Advantages of AI-based whole blood film scanning for blast detection in markedly leucopenic blood films

Objective: To evaluate performance of AI-assisted blast detection via whole blood film scanning in cases of severe leukopenia. Method: From August to October 2023, we collected 157 patient specimens with white blood cell (WBC) counts of ≤2.0 × 10⁹/L. We then evaluated and compared the blast detection capabilities of an artificial intelligence-based system (Cygnus instrument) against the CellaVision DI-60 for WBC analysis. Additionally, this study aimed to assess the comparative performance of these two automated blood cell morphology analyzers based on their underlying operational principles. Results: Following manual microscopy confirmation, 17 cases showing ≥1 blast cell in peripheral blood smear were identified among 157 specimens with WBC ≤2.0×10⁹/L. The Cygnus whole-slide scanning mode detected all 17 cases (sensitivity: 100%), whereas the Cygnus 200-cell mode detected only 9 cases (9/17), and the CellaVision DI-60 200-cell mode detected 8 cases (8/17). Conclusions: In leukopenic patients (WBC ≤2.0×10⁹/L), utilizing Cygnus' whole-slide scanning capability substantially improves blast identification rates, potentially enabling earlier detection of hematologic abnormalities.