{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:53:21Z","timestamp":1791536001851,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["20K20230"],"award-info":[{"award-number":["20K20230"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["18K07424"],"award-info":[{"award-number":["18K07424"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016980","name":"Otsuka Toshimi Scholarship Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016980","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Deep learning\u2010based systems have shown promise in automating white blood cell (WBC) classification; however, most validations are limited to single institutions. This study aimed to evaluate the multicenter performance and robustness of a CNN\u2010based deep learning system (DLS) for peripheral blood cell classification and morphologic abnormality detection across three hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 766 peripheral blood smears (613 routine and 153 abnormal) from Juntendo University Hospital, Kyoto University Hospital, and the National Cancer Center Hospital were analyzed using the Sysmex DI\u201060. The DLS, trained on 1.49 million annotated cell images, classified 16 cell types and 42 morphological features. Cell classification performance was assessed by standard metrics, including accuracy and\n                      <jats:italic>F<\/jats:italic>\n                      1 score, while agreement with manual WBC counts was evaluated through correlation and regression analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The DLS achieved high specificity, negative predictive value, and accuracy (&gt;\u200995%) across institutions. Mean\n                      <jats:italic>F<\/jats:italic>\n                      1 scores exceeded 0.80 for major WBC types in both routine and abnormal smears. Agreement with manual microscopy was strong for neutrophils, lymphocytes, and eosinophils (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009&gt;\u20090.8; Cb &gt;\u20090.9), while monocytes and basophils showed moderate variability. The DLS identified smears containing blasts or abnormal cells that required expert review and detected morphological features associated with specific diseases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This multicenter validation demonstrates robust and reproducible performance of the DLS across laboratories, supporting its clinical applicability for routine WBC differentials and detection of disease\u2010specific morphological abnormalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70256","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:40:28Z","timestamp":1791535228000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comprehensive Multicenter Evaluation of an\n                    <scp>AI<\/scp>\n                    \u2010Based Deep Learning System for Automated Blood Cell Classification and Morphologic Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5103-5279","authenticated-orcid":false,"given":"Mendamar","family":"Ravzanaadii","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"},{"name":"Department of Advanced Research Institute for Health Science Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2191-5405","authenticated-orcid":false,"given":"Yuki","family":"Horiuchi","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"},{"name":"Department of Advanced Research Institute for Health Science Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0424-4964","authenticated-orcid":false,"given":"Kayoko","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Medicine Kyoto University Hospital  Kyoto Japan"},{"name":"Department of Clinical Laboratory Medicine Shiga University of Medical Science Hospital  Otsu Shiga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiaki","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayaka","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Medicine Kyoto University Hospital  Kyoto Japan"},{"name":"Suita Municipal Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misato","family":"Tsubokura","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3701-3214","authenticated-orcid":false,"given":"Kenta","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Medicine Kyoto University Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4803-9994","authenticated-orcid":false,"given":"Makiko","family":"Yamasaki\u2010Morita","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Medicine Kyoto University Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-3227","authenticated-orcid":false,"given":"Hirotaka","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2410-3172","authenticated-orcid":false,"given":"Naoki","family":"Kosaka","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Hematology Juntendo University School of Medicine  Tokyo Japan"},{"name":"Division of Cell Therapy &amp; Blood Transfusion Medicine Juntendo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8871-1330","authenticated-orcid":false,"given":"Miki","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Hematology Juntendo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1629-6630","authenticated-orcid":false,"given":"Hiromichi","family":"Matsushita","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine National Cancer Center Hospital  Tokyo Japan"},{"name":"Department of Laboratory Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4624-9247","authenticated-orcid":false,"given":"Yosuke","family":"Iwasaki","sequence":"additional","affiliation":[{"name":"Department of Advanced Research Institute for Health Science Juntendo University Graduate School of Medicine  Tokyo Japan"},{"name":"Sysmex Corporation  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Konishi","sequence":"additional","affiliation":[{"name":"Department of Advanced Research Institute for Health Science Juntendo University Graduate School of Medicine  Tokyo Japan"},{"name":"Sysmex Corporation  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3734-0346","authenticated-orcid":false,"given":"Yoko","family":"Tabe","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Medicine Juntendo University Graduate School of Medicine  Tokyo Japan"},{"name":"Department of Advanced Research Institute for Health Science Juntendo University Graduate School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-49942-z"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-82826-9"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bspc.2021.103341"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13061026"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2023.101144"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2022.101019"},{"key":"e_1_2_12_8_1","volume-title":"Reference Leukocyte (WBC) Differential Count (Proportional) and Evaluation of Instrumental Methods; 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