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No. 49 (PH 15)
Evaluation of CellaVision DM96, an automated digital cell morphology
identification system, for the examination of body fluid cytospin slides
Hyun-Sook Chu, Young-Uk Cho, Sang Hyuk Park, Seongsoo Jang, Chan-Jeoung Park
Department of Laboratory Medicine, university of Ulsan, College of Medicine and Asan
Medical Center, Seoul, Korea
Background: Several automated digital imaging systems have been introduced in recent years and
showed excellent correlation with conventional manual and digital imaging differentials for the
evaluation of peripheral blood smears. The aim of this study was to evaluate one of the modern
automated digital imaging systems, the CellaVision DM96 (CellaVision AB, Sweden), for the
examination of body fluid cytospin slides.
Methods: We evaluated 101 body fluid cytospin slides from 91 patients. In the manual microscopic
differentials, 62 cases had malignant effusion or leptomeningeal seeding, of which 47 had metastatic
carcinoma and 15 had lymphoma or leukemia involvement. The remaining 39 cases showed benign
conditions. Specimen types included 40 peritoneal fluid, 26 pleural fluid, 25 cerebrospinal fluid (CSF),
5 bronchoalveolar lavage fluid, 3 dialysis fluid, and 2 pericardial fluid samples.
Results: Results from the comparisons showed good correlation for all cell classes with correlation
coefficients ranging from 0.643 to 0.998. Four CSF samples were not analyzed due to a very low
number of total leukocytes (< 2 /μL). Strong correlation was observed with neutrophils, lymphocytes,
macrophages and eosinophils with correlation coefficients greater than 0.8. However, correlation
coefficients for mesothelial cells and malignant cells were slightly lower, with the values of 0.698 and
0.643, respectively. More malignant cells were detected on manual microscopic examination than with
the digital imaging system, with a mean difference of 13.5%. Notably, cases with benign effusion or
CSF showed excellent correlation for all major cell classes, with correlation coefficients greater than 0.9.
Correlation was unaffected by the leukocyte count in the fluid.
Conclusions: Our evaluation of CellaVision DM96 revealed good correlation with manual microscopic
differentials for evaluation of body fluid cytospin slides. Thus, this system can be an effective option for
body fluid analysis in hematology laboratories needing an automated digital imaging system. In
particular, it can be used to rule out malignant effusion or leptomeningeal seeding as a first-line
screening tool and can help improve workflow and reduce turnaround time.
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