Smartphone epifluorescence microscopy for cellular imaging of fresh tissue in low-resource settings

Deep learning-assisted smartphone-based quantitative microscopy for label-free peripheral blood smear analysis

Hematologists evaluate alterations in blood cell enumeration and morphology to confirm peripheral blood smear findings through manual microscopic examination. However, routine peripheral blood smear analysis is both time-consuming and labor-intensive. Here, we propose using smartphone-based autofluorescence microscopy (Smart-AM) for imaging label-free blood smears at subcellular resolution with automatic hematological analysis. Smart-AM enables rapid and label-free visualization of morphological features of normal and abnormal blood cells (including leukocytes, erythrocytes, and thrombocytes). Moreover, assisted with deep-learning algorithms, this technique can automatically detect and classify different leukocytes with high accuracy, and transform the autofluorescence images into virtual Giemsa-stained images which show clear cellular features. The proposed technique is portable, cost-effective, and user-friendly, making it significant for broad point-of-care applications.

Feasibility of images acquired using smartphone camera for marginal and internal fit of fixed dental prosthesis: comparison and correlation study

This study aimed to measure marginal and internal fit using images captured with both an optical microscope and a smartphone camera, comparing the fit measurement performance of these devices and analyzing their correlation. Working casts (with 10 posterior and 10 anterior teeth) created to fabricate fixed dental prostheses were used. These working casts were scanned using a desktop scanner (E1) to design an interim crown, and the designed interim crown was fabricated using a three-dimensional (3D) printer. Utilizing the silicone replica technique, the fabricated interim crown replicated the fit, which was then captured using both an optical microscope and a smartphone camera. The captured images were used to measure the marginal and internal fit according to the imaging device. Intraclass correlation coefficients (ICC) were used for reliability analysis according to the imaging device. Furthermore, the Wilcoxon signed-rank test was adopted for the comparative evaluation of the marginal and internal fit between the imaging devices (α = 0.05). The measurement results of the marginal and internal fit according to the optical microscope and smartphone camera did exhibit a significant difference (P < 0.05). The ICC between the two devices showed an "excellent" agreement of over 0.9 at all measurement points (P < 0.001). A smartphone camera could be used to obtain images for evaluating the marginal and internal fit.

Diffuse transmittance visible spectroscopy using smartphone flashlight for photoplethysmography and vital signs measurements

Photoplethysmography (PPG), with its wide range of applications, has become one of the most promising modalities for healthcare monitoring technology. In this work, we present a new PPG measurement technique based on diffuse transmittance spectroscopy (DTS) with the help of a smartphone built-in flashlight as an alternative broadband light source. The blood Volume Pulse (BVP) signal was extracted from recorded transmittance spectra at 620 nm. The results were compared with the ground truth and conventional contact finger PPG sensors. A very high correlation was found between the diffuse transmittance signal and the reference PPG signals (r = 0.997, p < 0.0001). The accuracy and root mean square error (RMSE) were 99.23% and 0.8 bpm, respectively. In addition, a Bland-Altman analysis showed a good agreement between both techniques, with a very small bias between mean paired differences of heart rate observations. A simple forward model for diffuse transmittance spectra for different levels of blood oxygen saturation is developed and supported by experimental measurements. It was also found that blood oxygen saturation (SpO2) can be estimated with the aid of DTS based smartphone flash by tracking the wavelength corresponding to the oxygenation level in the visible range between orange and red regions of the visible spectrum particularly in the range between 610 and 635 nm for 26 healthy subjects. 624 nm on average seems to be the wavelength that corresponds with the normal blood oxygenation level. These findings show the potential of DTS PPG to reliably extract cardiac frequency and estimate SpO2 with adequate accuracy. The results also demonstrate the capability of smartphone flash as a miniature visible light source for recording multispectral PPG signals and quantifying vital signs in the transmission mode at the fingertip with acceptable signal quality over a wide range of wavelengths from 550 nm to 650 nm.

A Smartphone-Based Low-Cost Inverted Laser Fluorescence Microscope for Disease Diagnosis

Fluorescence microscopy is an important tool for disease diagnosis, often requiring costly optical components, such as fluorescence filter cubes and high-power light sources. Due to its high cost, conventional fluorescence microscopy cannot be fully exploited in low-income settings. Smartphone-based fluorescence microscopy becomes an interesting low-cost alternative, but raises challenges in the optical system. We present the development of a low-cost inverted laser fluorescence microscope that uses a smartphone to visualize the fluorescence image of biological samples. Our fluorescence microscope uses a laser-based simplified optical filter system that provides analog optical filtering capabilities of a fluorescence filter cube. Firstly, we validated our inverted optical filtering by visualizing microbeads labeled with three different fluorescent compounds or fluorophores commonly used for disease diagnosis. Secondly, we validated the disease diagnosis capabilities by comparing the results of our device with those of a commercial fluorescence microscope. We successfully detected and visualized Trypanosoma cruzi parasites, responsible for the Chagas infectious disease and the presence of Antineutrophil cytoplasmic antibodies of the ANCA non-communicable autoimmune disease. The samples were labeled with the fluorescein isothiocyanate (FITC) fluorophore, one of the most commonly used fluorophores for disease diagnosis. Our device provides a 400× magnification and is at least one order of magnitude cheaper than conventional commercial fluorescence microscopes.

A review on low-cost microscopes for Open Science

This article presents a review after an exhaustive search that yielded 23 works carried out in the last decade for the availability of optical microscopes with open hardware as a low-cost alternative to commercial systems. These works were developed with the aim of covering needs within several areas such as: Bio Sciences research in institutions with limited resources, diagnosis of diseases and health screenings in large populations in developing countries, and training in educational contexts with a need for high availability of equipment and low replacement cost. The analysis of the selected works allows us to classify the analyzed solutions into two main categories, for which their essential characteristics are enumerated: portable field microscopes and multipurpose automated microscopes. Moreover, this work includes a discussion on the degree of maturity of the solutions in terms of the adoption of practices aligned with the development of Open Science. RESEARCH HIGHLIGHTS: Concise review on low-cost microscopes for developing Open Science, exposing the role of smartphone-based microscopy. The work classifies microscopes in two main categories: (1) portable field microscopes, and (2) multipurpose automated microscopes.

Excitation modalities for enhanced micro and nanoparticle imaging in a smartphone coupled 3D printed fluorescent microscope

Smartphone fluorescent microscopes (SFM) offer many functional characteristics similar to their benchtop counterparts at a fraction of the cost and have been shown to work for biomarker detection in many biomedical applications. However, imaging and quantification of bioparticles in the sub-micron and nanometer range remains challenging as it requires aggressive robustness and high-performance metrics of the building blocks of SFM. Here, we explored multiple excitation modalities and their performance on the imaging capability of an SFM. Employing spatial positional variations of the excitation source with respect to the imaging sample plane (i.e., parallel, perpendicular, oblique), we developed three distinct SFM variants. These SFM variants were tested using green-fluorescent beads of four different sizes (8.3, 2, 1, 0.8 μm). Optimal excitation voltage range was determined by imaging these beads at multiple excitation voltages to optimize for no data loss and acceptable noise levels for each SFM variant. The SFM with parallel excitation was able to only image 8.3 μm beads while the SFM variants with perpendicular and oblique excitation were able to image all four bead sizes. Relative performance of the SFM variants was quantified by calculating signal difference to noise ratio (SDNR) and contrast to noise ratio (CNR) from the captured images. SFM with oblique excitation generated the highest SDNR and CNR values, whereas, for power consumption, SFM with perpendicular excitation generated the best results. This study sheds light on significant findings related to performance of SFM systems and their potential utility in biomedical applications involving sub-micron imaging. Similarly, findings of this study are translatable to benchtop microscopy instruments as well as to enhance their imaging performance metrics.

An affordable, handheld multimodal microscopic system with onboard cell morphology and counting features on a mobile device

A simple yet effective, handheld and flexible bright-field and fluorescence microscopic platform on a smartphone with varying optical magnifications is reported for morphological analysis and onboard cell counting features.

MicroHikari3D: an automated DIY digital microscopy platform with deep learning capabilities

A microscope is an essential tool in biosciences and production quality laboratories for unveiling the secrets of microworlds. This paper describes the development of MicroHikari3D, an affordable DIY optical microscopy platform with automated sample positioning, autofocus and several illumination modalities to provide a high-quality flexible microscopy tool for labs with a short budget. This proposed optical microscope design aims to achieve high customization capabilities to allow whole 2D slide imaging and observation of 3D live specimens. The MicroHikari3D motion control system is based on the entry level 3D printer kit Tronxy X1 controlled from a server running in a Raspberry Pi 4. The server provides services to a client mobile app for video/image acquisition, processing, and a high level classification task by applying deep learning models.

miniSPIM-A Miniaturized Light-Sheet Microscope

The miniSPIM is a miniaturized light-sheet microscope that enables imaging with optical sectioning on mobile camera devices such as smartphones and single-board computers. Applications of the miniSPIM include biosensing, field research, and education where maximum portability and robustness, low power consumption, and low cost are key. Here, it is shown how all of the components of a simple light-sheet microscope can be integrated within a footprint smaller than the average smartphone. Example applications include the quantification of the motion of microparticles and bacteria in fluids, the characterization of solvent polarity based on spectral shifts of the lipid probe Nile Red, and three-dimensional (3D) and time-lapse autofluorescence imaging of a live zebrafish embryo.

PARP1: A Potential Molecular Marker to Identify Cancer During Colposcopy Procedures

Despite efforts in prevention, cervical cancer still presents with a high worldwide incidence and remains a great problem in public health, especially in low-income countries. Screening programs, such as colposcopy with Papanicolaou testing, have greatly improved mortality rates. However, the agents currently used to delineate those lesions (topical application of acetic acid or Lugol iodine) lack specificity and sometimes can lead to unnecessary biopsies or even cervical excisions. A tool to enable in vivo histology to quickly and quantitatively distinguish between tumor, dysplastic tissue, and healthy tissue would be of great clinical interest. Methods: Here, we describe the use of PARPi-FL, a fluorescent inhibitor of poly[adenosine diphosphate-ribose]polymerase 1 (PARP1), which is a nuclear enzyme that is overexpressed in cancer when compared with the normal surrounding tissues. We exploit its use as an optical imaging agent to specifically target PARP1 expression, which was demonstrated to be higher in cervical cancer than the normal surrounding tissue. Results: After topical application of PARPi-FL on freshly excised cone biopsy samples, the nuclei of tumor cells emitted a specific fluorescent signal that could be visualized using a handheld fluorescence confocal microscope. Conclusion: This approach has the potential to improve in vivo identification of tumor cells during colposcopy examination, allowing a rapid, noninvasive, and accurate histopathologic assessment.

A modular microscopic smartphone attachment for imaging and quantification of multiple fluorescent probes using machine learning

Portable smartphone-based fluorescent microscopes are becoming popular owing to their ability to provide major functionalities offered by regular benchtop microscopes at a fraction of the cost. However, smartphone-based microscopes are still limited to a single fluorophore, fixed magnification, the inability to work with a different smartphones, and limited usability to either glass slides or cover slips. To overcome these challenges, here we present a modular smartphone-based microscopic attachment. The modular design allows the user to easily swap between different sets of filters and lenses, thereby enabling utility of multiple fluorophores and magnification levels. Our microscopic smartphone attachment can also be used with different smartphones and was tested with Nokia Lumia 1020, Samsung Galaxy S9+, and an iPhone XS. Further, we showed imaging results of samples on glass slides, cover slips, and microfluidic devices. A 1951 USAF resolution test target was used to quantify the maximum resolution of the microscope which was found to be 3.9 μm. The performance of the smartphone-based microscope was compared with a benchtop microscope and we found an R2 value of 0.99 using polystyrene beads and blood cells isolated from human blood samples collected from Robert Wood Johnson Medical Hospital. Additionally, to count the particles (cells and beads) imaged from the smartphone-based fluorescent microscope, we developed artificial neural networks (ANNs) using multiple training algorithms, and evaluated their performances compared to the control (ImageJ). Finally, we did ANOVA and Tukey's post-hoc analysis and found a p-value of 0.97 which shows that no statistical significant difference exists between the performance of the trained ANN and control (ImageJ).

Optical Imaging Modalities: Principles and Applications in Preclinical Research and Clinical Settings

With the ability to noninvasively image and monitor molecular processes within tumors, molecular imaging represents a fundamental tool for cancer scientists. In the current review, we describe emergent optical technologies for molecular imaging. We aim to provide the reader with an overview of the fundamental principles on which each imaging strategy is based, to introduce established and future applications, and to provide a rationale for selecting optical technologies for molecular imaging depending on disease location, biology, and anatomy. To accelerate clinical translation of imaging techniques, we also describe examples of practical applications in patients. Elevating these techniques into standard-of-care tools will transform patient stratification, disease monitoring, and response evaluation.

Improved radiosynthesis of 123I-MAPi, an auger theranostic agent

PURPOSE

123I-MAPi, a novel PARP1-targeted Auger radiotherapeutic has shown promising results in pre-clinical glioma model. Currently, 123I-MAPi is synthesized using multistep synthesis that results in modest yields and low molar activities (MA) that limits the ability to translate this technology for human studies where high doses are administered. Therefore, new methods are needed to synthesize 123I-MAPi in high activity yields (AY) and improved MA to facilitate clinical translation and multicenter trials.

MATERIALS AND METHODS

123I-MAPi was prepared in a single step via 123I-iododetannylation of the corresponding tributylstannane precursor. In vitro internalization assay, subcellular fractionation and confocal microscopy where used to evaluate the performance of 123I-MAPi in a small cell lung cancer model.

RESULTS

123I-MAPi was synthesized in a single step from the corresponding stannane precursor in AY of 45 ± 2% and MA of 11.8 ± 4.8 GBq µmol-1. In vitro in LX22 cells showed rapid internalization (5 min) with accumulation found predominantly in the membrane, nucleus and chromatin of the cell as determined by subcellular fractionation.

CONCLUSIONS

Here, we have developed an improved radiosynthesis of 123I-MAPi, an Auger theranostic agent. This process was achieved using a single step, 123I-iododestannylation reaction from the corresponding stannane precursor in good AY and MA. 123I-MAPi was evaluated in vitro in a small cell lung cancer model with high PARP expression, rapid internalization and high nuclear uptake shown.

Optical Technologies for Improving Healthcare in Low-Resource Settings: introduction to the feature issue

This feature issue of Biomedical Optics Express presents a cross-section of interesting and emerging work of relevance to optical technologies in low-resource settings. In particular, the technologies described here aim to address challenges to meeting healthcare needs in resource-constrained environments, including in rural and underserved areas. This collection of 18 papers includes papers on both optical system design and image analysis, with applications demonstrated for ex vivo and in vivo use. All together, these works portray the importance of global health research to the scientific community and the role that optics can play in addressing some of the world's most pressing healthcare challenges.

Robotic microscopy for everyone: the OpenFlexure microscope

Optical microscopes are an essential tool for both the detection of disease in clinics, and for scientific analysis. However, in much of the world access to high-performance microscopy is limited by both the upfront cost and maintenance cost of the equipment. Here we present an open-source, 3D-printed, and fully-automated laboratory microscope, with motorised sample positioning and focus control. The microscope is highly customisable, with a number of options readily available including trans- and epi- illumination, polarisation contrast imaging, and epi-florescence imaging. The OpenFlexure microscope has been designed to enable low-volume manufacturing and maintenance by local personnel, vastly increasing accessibility. We have produced over 100 microscopes in Tanzania and Kenya for educational, scientific, and clinical applications, demonstrating that local manufacturing can be a viable alternative to international supply chains that can often be costly, slow, and unreliable.