Performance of the CellaVision® DM96 system for detecting red blood cell morphologic abnormalities

Abstract

Background:Red blood cell (RBC) analysis is a key feature in the evaluation of hematological disorders. The gold standard light microscopy technique has high sensitivity, but is a relativity time-consuming and labor intensive procedure. This study tested the sensitivity and specificity of gold standard light microscopy manual differential to the CellaVision® DM96 (CCS; CellaVision, Lund, Sweden) automated image analysis system, which takes digital images of samples at high magnification and compares these images with an artificial neural network based on a database of cells and preclassified according to RBC morphology.Methods:In this study, 212 abnormal peripheral blood smears within the Calgary Laboratory Services network of hospital laboratories were selected and assessed for 15 different RBC morphologic abnormalities by manual microscopy. The same samples were reassessed as a manual addition from the instrument screen using the CellaVision® DM96 system with 8 microscope high power fields (×100 objective and a 22 mm ocular). The results of the investigation were then used to calculate the sensitivity and specificity of the CellaVision® DM96 system in reference to light microscopy.Results:The sensitivity ranged from a low of 33% (RBC agglutination) to a high of 100% (sickle cells, stomatocytes). The remainder of the RBC abnormalities tested somewhere between these two extremes. The specificity ranged from 84% (schistocytes) to 99.5% (sickle cells, stomatocytes).Conclusions:Our results showed generally high specificities but variable sensitivities for RBC morphologic abnormalities.

Digital morphology analyzers in hematology: ICSH review and recommendations

“…RBC overlap is sometimes falsely reported by the CellaVision as macrocytosis 5,6,16 A low sensitivity of 33% for RBC agglutination has been reported by Horn et al 31 They also reported high specificities but variable sensitivities for RBC morphologic abnormalities using the DM96. Sensitivity for sickle cells and stomatocytes reached 100%.…”

Assessment of semi‐quantitative grading of red blood cell abnormalities utilizing images from the CellaVision DM96 compared to manual light microscopy

“…1 Another study analyzed 15 RBC morphologies, but reported results as present or absent, which is not our practice. 2 Criel et al 3…”

Evaluation of the Red Blood Cell Advanced Software Application on the CellaVision DM96

“…Evaluation of white blood cell (WBC) morphology by these automated analyzers has a higher level of accuracy and precision compared to manual morphological assessment by microscope. Several performance evaluations of these platforms have been carried out, but mostly with the main focus on the leukocytes .…”