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The introduction of digital morphology in laboratory hematology
STRUSKOVÁ, Martina
The aim of my bachelor´s work is to compare the results of the diferential divide of leukocyte achieved in a trial run by a classical microscope and by a digital morphological system from the company CellaVision AB (Lund, Švédsko) Cella Vision DM96?. I concentrated on checking the correctness and accuracy of the measurement and I compared the work, time and financial demands. The methodical part of my work was done in the hematological laboratory in the hospital České Budějovice plc., where I work. The data file was formed of 50 samples, whose blood picture including the diferential divide of leukocyte was analysed at hematological analyzer Coulter LH 755. The samples were evaluated according to the rules stated in SOP of the laboratory and according to as it is called warning reports of the analyzer informing about the suspicion of occurrence of immature or atypical forms of cellular populations, which were marked as necessary for microscopic checking. After making and colouring the blood smear these samples were microscopic evaluated by a classical microscope and at the same time they were, in a trial run, analyzed by a digital microscope Cella Vision DM96. The results of the measurement are placed in corresponding diagrams showing the relations of correctness and correlation of cellular populations. The source of original data is to be found in the enclosure. The correlation of single population of leukocyte preclassified by a digital microscope in relation to conventional microscopy are for neutrofils 0,91, for lymphocytes 0,96, monocytes 0,89, bands 0,78. I don´t mention the figures for eosinofiles and basofiles, because they are of low informative value due to low cellular representation in the smears. The theory about results achieved by the digital system Cella Vision DM96? being unsatisfactory was proved, mainly because of neutrofiles. The leukocyte correlation after manual correction is for neutrofiles 0,97, lymfocyte 0,98, monocytes 0,94, bands 0,96. In this case the theory about results after manual preclassification being comparable to classical microscopy is true. The total average time of evaluation by the digital morphology is 9´55´´ where the time of stating by analyzer took on average 2´30´´ and the operation time of manual correction was on average 6´55´´. The measured average time of classical microscopy was 5´10´´.The time demands of the diferential divide of leukocyte analysis done by a microscope Cella Vision DM96? is bigger than by classical microscopy, which emerges from the resulting values. A very important aspect which influences the results of preclassification is the quality of smears and colouring. The observed samples were done manually. After finishing the study I had the oportunity to work with samples done mecanically. With samples prepared this way is the time demands much lower. For the group ofleukopenic samples (0,1 ? 3,9 x 109G/l) the manual preclassification of the diferential divide of leukocyte done mechanically by a digital machine from the point of view of time more favourable than the reclassification done by classical microscope. Time savings of these samples is nearly 50%. The financial demands are based on the time or rather the cost of operation time for people doing the manual reclassification of the digitally evaluated sample. The operating costs are higher at the time difference between classical and digital microscopy. If we take account of the machine price, the finantial demands increase multiply. Although there are some significant aspects the digital morphology is implemented for. For example results archiving and their reverse control including all cell exposures, possibility for so called teleconsultation, saving the exposures in electronic medical records. The digital system is also a significant help for emploees and trainees education.
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