Automated morphological analysis of cells in body fluids by the digital microscopy system DM96

Background Differential counting and morphological analysis of nucleated cells in body fluids (eg, cerebrospinal fluid and pleural fluid) are of great diagnostic importance to the clinician. A recent development in this field was the introduction of an application for an automated microscopy system, the DM96 Body Fluid module, enabling the automated analysis of body fluid samples. This computerised system provides an automated morphological analysis of body fluids, including an automated classification of all nucleated cells. Aims To investigate the ability of the digital microscopy system, DM96, to automatically classify cells in different types of body fluids. Methods A total of 177 body fluids (including cerebrospinal fluid, abdominal fluid and continuous ambulant peritoneal dialysis fluid) were analysed on the DM96, and results were compared with the manual microscopy method. Results A study in 177 samples demonstrates an overall preclassification accuracy of 90% in spinal fluid and 83% in other body fluids using the automated system. Correlation coefficients for postclassification as compared with manual review range from 0.92 to 0.99 for spinal fluid sample analyses and from 0.83 to 0.98 for other body fluids. The within-run variation of automated classification is less than 6% for all cell categories (4% excluding macrophages). Conclusion The DM96 has proven to be reliable and efficient, contributing to overall quality improvement in morphological analysis and automated cell classification of peripheral blood and other body-fluid samples.