A sample-preparation-free, automated, sample-to-answer system for cell counting in human body fluids

Area of Science:

• Clinical Laboratory Science
• Biomedical Engineering
• Microscopy

Background:

• Manual cell counting in body fluids, especially cerebrospinal fluid (CSF), remains a challenge due to low cellularity and lack of automation.
• Existing methods often require manual intervention, leading to potential variability and reduced sensitivity.

Purpose of the Study:

• To develop and validate a simple, cost-effective, automated fluorescence microscope system for accurate white and red blood cell counting in human body fluids.
• To assess the system's performance against manual counting methods, particularly for low-cellularity samples.

Main Methods:

• A compact, automated fluorescence microscope system was designed, incorporating a sample chamber with dry reagents for staining and sample preparation.
• Automated focusing, scanning, and multimodal image analysis were employed to extract cell counts.
• The system's performance was evaluated by comparing its counts with manual cell counts on over 200 clinical samples.

Main Results:

• The automated system demonstrated excellent agreement with manual cell counting across a wide dynamic range of body fluid cellularity.
• The system's ability to analyze larger image regions potentially offers higher sensitivity for detecting cells in extremely low-cellularity samples.
• The system successfully identified cells in samples where manual counts registered zero cells.

Conclusions:

• The developed automated fluorescence microscope system provides a promising solution for routine, automated, and sensitive analysis of cell counts in various body fluids.
• This cost-effective technology has the potential to enhance diagnostic accuracy and efficiency in clinical laboratories.
• The system's improved sensitivity for low-cellularity samples addresses a critical need in analyzing samples like CSF.