Use of Convolutional Neural Networks for the Detection of u-Serrated Patterns in Direct Immunofluorescence Images to Facilitate the Diagnosis of Epidermolysis Bullosa Acquisita

Chenyu Shi*, Joost Meijer, George Azzopardi, G.F.H. Diercks, Jiapan Guo, Nicolai Petkov

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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The u-serrated immunodeposition pattern in direct immunofluorescence (DIF) microscopy is a recognizable feature and confirmative for the diagnosis of epidermolysis bullosa acquisita (EBA). Due to unfamiliarity with serrated patterns, serration pattern recognition is still of limited use in routine DIF microscopy. The objective of this study was to investigate the feasibility of using convolutional neural networks (CNNs) for the recognition of u-serrated patterns that can assist in the diagnosis of EBA. The nine most commonly used CNNs were trained and validated by using 220,800 manually delineated DIF image patches from 106 images of 46 different patients. The data set was split into 10 subsets: nine training subsets from 42 patients to train CNNs and the last subset from the remaining four patients for a validation data set of diagnostic accuracy. This process was repeated 10 times with a different subset used for validation. The best-performing CNN achieved a specificity of 89.3% and a corresponding sensitivity of 89.3% in the classification of u-serrated DIF image patches, an expert level of diagnostic accuracy. Experiments and results show the effectiveness of CNN approaches for u-serrated pattern recognition with a high accuracy. The proposed approach can assist clinicians and pathologists in recognition of u-serrated patterns in DIF images and facilitate the diagnosis of EBA.

Original languageEnglish
Pages (from-to)1520-1525
Number of pages6
JournalThe American Journal of Pathology
Issue number9
Early online date8-Jun-2021
Publication statusPublished - Sep-2021


  • Epidermolysis Bullosa Acquisita/diagnosis
  • Fluorescent Antibody Technique, Direct
  • Humans
  • Image Interpretation, Computer-Assisted/methods
  • Microscopy, Fluorescence/methods
  • Neural Networks, Computer
  • Sensitivity and Specificity

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