Lab Med Qual Assur.  2023 Mar;45(1):18-24. 10.15263/jlmqa.2023.45.1.18.

Quality Assessment of Wright-Giemsa Staining in Digital Cell Imaging

• Park CH
• Kwon H

• KMID: 2541072
• DOI: http://doi.org/10.15263/jlmqa.2023.45.1.18

Abstract

Background
With the introduction of digital cell image analyzer and artificial intelligence, automatic cell image identification and disease diagnosis has become possible. However, an inappropriately stained image can cause errors in cell recognition in digital cell imaging. In this study, we aimed to determine the quality index for the quality control of the staining method.
Methods
The differences (calculated values, VAL _CELL ) in cell percentages (image counts [IMG _CELL ] and complete blood count with differential count [DIFF _CELL ]) between the image analyzer and the automatic hematology analyzer were calculated from the appropriately stained smears. Then, a Levey-Jennings control chart was plotted using the VAL _CELL and the inappropriately stained smears were evaluated against the Levey-Jennings control chart.
Results
The allowable ranges from the Levey-Jennings control charts for neutrophils and lymphocytes were –5.50 to 10.46 and –11.56 to 6.92, respectively. From the Levey-Jennings control charts, 33.3% (5/15) were outside the allowable ranges and considered inappropriately stained.
Conclusions
The differences in the cell percentages between the image analyzer and the automatic hematology analyzer may be used to detect inappropriately stained smears.

Keyword

Wright-Giemsa stain; Digital cell imaging analyzer; Quality assessment