Rapid, Reliable, and Interpretable CNV Curation Visualizations for Diagnostic Settings with SeeNV

ABSTRACT Copy number variants (CNVs), structural alterations in the genome involving duplication or deletion of DNA segments, are implicated in various health conditions. Despite their clinical significance, accurate identification and interpretation of CNVs remain challenging, especially in the context of whole exome sequencing (WES), which is commonly used in clinical diagnostic laboratories. While WES offers economic advantages over whole genome sequencing (WGS), it struggles with CNV detection due to technical noise introduced by laboratory and analytic processes. Manual curation of CNV calls generated by these tools is labor-intensive and error-prone. To address this, we introduce SeeNV, a command-line tool designed to aid manual curation of CNVs at scale. SeeNV is one solution to these issues developed in collaboration with and used by the Precision Diagnostics Laboratory at Children’s Hospital Colorado. SeeNV generates static infographics for each CNV, incorporating sample and cohort sequencing coverage statistics, CNV population frequency, and more, facilitating rapid and precise assessment. Using CNVs calls identified in publicly available WES and WGS samples, we show users can rapidly and reliably curate CNV calls, needing only 4.3 seconds to curate a call, achieving 0.93 precision and 0.72 recall. SeeNV is freely available for download on GitHub: https://github.com/MSBradshaw/SeeNV .