title: Automated signal pattern evaluation of a bladder cancer specific multiprobe-fish assay applying a user-trainable workstation.
abstract: OBJECTIVE
  Signal pattern enumeration of Urovysion Fluorescence in Situ Hybridization test is tedious and requires great experience. Our aim was to eliminate human interaction by automating the process, using an adoptable, automated image acquisition, and analysis system.
  
  
  METHODS
  For extensive analytical analysis control, cell populations were used, while preliminary clinical study was performed on 21 patients with clinical suspicion for bladder cancer. All investigations were carried out using an automated user-trainable workstation (Metafer4-Metacyte).
  
  
  RESULTS
  The system identified nuclei with a specificity and sensitivity of 92.7 and 96.6%, respectively, while signal detection accuracy was 81.1% on average. Both analytical and diagnostic accuracy of automated analysis was comparable to manual approach (94.8 and 71% vs. 97.9 and 76%, respectively), but classification accuracy increased with degree of polysomy, thus diagnostic sensitivity in low grade, low stage cases was poor.
  
  
  CONCLUSIONS
  It is possible to automate signal enumeration of Urovysion using a user-trainable system, and achieve efficiency comparable to manual analysis. Previously introduced automated immunophenotypic targeting should further increase diagnostic sensitivity, while resulting in a comprehensively automated method. However, the problem of reduced detection accuracy in cases featured with low polysomy is likely to remain a great challenge of automated signal enumeration.
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Pécs, Pécs, Hungary. gabor.pajor@kk.pte.hu
authors.forename: Gabor
authors.initials: G
authors.lastname: Pajor
authors.forename: Donat
authors.initials: D
authors.lastname: Alpar
authors.forename: Bela
authors.initials: B
authors.lastname: Kajtar
authors.forename: Bela
authors.initials: B
authors.lastname: Melegh
authors.forename: Laszlo
authors.initials: L
authors.lastname: Somogyi
authors.forename: Maria
authors.initials: M
authors.lastname: Kneif
authors.forename: Daniel
authors.initials: D
authors.lastname: Bollmann
authors.forename: Laszlo
authors.initials: L
authors.lastname: Pajor
authors.forename: Norbert
authors.initials: N
authors.lastname: Sule
mesh_terms: D057205:Automation, Laboratory / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D017404:In Situ Hybridization, Fluorescence / Q000379:methods*; D057089:Pathology, Molecular / Q000379:methods*; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*