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Visually searching for analyzable metaphase chromosome cells under microscopes is quite time-consuming and
difficult. To improve detection efficiency, consistency, and diagnostic accuracy, an automated microscopic image
scanning system was developed and tested to directly acquire digital images with sufficient spatial resolution for clinical
diagnosis. A computer-aided detection (CAD) scheme was also developed and integrated into the image scanning system
to search for and detect the regions of interest (ROI) that contain analyzable metaphase chromosome cells in the large
volume of scanned images acquired from one specimen. Thus, the cytogeneticists only need to observe and interpret the
limited number of ROIs. In this study, the high-resolution microscopic image scanning and CAD performance was
investigated and evaluated using nine sets of images scanned from either bone marrow (three) or blood (six) specimens
for diagnosis of leukemia. The automated CAD-selection results were compared with the visual selection. In the
experiment, the cytogeneticists first visually searched for the analyzable metaphase chromosome cells from specimens
under microscopes. The specimens were also automated scanned and followed by applying the CAD scheme to detect
and save ROIs containing analyzable cells while deleting the others. The automated selected ROIs were then examined
by a panel of three cytogeneticists. From the scanned images, CAD selected more analyzable cells than initially visual
examinations of the cytogeneticists in both blood and bone marrow specimens. In general, CAD had higher performance
in analyzing blood specimens. Even in three bone marrow specimens, CAD selected 50, 22, 9 ROIs, respectively. Except
matching with the initially visual selection of 9, 7, and 5 analyzable cells in these three specimens, the cytogeneticists
also selected 41, 15 and 4 new analyzable cells, which were missed in initially visual searching. This experiment showed
the feasibility of applying this CAD-guided high-resolution microscopic image scanning system to prescreen and select
ROIs that may contain analyzable metaphase chromosome cells. The success and the further improvement of this
automated scanning system may have great impact on the future clinical practice in genetic laboratories to detect and
diagnose diseases.
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