Detection of u-serrated patterns in direct immunofluorescence images of autoimmune bullous diseases by inhibition-augmented COSFIRE filters

Shi, C., Meijer, J., Guo, J., Azzopardi, G., Diercks, G. F. H., Schmidt, E., Zillikens, D., Jonkman, M. F. & Petkov, N., Feb-2019, In : International Journal of Medical Informatics. 122, p. 27-36 10 p.

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  • Detection of u-serrated patterns indirect immuno fluorescence images of autoimmunebullous diseases by inhibition-augmented COSFIRE filters

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Direct immunofluorescence (DIF) microscopy of a skin biopsy is used by physicians and pathologists to diagnose autoimmune bullous dermatoses (AIBD). This technique is the reference standard for diagnosis of AIBD, which is used worldwide in medical laboratories. For diagnosis of subepidermal AIBD (sAIBD), two different types of serrated pattern of immunodepositions can be recognized from DIF images, namely n- and u-serrated patterns. The n-serrated pattern is typically found in the most common sAIBD bullous pemphigoid. Presence of the userrated pattern indicates the sAIBD subtype epidermolysis bullosa acquisita (EBA), which has a different prognosis and requires a different treatment. The manual identification of these serrated patterns is learnable but challenging. We propose an automatic technique that is able to localize u-serrated patterns for automated computer-assisted diagnosis of EBA. The distinctive feature of u-serrated patterns as compared to n-serrated patterns is the presence of ridge-endings. We introduce a novel ridge-ending detector which uses inhibition-augmented trainable COSFIRE filters. Then, we apply a hierarchical clustering approach to detect the suspicious u-serrated patterns from the detected ridge-endings. For each detected u-serrated pattern we provide a score that indicates the reliability of its detection. In order to evaluate the proposed approach, we created a data set with 180 DIF images for serration pattern analysis. This data set consists of seven subsets which were obtained from various biopsy samples under different conditions. We achieve an average recognition rate of 82.2% of the userrated pattern on these 180 DIF images, which is comparable to the recognition rate achieved by experienced medical doctors and pathologists.

Original languageEnglish
Pages (from-to)27-36
Number of pages10
JournalInternational Journal of Medical Informatics
Early online date28-Nov-2018
Publication statusPublished - Feb-2019


  • Autoimmune bullous diseases, Direct immunofluorescence image, Serration pattern analysis, Ridge-ending detection, COSFIRE filter, Inhibition, VANISHING POINT DETECTION, VESSEL DELINEATION, RIDGE, CLASSIFICATION, ACQUISITA, EDGE, NEVI

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