fluorescent dye, and the PMN% were assessed twice by using a fluorescence microscope connected to a smartphone. Fluorescent images were analyzed via the Oculyze Monitoring Uterine Health (MUH) system, which uses a deep learning-based algorithm to identify PMN. Substantial intra-method repeatabilities (via Spearman correlation) were found for Diff-Quick, Naphthol, and Oculyze MUH (r = 0.67 to 0.76). The intra-method agreements (via Kappa value) at ≥1% PMN (κ = 0.44 to 0.47) were lower than at >5 (κ = 0.69 to 0.78) or >10% (κ = 0.67 to 0.85) PMN cut-offs. The inter-method repeatabilities (via Lin's correlation) were also substantial, and values between Diff-Quick and Oculyze MUH, Naphthol and Diff-Quick, and Naphthol and Oculyze MUH were 0.68, 0.69, and 0.77, respectively. The agreements among evaluation methods at ≥1% PMN were weak (κ = 0.06 to 0.28), while it increased at >5 (κ = 0.48 to 0.81) or >10% (κ = 0.50 to 0.65) PMN cut-offs. To conclude, deep learning-based algorithms in endometrial cytology are reliable and useful for simplifying and reducing the diagnosis bias of SCE in dairy cows.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Animals
  • Cattle
  • Dairying*
  • Deep Learning*
  • Endometritis / diagnosis*
  • Endometritis / diagnostic imaging
  • Endometritis / pathology
  • Endometritis / veterinary*
  • Endometrium / pathology
  • Female
  • Image Processing, Computer-Assisted*
  • Leukocytes, Mononuclear / metabolism
  • Reproducibility of Results

Grants and funding

Oculyze GmbH received funding for the development of Oculyze MUH from the European Regional Development Fund under project number 80176988. Osvaldo Bogado Pascottini was granted by Fonds voor Wetenschappelijk OnderzoekeVlaanderen (FWO, Research Foundation, Flanders) under project number 12Y5220N. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.