Novel Comparison of Cellavision Dc-1 and Microscopic Assessment of Blood Film Morphology in Paediatrics

Abstract

Background The aim of this study was to evaluate the blood film assessment of CellaVision DC-1 compared to conventional microscopy in stained peripheral blood (PB) films from paediatric samples. Methods Blood films (n = 50) including clinically normal samples as well as common pathological conditions, were collected and examined by conventional microscopy and CellaVision DC-1. Manual microscopy counts vs. automated WBC differentiation and RBC grading via Cellavision, including manual re-classification, were compared to expert morphologist reporting. Using statistical analysis, the following metrics were measured including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results The reliability of RBC grading was measured at >60% sensitivity and 55-74% specificity for CellaVision method compared to 78-93% sensitivity with manual microscopy, demonstrating the latter as the superior method. Additionally, DC-1 misclassified the presence of blasts for lymphocytes, with 67% compared to 100% specificity with the gold standard microscopy. Both pre- and post-classification, re-classifications, and manual microscopy showed strong correlations of WBC differential counts with expert/known readings, mainly for neutrophils and lymphocytes ([[EQUATION]] 0.60-0.85). In terms of time, CellaVision took 1 min longer to scan and assess each slide than did light microscopy. Conclusion The use of CellaVision DC-1 may be beneficial to diagnostic laboratories in the adult setting; however, further research is needed when assessing paediatric samples that demand human intellect and critical thinking. Medical Scientist training and software development are recommended. Manual microscopy is faster and more accurate. Slide signing and DC-1 classifications of unclassified WBCs need scientist intervention.

Note:
Funding Information: This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

Conflict of Interests: he authors declare no conflicts of interest.

Keywords: CellaVision, Conventional Microscopy, Paediatrics, Blood Diseases, Peripheral Blood