Journal of Pathology Informatics

TECHNICAL NOTE
Year
: 2021  |  Volume : 12  |  Issue : 1  |  Page : 18-

Image Analysis Using Machine Learning for Automated Detection of Hemoglobin H Inclusions in Blood Smears A Method for Morphologic Detection of Rare Cells


Shir Ying Lee1, Crystal M E Chen2, Elaine Y P Lim2, Liang Shen3, Aneesh Sathe4, Aahan Singh4, Jan Sauer4, Kaveh Taghipour4, Christina Y C Yip2 
1 Department of Laboratory Medicine, Division of Haematology, National University Hospital; Department of Haematology-Oncology, National University Cancer Institute, Singapore
2 Department of Laboratory Medicine, Division of Haematology, National University Hospital, Singapore
3 Unit of Biostatistics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
4 Qritive Pte Ltd, Singapore

Correspondence Address:
Dr. Shir Ying Lee
National University Health System, 1E Kent Ridge Road, Level 7
Singapore

Background: Morphologic rare cell detection is a laborious, operator-dependent process which has the potential to be improved by the use of image analysis using artificial intelligence. Detection of rare hemoglobin H (HbH) inclusions in red cells in the peripheral blood is a common screening method for alpha-thalassemia. This study aims to develop a convolutional neural network-based algorithm for the detection of HbH inclusions. Methods: Digital images of HbH-positive and HbH-negative blood smears were used to train and test the software. The software performance was tested on images obtained at various magnifications and on different scanning platforms. Another model was developed for total red cell counting and was used to confirm HbH cell frequency in alpha-thalassemia trait. The threshold minimum red cells to image for analysis was determined by Poisson modeling and validated on image sets. Results: The sensitivity and specificity of the software for HbH+ cells on images obtained at ×100, ×60, and ×40 objectives were close to 91% and 99%, respectively. When an AI-aided diagnostic model was tested on a pilot of 40 whole slide images (WSIs), good inter-rater reliability and high sensitivity and specificity of slide-level classification were obtained. Using the lowest frequency of HbH+ cells (1 in 100,000) observed in our study, we estimated that a minimum of 2.4 × 106 red cells would need to be analyzed to reduce misclassification at the slide level. The minimum required smear size was validated on 78 image sets which confirmed its validity. Conclusions: WSI image analysis can be utilized effectively for morphologic rare cell detection. The software can be further developed on WISs and evaluated in future clinical validation studies comparing AI-aided diagnosis with the routine diagnostic method.


How to cite this article:
Lee SY, Chen CM, Lim EY, Shen L, Sathe A, Singh A, Sauer J, Taghipour K, Yip CY. Image Analysis Using Machine Learning for Automated Detection of Hemoglobin H Inclusions in Blood Smears A Method for Morphologic Detection of Rare Cells.J Pathol Inform 2021;12:18-18


How to cite this URL:
Lee SY, Chen CM, Lim EY, Shen L, Sathe A, Singh A, Sauer J, Taghipour K, Yip CY. Image Analysis Using Machine Learning for Automated Detection of Hemoglobin H Inclusions in Blood Smears A Method for Morphologic Detection of Rare Cells. J Pathol Inform [serial online] 2021 [cited 2021 Apr 12 ];12:18-18
Available from: https://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2021;volume=12;issue=1;spage=18;epage=18;aulast=Lee;type=0