ArticleFrontiers in medicine2026
Clinical utility of optical scatter-derived red blood cell parameters for the rapid identification and correction of lipemic interference.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Lipemic interference is a common cause of spuriously increased hemoglobin (HGB) and red blood cell indices in routine complete blood count testing. This study evaluated whether Delta-HGB, an optical scatter-derived parameter generated in the reticulocyte (RET) channel of an automated hematology analyzer, can identify lipemic interference and whether optical scatter-derived HGB-O and MCHC-O can rapidly correct lipemia-related bias. Methods: A total of 471 complete blood count specimens collected between April 2025 and February 2026 were included, comprising 158 non-lipemic and 313 lipemic samples. The precision and linearity of optical scatter-based HGB measurement were first assessed. HGB-I obtained by the conventional colorimetric method was then compared with HGB-O obtained by the optical scatter method in non-lipemic samples. Lipemic specimens were analyzed using the colorimetric method, optical scatter method, plasma replacement, and formula-based correction. Receiver operating characteristic (ROC) analysis was used to evaluate the performance of Delta-HGB and MCHC-I, and agreement among correction methods was assessed. Results: The optical scatter method showed acceptable within-run precision, with coefficients of variation of 1.0-1.3% in non-lipemic samples and 0.9-1.4% in lipemic samples, all meeting the WS/T 406-2012 criterion. Linearity was excellent. In non-lipemic samples, HGB results measured by the colorimetric and optical scatter methods did not differ significantly. For overall lipemic interference, the AUC was 0.703 (95% CI: 0.658-0.749) for Delta-HGB and 0.668 (95% CI: 0.620-0.716) for MCHC-I. After stratification by lipemic index, discrimination of severe lipemic interference improved markedly, with AUCs of 0.988 (95% CI: 0.970-1.000) and 0.979 (95% CI: 0.950-1.000), respectively. The optimal cutoffs were 7 g/L for Delta-HGB and 359.5 g/L for MCHC-I, both yielding sensitivity and specificity above 95%. Optical scatter-derived HGB, MCHC, and MCH showed good agreement with plasma replacement and formula-based correction. Conclusion: Delta-HGB combined with MCHC-I is useful for identifying severe lipemic interference. Optical scatter-derived parameters can correct lipemia-induced bias without specimen pretreatment, providing a rapid and practical strategy for routine laboratory use.
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