Red and white blood cell morphology characterization and hands-on time analysis by the digital cell imaging analyzer DI-60open access
- Authors
- Kweon, Oh Joo; Lim, Yong Kwan; Lee, Mi-Kyung; Kim, Hye Ryoun
- Issue Date
- Apr-2022
- Publisher
- NLM (Medline)
- Citation
- PloS one, v.17, no.4, pp e0267638
- Journal Title
- PloS one
- Volume
- 17
- Number
- 4
- Start Page
- e0267638
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/58003
- DOI
- 10.1371/journal.pone.0267638
- ISSN
- 1932-6203
- Abstract
- BACKGROUND: The Sysmex DI-60 digital morphology analyzer is a fully automated, cell-locating image analysis system. This study aimed to evaluate the analytical performance of DI-60. METHODS: A total of 822 peripheral blood smears were used. The diagnostic performance of DI-60 in terms of red blood cell (RBC) morphology characterization, white blood cell (WBC) differentials, and the total assay time including hands-on time was evaluated. RESULTS: In comparison with manual slide review, DI-60 demonstrated acceptable accuracy in recognizing polychromasia, target cells, and ovalocytes. However, for schistocytes, DI-60 demonstrated low specificity (10.4%) despite the high sensitivity (97.2%). In the precision analysis of RBC morphology characterization, borderline samples harboring specific RBCs showed inconsistencies in the positive results among 20 replicates. Particularly, 6 of 10 samples showed inconsistencies in the precision for schistocytes. For WBC differentials, the overall agreement between pre-classification results and user-verified results was 89.4%. Except for basophils, normal WBCs showed a good correlation between DI-60 (after user verification) and manual counts. The sensitivities in detecting immature granulocytes, blasts, atypical lymphocytes, and normoblasts were 85.9%, 92.0%, 37.5%, and 77.6%, respectively. Although the total assay time of DI-60 was longer than that of manual review, the hands-on time was considerably shorter with a difference of 144.1 s/slide for abnormal samples. CONCLUSION: DI-60 demonstrated acceptable performance for normal samples. However, for abnormal WBC differentials and RBC morphology characterization, it should be utilized carefully. DI-60 may contribute to an improvement in laboratory efficiency with increased feasibility.
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