Image cytometry in automated cervical screening.

Severe restrictions with regard to false negative rates have played a major role in the development of the LEYden Television Analysis System (LEYTAS). The present paper describes a test with a continuous series of 1500 cervical samples illustrating the accuracy of LEYTAS in a fully automated screening procedure using cell selection transformations and artefact rejection procedures. Specimen classification with a cut-off at greater than 0.3% alarms (= percentage of automatically selected objects per epithelial cells) and greater than 10 alarms, results in a false negative rate (FNR) of 0.3% (1 case out of 321 cases with severe dysplasia or more serious lesions), a false positive rate (FPR) of 13% (663 negative cases) and a rejection rate of 2.7%. Besides a machine classification, LEYTAS offers a second, machine-interaction classification of those preparations which have been declared positive by the machine. Machine-interaction involves visual evaluation of the stored images of the detected objects (alarms) and reduces the FPR from 13 to 8%. Statistical tests further demonstrate the significance of the screening results. Presently the main drawback for routine use of automated screening with LEYTAS seems to be the time consuming preparation procedure, since instrumentation has now been updated to a new, fast and user-friendly version of LEYTAS.