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Bermejo-Peláez D, Rueda Charro S, García Roa M, Trelles-Martínez R, Bobes-Fernández A, Hidalgo Soto M, García-Vicente R, Morales ML, Rodríguez-García A, Ortiz-Ruiz A, Blanco Sánchez A, Mousa Urbina A, Álamo E, Lin L, Dacal E, Cuadrado D, Postigo M, Vladimirov A, Garcia-Villena J, Santos A, Ledesma-Carbayo MJ, Ayala R, Martínez-López J, Linares M, Luengo-Oroz M. Digital Microscopy Augmented by Artificial Intelligence to Interpret Bone Marrow Samples for Hematological Diseases. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2024; 30:151-159. [PMID: 38302194 DOI: 10.1093/micmic/ozad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/15/2023] [Accepted: 12/22/2023] [Indexed: 02/03/2024]
Abstract
Analysis of bone marrow aspirates (BMAs) is an essential step in the diagnosis of hematological disorders. This analysis is usually performed based on a visual examination of samples under a conventional optical microscope, which involves a labor-intensive process, limited by clinical experience and subject to high observer variability. In this work, we present a comprehensive digital microscopy system that enables BMA analysis for cell type counting and differentiation in an efficient and objective manner. This system not only provides an accessible and simple method to digitize, store, and analyze BMA samples remotely but is also supported by an Artificial Intelligence (AI) pipeline that accelerates the differential cell counting process and reduces interobserver variability. It has been designed to integrate AI algorithms with the daily clinical routine and can be used in any regular hospital workflow.
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Affiliation(s)
| | | | - María García Roa
- Department of Hematology, Hospital Universitario Fundación Alcorcón, C. Budapest, 1, Alcorcón 28922, Madrid, Spain
| | - Roberto Trelles-Martínez
- Department of Hematology, Hospital Universitario Fundación Alcorcón, C. Budapest, 1, Alcorcón 28922, Madrid, Spain
| | - Alejandro Bobes-Fernández
- Department of Hematology, Hospital Universitario Fundación Alcorcón, C. Budapest, 1, Alcorcón 28922, Madrid, Spain
| | - Marta Hidalgo Soto
- Vall Hebron Institute of Oncology (VHIO), Carrer de Natzaret, 115-117, Horta-Guinardó, Barcelona 08035, Spain
| | - Roberto García-Vicente
- Department of Translational Hematology, Research Institute Hospital 12 de Octubre (imas12), Av. de Córdoba, s/n, Madrid 28041, Spain
- Hematological Malignancies Clinical Research Unit H120-CNIO, CIBERONC, C. de Melchor Fernández Almagro, 3, Madrid 28029, Spain
| | - María Luz Morales
- Department of Translational Hematology, Research Institute Hospital 12 de Octubre (imas12), Av. de Córdoba, s/n, Madrid 28041, Spain
- Hematological Malignancies Clinical Research Unit H120-CNIO, CIBERONC, C. de Melchor Fernández Almagro, 3, Madrid 28029, Spain
| | - Alba Rodríguez-García
- Department of Translational Hematology, Research Institute Hospital 12 de Octubre (imas12), Av. de Córdoba, s/n, Madrid 28041, Spain
- Hematological Malignancies Clinical Research Unit H120-CNIO, CIBERONC, C. de Melchor Fernández Almagro, 3, Madrid 28029, Spain
| | - Alejandra Ortiz-Ruiz
- Department of Translational Hematology, Research Institute Hospital 12 de Octubre (imas12), Av. de Córdoba, s/n, Madrid 28041, Spain
- Hematological Malignancies Clinical Research Unit H120-CNIO, CIBERONC, C. de Melchor Fernández Almagro, 3, Madrid 28029, Spain
| | - Alberto Blanco Sánchez
- Department of Hematology, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, Madrid 28041, Spain
| | | | - Elisa Álamo
- Spotlab, P.º de Juan XXIII, 36B, Madrid 28040, Spain
| | - Lin Lin
- Spotlab, P.º de Juan XXIII, 36B, Madrid 28040, Spain
- Biomedical Image Technologies Laboratory, ETSI Telecomunicación, Universidad Politécnica de Madrid, Av. Complutense, 30, Madrid 28040, Spain
| | - Elena Dacal
- Spotlab, P.º de Juan XXIII, 36B, Madrid 28040, Spain
| | | | - María Postigo
- Spotlab, P.º de Juan XXIII, 36B, Madrid 28040, Spain
| | | | | | - Andrés Santos
- Biomedical Image Technologies Laboratory, ETSI Telecomunicación, Universidad Politécnica de Madrid, Av. Complutense, 30, Madrid 28040, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, C. de Melchor Fernández Almagro, 3, Madrid 28029, Spain
| | - María Jesús Ledesma-Carbayo
- Biomedical Image Technologies Laboratory, ETSI Telecomunicación, Universidad Politécnica de Madrid, Av. Complutense, 30, Madrid 28040, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, C. de Melchor Fernández Almagro, 3, Madrid 28029, Spain
| | - Rosa Ayala
- Department of Translational Hematology, Research Institute Hospital 12 de Octubre (imas12), Av. de Córdoba, s/n, Madrid 28041, Spain
- Hematological Malignancies Clinical Research Unit H120-CNIO, CIBERONC, C. de Melchor Fernández Almagro, 3, Madrid 28029, Spain
- Department of Hematology, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, Madrid 28041, Spain
| | - Joaquín Martínez-López
- Department of Translational Hematology, Research Institute Hospital 12 de Octubre (imas12), Av. de Córdoba, s/n, Madrid 28041, Spain
- Hematological Malignancies Clinical Research Unit H120-CNIO, CIBERONC, C. de Melchor Fernández Almagro, 3, Madrid 28029, Spain
- Department of Hematology, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, Madrid 28041, Spain
| | - María Linares
- Department of Translational Hematology, Research Institute Hospital 12 de Octubre (imas12), Av. de Córdoba, s/n, Madrid 28041, Spain
- Hematological Malignancies Clinical Research Unit H120-CNIO, CIBERONC, C. de Melchor Fernández Almagro, 3, Madrid 28029, Spain
- Department of Biochemistry and Molecular Biology, Pharmacy School, Universidad Complutense de Madrid, Pl. de Ramón y Cajal, s/n, Madrid 28040, Spain
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Fu X, Fu M, Li Q, Peng X, Lu J, Fang F, Chen M. Morphogo: An Automatic Bone Marrow Cell Classification System on Digital Images Analyzed by Artificial Intelligence. Acta Cytol 2020; 64:588-596. [PMID: 32721953 DOI: 10.1159/000509524] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/16/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The nucleated-cell differential count on the bone marrow aspirate smears is required for the clinical diagnosis of hematological malignancy. Manual bone marrow differential count is time consuming and lacks consistency. In this study, a novel artificial intelligence (AI)-based system was developed to perform cell automatic classification of bone marrow cells and determine its potential clinical applications. MATERIALS AND METHODS Bone marrow aspirate smears were collected from the Xinqiao Hospital of Army Medical University. First, an automated analysis system (Morphogo) scanned and generated whole digital images of bone marrow smears. Then, the nucleated marrow cells in the selected areas of the smears at a magnification of ×1,000 were analyzed by the software utilizing an AI-based platform. The cell classification results were further reviewed and confirmed independently by 2 experienced pathologists. The automatic cell classification performance of the system was evaluated using 3 categories: accuracy, sensitivity, and specificity. Correlation coefficients and linear regression equations between automatic cell classification by the AI-based system and concurrent manual differential count were calculated. RESULTS In 230 cases, the classification accuracy was above 85.7% for hematopoietic lineage cells. Averages of sensitivity and specificity of the system were found to be 69.4 and 97.2%, respectively. The differential cell percentage of the automated count based on 200-500 cell counts was correlated with differential cell percentage provided by the pathologists for granulocytes, erythrocytes, and lymphocytes (r ≥ 0.762, p < 0.001). DISCUSSION/CONCLUSION This pilot study confirmed that the Morphogo system is a reliable tool for automatic bone marrow cell differential count analysis and has potential for clinical applications. Current ongoing large-scale multicenter validation studies will provide more information to further confirm the clinical utility of the system.
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Affiliation(s)
- Xinyan Fu
- Division of Medical Technology Development, Hangzhou Zhiwei Information & Technology Ltd., Hangzhou, China
| | - May Fu
- Department of Pathology and Laboratory Medicine, University of Texas, Southwestern Medical Center, Dallas, Texas, USA
| | - Qiang Li
- Division of Medical Technology Development, Hangzhou Zhiwei Information & Technology Ltd., Hangzhou, China
| | - Xiangui Peng
- Department of Hematology, The Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Ju Lu
- Division of Medical Technology Development, Hangzhou Zhiwei Information & Technology Ltd., Hangzhou, China
| | - Fengqi Fang
- Department of Oncology, The First Hospital of Dalian Medical University, Dalian, China
| | - Mingyi Chen
- Department of Pathology and Laboratory Medicine, University of Texas, Southwestern Medical Center, Dallas, Texas, USA,
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