Performance evaluation of digital morphology analyzer Sysmex DI-60 in capturing platelet aggregation on blood smears

Abstract Objectives This study evaluated the Sysmex DI-60’s capability to identify varying degrees of platelet aggregation on blood smears and verified its sensitivity. Methods A comparative analysis was conducted using manual microscopy as the reference and the Sysmex DI-60 as the evaluation method. The study involved 432 blood smears with platelet aggregation from Union Hospital between 2022 and 2023. Additionally, 488 samples from routine blood tests in January 2024 that triggered platelet review rules were selected for manual and DI-60 analysis. Results The DI-60 detected 429 out of 432 blood smears with platelet aggregation, achieving a sensitivity of 99.3 %. Among these, mild, moderate, and severe aggregations were detected with sensitivities of 98.8 %, 100.0 %, and 100.0 %, respectively. The sensitivity for detecting platelet aggregation was higher when observing multiple interfaces. Among the 488 selected samples, 31 cases of platelet aggregation were initially detected by manual microscopy, while the DI-60 detected 36 cases. Upon review, both methods detected 36 cases, achieving a sensitivity of 100 %. Conclusions The Sysmex DI-60 demonstrates high sensitivity in detecting platelet aggregation and yields consistent results compared to manual microscopy.