Volume 47, Issue 4 pp. 730-737
ORIGINAL ARTICLE

Automated Von Willebrand Factor Multimer Image Analysis for Improved Diagnosis and Classification of Von Willebrand Disease

Karthik Anand

Karthik Anand

Mayo High School, Rochester, Minnesota, USA

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Vincent Olteanu

Vincent Olteanu

Mayo High School, Rochester, Minnesota, USA

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Chi Zhang

Chi Zhang

Special Coagulation Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA

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Katelynn Nelton

Katelynn Nelton

Special Coagulation Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA

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Erin Aakre

Erin Aakre

Special Coagulation Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA

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Juliana Perez Botero

Juliana Perez Botero

Special Coagulation Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA

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Rajiv Pruthi

Rajiv Pruthi

Special Coagulation Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA

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Dong Chen

Dong Chen

Special Coagulation Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA

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Jansen N. Seheult

Corresponding Author

Jansen N. Seheult

Special Coagulation Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA

Correspondence:

Jansen N. Seheult ([email protected])

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First published: 02 March 2025

Funding: The authors received no specific funding for this work.

Karthik Anand and Vincent Olteanu contributed equally.

ABSTRACT

Introduction

Von Willebrand factor (VWF) multimer analysis is essential for diagnosing and classifying von Willebrand disease (VWD) but requires expert interpretation and is subject to inter-rater variability. We developed an automated image analysis pipeline using deep learning to improve the reproducibility and efficiency of VWF multimer pattern classification.

Methods

We trained a YOLOv8 deep learning model on 514 gel images (6168 labeled instances) to classify VWF multimer patterns into 12 classes. The model was validated on 192 images (2304 instances) and tested on an independent set of 94 images (1128 instances). Images underwent preprocessing, including histogram equalization, contrast enhancement, and gamma correction. Two expert raters provided ground truth classifications.

Results

The model achieved 91% accuracy compared to Expert 1 (macro-averaged precision = 0.851, recall = 0.757, F1-score = 0.786) and 87% accuracy compared to Expert 2 (macro-averaged precision = 0.653, recall = 0.653, F1-score = 0.641). Inter-rater agreement was very high between experts (κ = 0.883), with strong agreement between the model and Expert 1 (κ = 0.845) and good agreement with Expert 2 (κ = 0.773). The model performed exceptionally well on common patterns (F1 > 0.93) but showed lower performance on rare subtypes.

Conclusion

Automated VWF multimer analysis using deep learning demonstrates high accuracy in pattern classification and could standardize the interpretation of VWF multimer patterns. While not replacing expert analysis, this approach could improve the efficiency of expert human review, potentially streamlining laboratory workflow and expanding access to VWF multimer testing.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

Research data are not shared due to commercial restrictions.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.