Improving turn-around times in low-throughput distributed hematology laboratory settings with the CellaVision® DC-1 instrument

Abstract

Abstract Objectives Digital pathology is becoming standard in the delivery of timely, high-quality clinical services, inclusive of morphological assessment in laboratory hematology. While many digital hematology systems are designed with high-throughput in mind, CellaVision ® has recently developed a low-throughput instrument, the CellaVision ® DC-1. The utility of the CellaVision ® DC-1 was tested in a distributed laboratory system, with a focus on turn-around times (TATs). Methods We evaluated the TATs of a CellaVision ® DC-1 workflow, with specimens originating in a small spoke-laboratory referring materials to a central hub-laboratory. Our spoke-laboratories perform on-site complete blood counts (CBC’s) and manual peripheral blood smears (PBS’s), with complex cases referred for review to the hub-laboratory. Baseline TATs were collected, followed by prospective evaluation of 21 cases analyzed using the CellaVision ® DC-1, with digital review by spoke-laboratory staff in concert with remote review by hub-laboratory staff. The TATs for the same 21 cases by standard manual assessment were compared. Results Improvement in the distribution of TATs using the CellaVision ® DC-1 was noted relative to the retrospective spoke-laboratory data (Mann–Whitney U=26, p<0.0001) and the parallel manual PBS review (Wilcoxon W=190, p<0.0001). The CellaVision ® DC-1 permitted a significant reduction in case-assessment times (Wilcoxon W=105, p=0.0001). No significant diagnostic discrepancies were identified during the testing timeframe. Conclusions We describe a real-world assessment of the CellaVision ® DC-1 analyzer in a distributed (hub-and-spoke) laboratory network, linking low-volume laboratories to high-throughput sites. Our evaluation highlights significant improvements in case TATs with a CellaVision ® DC-1 assisted digital pathology workflow.