Hi All,

 

I'm interested to know your thoughts on digital imaging for manual differentials. Does anyone have any experience of the EasyCell Assistant? It digitally scans blood films and then categorises them into cell populations. You then manually review the morphology on a computer screen before authorising or sending for clinical review. It is claimed that this technology can cut manual diff times in half, and a UK company (Horiba Medical) has just announced that it will be distributing this system. I'm interested to hear from anyone who has used one?

 

Thanks, Sonia Nicholas

 

Here is the Horiba press release: http://bit.ly/ZaUTRP  

Sonia - i don't have any experience with the Horiba model, but i do have a CellaVision that pretty much does the same thing: you make and stain the slide and the instrument scans, takes pictures, and pre-classifies.  I truly believe these systems have the potential to cut manual differential time in half, but you have to make sure you have all of the supporting pieces to ensure efficient workflow.  My problems include (and things that you should check out before purchasing a system):

1. We make our smears by hand and then stain on an old HemaTek stainer.  Slide quality is of utmost importance in order for something like EasyCell or Cellavision to work efficiently. The smears must be consistent, of the proper length, and stained well -- all qualities that we struggle with in a large lab with 30+ techs making slides.  (Something like Beckman's slide-maker-stainer would resolve this problem)

2. Interfacing. Make sure your Information System (we use SoftLab) will be able to interface the results and merge them with your hematology analyzer results.  This piece took us months to iron out and we still have two separate interfaces: one for the hemo results, and the other for our Cellavision results.

3. do the slides require a barcode in order to be recognized by the EasyCell - if so, do you have a system that will EASILY create these slide labels?

Hope that helps -

Nicole

For the time taken to do a manual diff, which for an experienced tech is less than 5 minutes, how can you justify an expensive technology that still requires further review. It isn't saving any time, but costing £$£$£ extra. I could understand if it was reporting them off but just to bring cells forwards to view - it's hardly rocket science...

 

We do all diffs manually, but ensure competancies by having the computer based QA done daily by the person on the films bench.

I think the usefulness of these machines depends a lot on the type of patient population you are serving.  We did a test run on a Cellavision for about a month.  We were a fairly small hospital but serviced a cancer center.  We found that it took about 1 minute less to do a normal manual diff and on the abnormal diffs it was taking us anywhere from 10-15 minutes more per diff because the machine was incorrectly classifying so many cells.  We weren't terribly impressed and ended up deciding it would save us time to continue to do them manually.  Also on questionable cells and RBC inclusions it is more difficult to differentiate certain cells when you cannot focus in or out.