Background: With the introduction of digital cell image analyzer and artificial intelligence, automatic cell image identification and disease diagnosis has become possible. However, an inappropriately stained image can cause errors in cell recognition in digital cell imaging. In this study, we aimed to determine the quality index for the quality control of the staining method.
Methods: The differences (calculated values, VAL_CELL) in cell percentages (image counts [IMG_CELL] and complete blood count with differential count [DIFF_CELL]) between the image analyzer and the automatic hematology analyzer were calculated from the appropriately stained smears. Then, a Levey-Jennings control chart was plotted using the VAL_CELL and the inappropriately stained smears were evaluated against the Levey-Jennings control chart.
Results: The allowable ranges from the Levey-Jennings control charts for neutrophils and lymphocytes were –5.50 to 10.46 and –11.56 to 6.92, respectively. From the Levey-Jennings control charts, 33.3% (5/15) were outside the allowable ranges and considered inappropriately stained.
Conclusions: The differences in the cell percentages between the image analyzer and the automatic hematology analyzer may be used to detect inappropriately stained smears.

Keywords: Wright-Giemsa stain, Digital cell imaging analyzer, Quality assessment