Interlaboratory Reproducibility of Blood Morphology Using the Digital Microscope.
Differential counting of peripheral blood cells is an important diagnostic tool. However, manual morphological analysis using the microscope is time-consuming and requires highly trained personnel. The digital microscope is capable of performing an automated peripheral blood cell differential, which is as reliable as manual classification by experienced laboratory technicians. To date, information concerning the interlaboratory variation and quality of cell classification by independently operated digital microscopy systems is limited. We compared four independently operated digital microscope systems for their ability in classifying the five main peripheral blood cell classes and detection of blast cells in 200 randomly selected samples. Set against the averaged results, the R(2) values for neutrophils ranged between 0.90 and 0.96, for lymphocytes between 0.83 and 0.94, for monocytes between 0.77 and 0.82, for eosinophils between 0.70 and 0.78, and for blast cells between 0.94 and 0.99. The R(2) values for the basophils were between 0.28 and 0.34. This study shows that independently operated digital microscopy systems yield reproducible preclassification results when determining the percentages of neutrophils, eosinophils, lymphocytes, monocytes, and blast cells in a peripheral blood smear. Detection of basophils was hampered by the low incidence of this cell class in the samples.
Department of Clinical Chemistry, Geïntegreerd Klinisch Chemisch Laboratorium, Albert Schweitzer Hospital, Dordrecht, Netherlands j.riedl@asz.nl.
Jurgen A
JA
Riedl
Department of Clinical Chemistry, Geïntegreerd Klinisch Chemisch Laboratorium, Albert Schweitzer Hospital, Dordrecht, Netherlands Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, Netherlands.
Karlijn
K
Stouten
Department of Clinical Chemistry, Vlietland Hospital, Schiedam, Netherlands.
Huib
H
Ceelie
Department of Clinical Chemistry, Erasmus Medical Centre, Rotterdam, Netherlands Department of Clinical Chemistry, IJsselland Hospital, Capelle aan den IJssel, Netherlands.
Joke
J
Boonstra
Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, Netherlands.
Mark-David
MD
Levin
Department of Clinical Chemistry, Geïntegreerd Klinisch Chemisch Laboratorium, Albert Schweitzer Hospital, Dordrecht, Netherlands.
Warry
W
van Gelder
D001773:Blood Cells / Q000145:classification* / Q000166:cytology*; D006801:Humans; D019044:Image Cytometry / Q000295:instrumentation / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D008853:Microscopy / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results
blood differential; digital microscopy; hematology; preclassification