Automation and the role of AI in urinalysis

Urinalysis plays an important role in the diagnosis and monitoring of nephrological, urological, and hepatic conditions. In the last 25 years, new automated technologies have greatly reduced the labor intensity of urinalysis, and new technical possibilities have emerged.

Automation in urinalysis has been gaining ground in the context of laboratory medicine. More and more technological resources are sought to optimize routines. Microscopy-based urine particle analysis has greatly progressed over the past decades, enabling high throughput in clinical laboratories. Today, there are walkaway systems for automated chemistry and sedimentation/microscopic analysis of urine samples. These analyzers offer fast and accurate classification and quantitative determination of the urine sediment. Further, they produce clear and sharp images of the actual appearance of elements simulating visual microscopy. In addition to automatic recognition of elements in sediment, based on sophisticated artificial intelligence (AI), these systems also offer accurate evaluation of test strips by color matrix definition technology. In general, the greatest advantage of automated devices is the standardization of results and the performance of large routines in a short time.

Automation with the advantages of visual microscopy
Urinalysis examination consists of three stages, which include physical, chemical, and sedimentation analysis. Sedimentation allows evaluating the presence of several elements, such as bacteria, red blood cells, epithelial cells, crystals, such as calcium oxalate, and the presence of mucus, among other elements.

As new and improved technologies developed, automation based on digital microscopy have started gaining traction, as they provide actual images of the sedimentation analysis and offer in-depth data, which allows easy interpretation. Laura XL by Transasia Bio-Medicals Ltd. is one the analyzers that provides visual detection for both urine chemistry and sedimentation, allowing the users to view the chemistry results as well as sedimentation images. Laura XL has the capability to perform digital microscopy with the help of its imaging apparatus and a reusable cuvette assembly. Multiple samples can be loaded in the cuvette assembly to achieve higher throughput. The specimen is loaded in the cuvette assembly and is allowed to settle down based on gravity sedimentation. This is a gentle technique meaning less damage to fragile elements like casts, and a lower risk of RBC lysis. Gravity sedimentation also results in cost savings, compared to centrifugation and measurement in flow techniques, as it removes the need for expensive disposable cuvettes.

The Imaging apparatus on Laura XL captures multiple clear high-resolution digital images of a single sample, which can then be viewed and interpreted providing the user with the advantages of visual microscopy in a fully automated format. Laura XL also provides the users with an image of the sample-specific strip, which was used for urine chemistry.

AI is a game changer in sedimentation analysis
Images that are captured by Laura XL are interpreted using the AI software, which analyzes all the images of the specimen of interest, and identifies multiple sedimentation parameters based on their morphology and further quantified allowing the user with easy interpretation data. The user can also revisit the images and observe the results, in case they wish to manually interpret or clarify any doubts based on other medical findings.

As AI is becoming an indispensable tool to augment decision making in various healthcare settings. Considering the surge in the volume of tests being run, post Covid-19 pandemic, there is a need for laboratories, big and small, to undergo automation and digitization by introducing AI-based technology, and Transasia Bio medicals is working toward providing affordable advance tech in the automation space for the users with an offering like Laura XL.