Abstract

BackgroundEarly detection is an essential component of cancer management. Unfortunately, visual examination can often be unreliable, and many settings lack the financial capital and infrastructure to operate PET, CT, and MRI systems. Moreover, the infrastructure and expense associated with surgical biopsy and microscopy are a challenge to establishing cancer screening/early detection programs in low-resource settings. Improvements in performance and declining costs have led to the availability of optoelectronic components, which can be used to develop low-cost diagnostic imaging devices for use at the point-of-care. Here, we demonstrate a fiber-optic fluorescence microscope using a consumer-grade camera for in vivo cellular imaging.MethodsThe fiber-optic fluorescence microscope includes an LED light, an objective lens, a fiber-optic bundle, and a consumer-grade digital camera. The system was used to image an oral cancer cell line labeled with 0.01% proflavine. A human tissue specimen was imaged following surgical resection, enabling dysplastic and cancerous regions to be evaluated. The oral mucosa of a healthy human subject was imaged in vivo, following topical application of 0.01% proflavine.FindingsThe fiber-optic microscope resolved individual nuclei in all specimens and tissues imaged. This capability allowed qualitative and quantitative differences between normal and precancerous or cancerous tissues to be identified. The optical efficiency of the system permitted imaging of the human oral mucosa in real time.ConclusionOur results indicate this device as a useful tool to assist in the identification of early neoplastic changes in epithelial tissues. This portable, inexpensive unit may be particularly appropriate for use at the point-of-care in low-resource settings.

Highlights

  • Point-of-care diagnostic devices should be small, inexpensive, and portable, yet accurate, robust, and simple to use

  • SLR (Single Lens Reflex) digital cameras are relatively inexpensive in comparison to the scientific-grade CCD cameras which are used in many biological imaging applications [10,11,12]

  • A healthy human subject was imaged in vivo. These studies demonstrate the capability of the system to obtain images with sub-cellular resolution, noninvasively, and in real-time. We propose that this portable, inexpensive diagnostic imaging device may be useful as an efficient diagnostic tool at the point-of-care for populations in remote or rural communities in the U.S as well as in developing countries

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Summary

Introduction

Point-of-care diagnostic devices should be small, inexpensive, and portable, yet accurate, robust, and simple to use. Flexible, miniature fiber-optic components have made it possible to access tissue at confined sites within the body, enabling cellular level imaging to be performed in tandem with standard wide-field methods, such as endoscopy These capabilities are currently being investigated for potential roles in clinical diagnostics, screening, and surgical guidance [1,2,3,4,5,6,7,8,9], but for translation of the technology to the point-of-care setting to become realistic, issues of cost, complexity, size, and performance must be addressed. SLR (Single Lens Reflex) digital cameras are relatively inexpensive in comparison to the scientific-grade CCD cameras which are used in many biological imaging applications [10,11,12] Most of these cameras are powered by a rechargeable battery pack and include a built-in LCD screen for real-time visualization. We demonstrate a fiber-optic fluorescence microscope using a consumer-grade camera for in vivo cellular imaging

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