Aggregation of classifiers for staining pattern recognition in antinuclear autoantibodies analysis

Indirect immunofluorescence is currently the recommended method for the detection of antinuclear autoantibodies (ANA). The diagnosis consists of both estimating the fluorescence intensity and reporting the staining pattern for positive wells only. Since resources and adequately trained personnel are not always available for these tasks, an evident medical demand is the development of computer-aided diagnosis (CAD) tools that can support the physician decisions. In this paper, we present a system that classifies the staining pattern of positive wells on the strength of the recognition of their cells. The core of the CAD is a multiple expert system (MES) based on the one-per-class approach devised to label the pattern of single cells. It employs a hybrid approach since each composing binary module is constituted by an ensemble of classifiers combined by a fusion rule. Each expert uses a set of stable and effective features selected from a wide pool of statistical and spectral measurements. In this framework, we present a novel parameter that measures the reliability of the final classification provided by the MES. This feature is used to introduce a reject option that allows to reduce the error rate in the recognition of the staining pattern of the whole well. The approach has been evaluated on 37 wells, for a total of 573 cells. The measured performance shows a low overall error rate (2.7%-5.8%), which is below the observed intralaboratory variability.