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Complete blood count performed by an automated analyser. Differentials not seen here.

Most blood counts today include a CBC count and leukocyte differential count (LDC) (that is, not just the total
WBC count but also the count of each WBC type, such as neutrophils, eosinophils, basophils, monocytes, and
lymphocytes). More sophisticated modern analyzers can provide extended differential counts, which include
hematopoietic progenitor cells, immature granulocytes, and erythroblasts.[4]
The blood is well mixed (though not shaken) and placed on a rack in the analyzer. This instrument has flow
cells, photometers and apertures that analyze different elements in the blood. The cell counting component
counts the numbers and types of different cells within the blood. The results are printed out or sent to a
computer for review.
Blood counting machines aspirate a very small amount of the specimen through narrow tubing followed by an
aperture and a laser flow cell. Laser eye sensors count the number of cells passing through the aperture, and
can identify them; this is flow cytometry. The two main sensors used are light detectors and electrical
impedance. The instrument measures the type of blood cell by analyzing data about the size and aspects of
light as they pass through the cells (called front and side scatter). Other instruments measure different
characteristics of the cells to categorize them.
Because an automated cell counter samples and counts so many cells, the results are very precise. However,
certain abnormal cells in the blood may not be identified correctly, requiring manual review of the instrument's
results and identification of any abnormal cells the instrument could not categorize.
In addition to counting, measuring and analyzing red blood cells, white blood cells and platelets, automated
hematology analyzers also measure the amount of hemoglobin in the blood and within each red blood cell. This
is done by adding a diluent that lyses the cells which is then pumped into a spectro-photometric
measuring cuvette. The change in color of the lysate equates to the hemoglobin content of the blood. This
information can be very helpful to a physician who, for example, is trying to identify the cause of a
patient'sanemia. If the red cells are smaller or larger than normal, or if there is a lot of variation in the size of the
red cells, this data can help guide the direction of further testing and expedite the diagnostic process so
patients can get the treatment they need quickly.

Automated Cell Counting[edit]

Electrical resistance[edit]

The electrode of a Coulter counter

A Coulter counter is an appliance that can count cells as well as measure their volume. It is based on the fact
that cells show great electrical resistance; in other words, they conduct almost no electricity. In a Coulter
counter the cells, swimming in a solution that conducts electricity, are sucked one by one into a tiny gap.
Flanking the gap are two electrodes that conduct electricity. When no cell is in the gap, electricity flows
unabated, but when a cell is sucked into the gap the current is resisted. The Coulter counter counts the number
of such events and also measures the current (and hence the resistance), which directly correlates to the
volume of the cell trapped. A similar system is the CASY cell counting technology.
Coulter and CASY counters are much cheaper than flow cytometers, and for applications that require cell
numbers and sizes, such as cell-cycle research, they are the method of choice. Its advantage over the methods
above is the large number of cells that can be processed in a short time, namely: thousands of cells per
second. This offers great accuracy and statistical significance.

Flow cytometry[edit]

Automated Cell Counter

Flow cytometry is by far the most sophisticated and expensive method for cell counting. In a flow cytometer the
cells flow in a narrow stream in front of a laser beam. The beam hits them one by one, and a light detector
picks up the light that is reflected from the cells.
Flow cytometers have many other abilities, such as analyzing the shape of cells and their internal and external
structures, as well as measuring the amount of specific proteins and other biochemicals in the cells. Therefore,
flow cytometers are rarely purchased for the sole purpose of counting cells.[citation needed]

Image analysis[edit]
Recent approaches consider the use of high-quality microscopy images over which a statistical
classification algorithm is used to perform automated cell detection and counting as an image

analysis task.[2] Generally performs with a constant error rate as an off-line (batch) type process. A range
of image classification techniques can be employed for this purpose.[3]