title: The classification of Crithidia luciliae immunofluorescence test (CLIFT) using a novel automated system.
abstract: BACKGROUND
  In recent years, there has been an increased demand for computer-aided diagnosis (CAD) tools to support clinicians in the field of indirect immunofluorescence. To this aim, academic and industrial research is focusing on detecting antinuclear, anti-neutrophil, and anti-double-stranded (anti-dsDNA) antibodies. Within this framework, we present a CAD system for automatic analysis of dsDNA antibody images using a multi-step classification approach. The final classification of a well is based on the classification of all its images, and each image is classified on the basis of the labeling of its cells.
  
  
  METHODS
  We populated a database of 342 images--74 positive (21.6%) and 268 negative (78.4%)-- belonging to 63 consecutive sera: 15 positive (23.8%) and 48 negative (76.2%). We assessed system performance by using k-fold cross-validation. Furthermore, we successfully validated the recognition system on 83 consecutive sera, collected by using different equipment in a referral center, counting 279 images: 92 positive (33.0%) and 187 negative (67.0%).
  
  
  RESULTS
  With respect to well classification, the system correctly classified 98.4% of wells (62 out of 63). Integrating information from multiple images of the same wells recovers the possible misclassifications that occurred at the previous steps (cell and image classification). This system, validated in a clinical routine fashion, provides recognition accuracy equal to 100%.
  
  
  CONCLUSIONS
  The data obtained show that automation is a viable alternative for Crithidia luciliae immunofluorescence test analysis.
authors.forename: Francesca
authors.initials: F
authors.lastname: Buzzulini
authors.forename: Amelia
authors.initials: A
authors.lastname: Rigon
authors.forename: Paolo
authors.initials: P
authors.lastname: Soda
authors.forename: Leonardo
authors.initials: L
authors.lastname: Onofri
authors.forename: Maria
authors.initials: M
authors.lastname: Infantino
authors.forename: Luisa
authors.initials: L
authors.lastname: Arcarese
authors.forename: Giulio
authors.initials: G
authors.lastname: Iannello
authors.forename: Antonella
authors.initials: A
authors.lastname: Afeltra
mesh_terms: D000974:Antibodies, Antinuclear / Q000032:analysis*; D001331:Automation; D003421:Crithidia; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005455:Fluorescent Antibody Technique; D006801:Humans
chemical_list: D000974:Antibodies, Antinuclear