Real-World Application of Digital Morphology Analyzers: Practical Issues and Challenges in Clinical Laboratories

Digital morphology (DM) analyzers have advanced clinical hematology laboratories by enhancing the efficiency and precision of peripheral blood (PB) smear analysis. This review explores the real-world application of DM analyzers with their benefits and challenges by focusing on PB smear analysis and...

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Main Authors: Hanah Kim, Mina Hur, Giuseppe d’Onofrio, Gina Zini
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/6/677
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author Hanah Kim
Mina Hur
Giuseppe d’Onofrio
Gina Zini
author_facet Hanah Kim
Mina Hur
Giuseppe d’Onofrio
Gina Zini
author_sort Hanah Kim
collection DOAJ
description Digital morphology (DM) analyzers have advanced clinical hematology laboratories by enhancing the efficiency and precision of peripheral blood (PB) smear analysis. This review explores the real-world application of DM analyzers with their benefits and challenges by focusing on PB smear analysis and less common analyses, such as bone marrow (BM) aspirates and body fluids (BFs). DM analyzers may automate blood cell classification and assessment, reduce manual effort, and provide consistent results. However, recognizing rare and dysplastic cells remains challenging due to variable algorithmic performances, which affect diagnostic reliability. The quality of blood film as well as staining techniques significantly influence the accuracy of DM analyzers, and poor-quality samples may lead to errors. In spite of reduced inter-observer variability compared with manual counting, an expert’s review is still needed for complex cases with atypical cells. DM analyzers are less effective in BM aspirates and BF examinations because of their higher complexity and inconsistent sample preparation compared with PB smears. This technology relies heavily on artificial intelligence (AI)-based pre-classifications, which require extensive, well-annotated datasets for improved accuracy. The performance variation across platforms in BM aspirates and rare-cell analysis highlights the need for AI algorithm advancements and DM analysis standardization. Future clinical practice integration will likely combine advanced digital platforms with skilled oversight to enhance diagnostic workflow in hematology laboratories. Ongoing research aims to develop robust and validated AI models for broader clinical applications and to overcome the current limitations of DM analyzers. As technology evolves, DM analyzers are set to transform laboratory efficiency and diagnostic precision in hematology.
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spelling doaj-art-d67459adab5f440baef014232b5ce08e2025-08-20T03:43:36ZengMDPI AGDiagnostics2075-44182025-03-0115667710.3390/diagnostics15060677Real-World Application of Digital Morphology Analyzers: Practical Issues and Challenges in Clinical LaboratoriesHanah Kim0Mina Hur1Giuseppe d’Onofrio2Gina Zini3Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Republic of KoreaDepartment of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, Republic of KoreaDepartment of Hematology, Università Cattolica del S. Cuore, 00168 Rome, ItalyDepartment of Hematology, Università Cattolica del S. Cuore-Fondazione Policlinico Gemelli, 00168 Rome, ItalyDigital morphology (DM) analyzers have advanced clinical hematology laboratories by enhancing the efficiency and precision of peripheral blood (PB) smear analysis. This review explores the real-world application of DM analyzers with their benefits and challenges by focusing on PB smear analysis and less common analyses, such as bone marrow (BM) aspirates and body fluids (BFs). DM analyzers may automate blood cell classification and assessment, reduce manual effort, and provide consistent results. However, recognizing rare and dysplastic cells remains challenging due to variable algorithmic performances, which affect diagnostic reliability. The quality of blood film as well as staining techniques significantly influence the accuracy of DM analyzers, and poor-quality samples may lead to errors. In spite of reduced inter-observer variability compared with manual counting, an expert’s review is still needed for complex cases with atypical cells. DM analyzers are less effective in BM aspirates and BF examinations because of their higher complexity and inconsistent sample preparation compared with PB smears. This technology relies heavily on artificial intelligence (AI)-based pre-classifications, which require extensive, well-annotated datasets for improved accuracy. The performance variation across platforms in BM aspirates and rare-cell analysis highlights the need for AI algorithm advancements and DM analysis standardization. Future clinical practice integration will likely combine advanced digital platforms with skilled oversight to enhance diagnostic workflow in hematology laboratories. Ongoing research aims to develop robust and validated AI models for broader clinical applications and to overcome the current limitations of DM analyzers. As technology evolves, DM analyzers are set to transform laboratory efficiency and diagnostic precision in hematology.https://www.mdpi.com/2075-4418/15/6/677digital morphology analyzersperipheral blood smearsbone marrow aspiratesbody fluidclinical laboratorypractical issues
spellingShingle Hanah Kim
Mina Hur
Giuseppe d’Onofrio
Gina Zini
Real-World Application of Digital Morphology Analyzers: Practical Issues and Challenges in Clinical Laboratories
Diagnostics
digital morphology analyzers
peripheral blood smears
bone marrow aspirates
body fluid
clinical laboratory
practical issues
title Real-World Application of Digital Morphology Analyzers: Practical Issues and Challenges in Clinical Laboratories
title_full Real-World Application of Digital Morphology Analyzers: Practical Issues and Challenges in Clinical Laboratories
title_fullStr Real-World Application of Digital Morphology Analyzers: Practical Issues and Challenges in Clinical Laboratories
title_full_unstemmed Real-World Application of Digital Morphology Analyzers: Practical Issues and Challenges in Clinical Laboratories
title_short Real-World Application of Digital Morphology Analyzers: Practical Issues and Challenges in Clinical Laboratories
title_sort real world application of digital morphology analyzers practical issues and challenges in clinical laboratories
topic digital morphology analyzers
peripheral blood smears
bone marrow aspirates
body fluid
clinical laboratory
practical issues
url https://www.mdpi.com/2075-4418/15/6/677
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