Opportunities and Drawbacks of Digitalized Morphologic Analysis of Body Fluids

Abstract

Body fluid analysis has become a critical component of diagnostic and clinical decision making for a wide spectrum of human pathologies. Recent biological discoveries, paired with significant technology breakthroughs, have made it possible to partially or totally automate the study of body fluids. An automated microscope, a high-quality digital camera, and software designed to identify and automatically pre-classify cells and other features in stained smears comprise the most recent generation of digital morphological analyzers. Although the use of this instrumentation for body fluid analysis is still in its early stages, it has the potential to provide some significant benefits such as the potential production of highly standardized and reproducible body fluid smears (especially when the cytospin preparation will be automated) human and economic savings, improved operator health and wellness, automatic pre-classification of certain types of cells, improved visualization of cell classes and specific cell features, the creation of a reference library, the use of digital images for remote analysis, future revision, and educational purposes, and the incorporation of digital images into electronic health records. However, some drawbacks of digitalized morphological analysis of body fluids remain, such as standardization of cytospin preparation, initially high cost of purchasing the analyzers, the larger space required for their installation, the inability to focus on the image, the different mental approach that must be used for cell recognition and classification, and the important fact that some cells and elements not typically found in blood cannot be accurately pre-classified. The time necessary for expert operator reclassification is another aspect that must be considered at this stage of development, because identifying and sorting distinct elements in body fluids still necessitates the involvement of an expert morphologist.