Abstract
Objective. To evaluate NOVA View with focus on reading archived images versus microscope based manual interpretation of ANA HEp-2 slides by an experienced, certified medical technologist. Methods. 369 well defined sera from: 44 rheumatoid arthritis, 50 systemic lupus erythematosus, 35 scleroderma, 19 Sjögren's syndrome, and 10 polymyositis patients as well as 99 healthy controls were examined. In addition, 12 defined sera from the Centers for Disease Control and 100 random patient sera sent to ARUP Laboratories for ANA HEp-2 IIF testing were included. Samples were read using the archived images on NOVA View and compared to results obtained from manual reading. Results. At a 1 : 40/1 : 80 dilution the resulting comparison demonstrated 94.8%/92.9% positive, 97.4%/97.4% negative, and 96.5%/96.2% total agreements between manual IIF and NOVA View archived images. Agreement of identifiable patterns between methods was 97%, with PCNA and mixed patterns undetermined. Conclusion. Excellent agreements were obtained between reading archived images on NOVA View and manually on a fluorescent microscope. In addition, workflow benefits were observed which need to be analyzed in future studies.
Highlights
The antinuclear antibody (ANA) test is a standard screening assay for detecting multiple antibodies that may be produced by a patient with an autoimmune or ANA associated rheumatic disease (AARD)
There are 5 to 6 indirect immunofluorescence (IIF) nuclear patterns that are commonly reported by most laboratories, namely, homogeneous, speckled, nucleolar, centromere, peripheral/rimmed, and proliferating cell nuclear antigen (PCNA)
Manual results were read on a Nikon Eclipse 400 fluorescent microscope with an LED light source
Summary
The antinuclear antibody (ANA) test is a standard screening assay for detecting multiple antibodies that may be produced by a patient with an autoimmune or ANA associated rheumatic disease (AARD). There are several methodologies available to screen ANA, the American College of Rheumatology (ACR) issued a statement declaring HEp-2 indirect immunofluorescence (IIF) as the preferred method for ANA screening [1]. This declaration was based on the findings of a task force which investigated and collected information from physicians to evaluate nonstandardization of the various methodologies on the market for evaluating ANA. Laboratories performing the ANA IIF test typically report a positive result with a pattern and titer. This aids the physician when deciding what tests to order if any
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