Performance of digital morphology analyzer Vision Pro on white blood cell differentials

Abstract

Objectives Vision Pro (West Medica, Perchtoldsdorf, Austria) is a recently developed digital morphology analyzer. We evaluated the performance of Vision Pro on white blood cell (WBC) differentials. Methods In a total of 200 peripheral blood smear samples (100 normal and 100 abnormal samples), WBC preclassification and reclassification by Vision Pro were evaluated and compared with manual WBC count, according to the Clinical and Laboratory Standards Institute guidelines (H20-A2). Results The overall sensitivity was high for normal WBCs and nRBCs (80.1–98.0%). The overall specificity and overall efficiency were high for all cell classes (98.1–100.0% and 97.7–99.9%, respectively). The absolute values of mean differences between Vision Pro and manual count ranged from 0.01 to 1.31. In leukopenic samples, those values ranged from 0.09 to 2.01. For normal WBCs, Vision Pro preclassification and manual count showed moderate or high correlations (r=0.52–0.88) except for basophils (r=0.34); after reclassification, the correlation between Vision Pro and manual count was improved (r=0.36–0.90). Conclusions This is the first study that evaluated the performance of Vision Pro on WBC differentials. Vision Pro showed reliable analytical performance on WBC differentials with improvement after reclassification. Vision Pro could help improve laboratory workflow.

How Reproducible Is the Data from Sysmex DI-60 in Leukopenic Samples?

“…DI-60 on WBC preclassification showed high efficiency with verification in total samples; even in each group according to the WBC count ( Table 3 ). These results are similar to previous studies that evaluated the performance of DI-60, DM96, and Vision Pro [ 9 , 15 , 20 ]. However, DI-60 tended to show lower sensitivity with fewer WBCs in the sample for neutrophils, lymphocytes, and monocytes.…”

“…According to the ICSH guidelines [ 21 ], mean difference or Bland–Altman plots should be evaluated in leukopenic, anemic or thrombocytopenic samples. In our previous study that evaluated a DM analyzer Vision Pro on WBC differentials, we found that the mean differences between the Vision Pro and manual count results were larger when analyzing only leukopenic samples than total samples [ 20 ]. Based on our previous study, we questioned and evaluated the analytical performance of DI-60 on WBC differentials in leukopenic samples, especially focusing on the precision.…”

“…Other DM analyzers include Vision Pro (West Medica, Perchtoldsdorf, Austria), EasyCell assistant (Medica, Bedford, MA, USA), Nextslide (Nextslide Imaging, LLC, Cleveland, OH, USA), and so on [ 1 ]. Since DM analyzers were first developed in the 1970s, a number of studies have been reported to evaluate the performance of DM analyzers [ 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

“…It is necessary to evaluate the performance of DM analyzers on WBC differentials by focusing on leukopenic samples. Most of previous studies evaluated DM analyzers using pathological samples including some leukopenic samples [ 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. To the best of our knowledge, however, there has been no study that analyzed leukopenic samples separately as the main subjects to fully evaluate the performance of DM analyzers, including precision [ 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

“…Most of previous studies evaluated DM analyzers using pathological samples including some leukopenic samples [ 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. To the best of our knowledge, however, there has been no study that analyzed leukopenic samples separately as the main subjects to fully evaluate the performance of DM analyzers, including precision [ 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. In this study, we aimed to evaluate the performance of DI-60 on WBC differentials, especially precision according to the Clinical and Laboratory Standards Institute (CLSI) guidelines, using PBS of leukopenic samples.…”