Hematology laboratories face numerous challenges, including an increasing volume of tests, complex case requirements, and a dwindling workforce. These issues are compounded by the reliance on traditional manual processes, which are both time-consuming and prone to errors. As the demand for accurate and timely diagnostics continues to grow, clinical labs are seeking innovative solutions to enhance efficiency and maintain high standards of patient care.

One of the most promising advancements in this field is the adoption of digital morphology. By leveraging high-resolution imaging and AI technology, digital morphology provides a comprehensive, automated approach to analyzing blood samples. This shift from manual to digital workflows addresses several critical bottlenecks, offering significant improvements in accuracy, efficiency, and accessibility.

In this blog, we delve into the transformative impact of digital morphology on hematology diagnostics. We explore the cutting-edge technology behind it, compare it to traditional methods, and highlight its various applications within the field.

The technology behind digital morphology

Traditional blood testing methods involve examining blood smears under a microscope to identify and classify cells. Although effective, this manual process is time-consuming and prone to human error. Digital morphology represents a significant leap forward by automating and enhancing this process with advanced imaging technology and AI.

1. Cell locating technology

The first technology to digitize morphology solutions did so by combining traditional microscopy with digital imaging capabilities. This allowed for both manual and automated analysis of a single cell at a time, serving as a bridge for laboratories transitioning from manual to fully digital workflow.

While innovative, this approach does have limitations: static images of individual cells lack the full field context needed for a comprehensive analysis. Pathologists often have to revert to manual microscopy to get a complete picture, leading to inefficiencies and potential diagnostic errors. As such, cell locating technology is a significant step toward digitalization but does not fully address the needs of hematology labs.

2. Full-field technology

Further advancements in digital morphology have introduced full-field technology, which can scan the entire blood smear at 100x resolution. This approach provides a dynamic and comprehensive view of the sample, akin to viewing it through a microscope but with the added benefits of digital technology. The full-field image allows pathologists to zoom in and out, pan around, and explore the sample in its entirety, offering both detailed cell views and the broader context.

Full-field peripheral blood smear (PBS)*  applications integrate AI decision support, which pre-classifies cells and provides suggested counts, significantly reducing the time required for manual differentials. This AI-driven approach ensures that the analysis starts at a consistent baseline, improving accuracy and standardizing results across different laboratories​​​​.

Advantages of digital morphology over traditional methods

Digital morphology offers significant advantages over traditional manual methods in hematology diagnostics, including accuracy, efficiency, remote capabilities, and workflow integration.

1. Enhanced accuracy

One of the primary benefits of digital morphology is the enhanced accuracy it can potentially bring to cell analysis. Traditional methods involve manual counting and classification of cells under a microscope, which is inherently prone to human error and variability between different technicians. Digital morphology utilizes AI-driven algorithms to analyze blood smears, providing consistent and precise results. This standardization minimizes discrepancies and could potentially ensure a higher level of diagnostic reliability.

2. Improved efficiency

Digital morphology drastically improves the efficiency of hematology laboratories. The traditional process of preparing and manually examining blood smears is time-consuming and labor-intensive. By digitizing the entire workflow, from slide preparation to image analysis, digital morphology reduces the time required for each step. AI algorithms pre-classify cells and suggest counts, enabling faster review and reducing the need for repeated examinations. Studies have shown that digital morphology can lead to a 60% improvement in workflow efficiency compared to manual methods1​​​​.

3. Remote capabilities

The ability to review samples remotely is a significant advantage of digital morphology, as it allows high-resolution images of blood smears to be accessed and analyzed from anywhere within the hospital network, addressing staffing shortages and facilitating consultations with off-site specialists. This remote capability provides flexibility for pathologists to work from different locations, improving turnaround times and ensuring timely diagnoses. A study by Tel Aviv Sourasky Medical Center demonstrated that implementing remote digital microscopy for PBS analysis reduced turnaround time by up to 59.1%2. This capability is crucial for maintaining efficiency in hematology labs, especially during weekends and off-hours, without the need for additional staff on-site.

4. Workflow integration

Digital morphology seamlessly integrates with existing laboratory workflows and information systems. The digital platform can be accessed through secure hospital networks, allowing for easy sharing and collaboration among lab personnel. This integration ensures that all relevant data, including complete blood count results and flagged abnormalities, are readily available for review alongside the digital images. The ability to store and retrieve digital slides also enhances teaching and training, as well as quality control processes, by providing a permanent record of each case​​​​.

Applications in digital hematology diagnosis

With its wide range of benefits, digital morphology has revolutionized hematology diagnostics. It offers a wide range of applications that maintain accuracy, efficiency, and accessibility. These applications leverage advanced imaging technology and AI-driven analysis to improve diagnostic outcomes and streamline laboratory workflows.

1. Peripheral blood smear analysis

Traditional PBS analysis involves the manual examination of stained blood smears under a microscope to identify and classify different cell types. Digital morphology automates this process by capturing high-resolution images of the entire blood smear and using AI to pre-classify cells and suggest counts. This not only speeds up the analysis but also has the potential to reduce human error, providing more consistent and reliable results​​​​.

2. Bone marrow aspirate examination

Digital morphology allows for the digital scanning and analysis of bone marrow samples at high magnification. AI algorithms assist in identifying and classifying various cell types, including rare and abnormal cells that are critical for diagnosing hematological disorders such as leukemia and lymphoma. The ability to review and analyze bone marrow samples digitally enhances diagnostic accuracy and facilitates remote consultations with specialists​​​​.

3. Remote review and consultation

The remote capabilities of digital morphology are particularly valuable in hematology diagnostics. High-resolution digital images of blood smears and bone marrow samples can be accessed and reviewed from anywhere, allowing pathologists and hematologists to consult on cases without being physically present in the lab. This remote functionality is essential for addressing the global shortage of experienced laboratory staff and ensuring timely diagnoses, especially in emergency situations or when specialized expertise is required​​​​.

4. Educational and quality control uses

Digital morphology also has significant applications in education and quality control. The digital platform allows for the storage and retrieval of annotated slides, which can be used for training new technicians and pathologists. Additionally, the ability to review past cases and compare results enhances quality control processes, ensuring that diagnostic standards are consistently met​​​.

Embracing the digital transformation in hematology

Hematology, like many fields of medicine, is rapidly evolving towards a digital transformation where data and technology drive diagnostic insights and effective treatment plans. This shift brings with it incredible opportunities for enhanced clinical capabilities and improved patient outcomes. However, to fully realize these benefits, laboratories must be open to adopting digital technologies and workflows.

The advantages of digital morphology are clear: accuracy, improved efficiency, seamless workflow integration, and the ability to conduct remote reviews and consultations. These benefits not only streamline laboratory operations but also ensure more reliable and timely diagnoses, ultimately contributing to better patient care.

As the demand for sophisticated hematology diagnostics grows, embracing digital morphology is no longer just an option but a necessity. By doing so, labs can stay ahead in the competitive healthcare landscape and provide the highest standard of diagnostic services.

To learn more about full-field digital imaging solutions and how they can transform your lab, book a demo with Scopio Labs today.

Sources

1. Katz B-Z, et al. Evaluation of Scopio Labs X100 Full Field PBS: The first high-resolution full field viewing of peripheral blood specimens combined with artificial intelligence-based morphological analysis. Int J Lab Hematol. 2021;00:1–9. https://doi.org/10.1111/ijlh.13681
2. “Remote Digital Microscopy Improves Hematology Laboratory Workflow by Reducing Peripheral Blood Smear Analysis Turnaround Time” (Applied Clinical Informatics, 2022)

* Scopio Labs’ Full-Field Peripheral Blood Smear application is CE marked and FDA-cleared, and its commercially available across the U.S., UK and Europe and other territories.

**Scopio’s Full-Field Bone Marrow Aspirate Application is CE-marked and cleared for sale in CE countries as well as in additional regions. Not commercially available in the US for in vitro diagnostic procedures.