Computer-Aided Diagnosis of Equine Pharyngeal Lymphoid Hyperplasia Using the Object Detection-Based Processing Technique of Digital Endoscopic Images

In human medicine, computer-aided diagnosis (CAD) is increasingly employed for screening, identifying, and monitoring early endoscopic signs of various diseases. However, its potential-despite proven benefits in human healthcare-remains largely underexplored in equine veterinary medicine. This study aimed to quantify endoscopic signs of pharyngeal lymphoid hyperplasia (PLH) as digital data and to assess their effectiveness in CAD of PLH in comparison and in combination with clinical data reflecting respiratory tract disease. Endoscopic images of the pharynx were collected from 70 horses clinically assessed as either healthy or affected by PLH. Digital data were extracted using an object detection-based processing technique and first-order statistics (FOS). The data were transformed using linear discriminant analysis (LDA) and classified with the random forest (RF) algorithm. Classification metrics were then calculated. When considering digital and clinical data, high classification performance was achieved (0.76 accuracy, 0.83 precision, 0.78 recall, and 0.76 F1 score), with the highest importance assigned to selected FOS features: Number of Objects and Neighbors, and Tracheal Auscultation. The proposed protocol of digitizing standard respiratory tract diagnostic methods provides effective discrimination of PLH grades, supporting the clinical value of CAD in veterinary medicine and paving the way for further research in digital medical diagnostics.