Abstract
Light microscopy provides a simple, cost-effective, and vital method for the diagnosis and screening of hematologic and infectious diseases. In many regions of the world, however, the required equipment is either unavailable or insufficiently portable, and operators may not possess adequate training to make full use of the images obtained. Counterintuitively, these same regions are often well served by mobile phone networks, suggesting the possibility of leveraging portable, camera-enabled mobile phones for diagnostic imaging and telemedicine. Toward this end we have built a mobile phone-mounted light microscope and demonstrated its potential for clinical use by imaging P. falciparum-infected and sickle red blood cells in brightfield and M. tuberculosis-infected sputum samples in fluorescence with LED excitation. In all cases resolution exceeded that necessary to detect blood cell and microorganism morphology, and with the tuberculosis samples we took further advantage of the digitized images to demonstrate automated bacillus counting via image analysis software. We expect such a telemedicine system for global healthcare via mobile phone – offering inexpensive brightfield and fluorescence microscopy integrated with automated image analysis – to provide an important tool for disease diagnosis and screening, particularly in the developing world and rural areas where laboratory facilities are scarce but mobile phone infrastructure is extensive.
Highlights
Light microscopy is an essential tool in modern healthcare
Much of the power of light microscopy, especially fluorescence imaging and the opportunity for remote consultation and electronic record keeping, remains inaccessible in rural and developing areas due to prohibitive equipment and training costs. This is especially problematic since the diagnosis, screening, and monitoring of treatment for many diseases and infections endemic to such areas – e.g. tuberculosis (TB), malaria, and sickle cell disease – depend on light microscopy as a screening tool or a definitive diagnostic test [2,3,4,5,6]
Given the ubiquity of mobile phone networks, the fact that many mobile phones are equipped with digital cameras, the increase in computational power of mobile phones, and the advent of inexpensive high-power light emitting diodes (LEDs), we believe that these technologies can be combined to create an inexpensive and powerful tool for light microscopy in developing regions
Summary
Light microscopy is an essential tool in modern healthcare. The advent of digital imaging has only enhanced this diagnostic role, as sample images are frequently transferred among technologically-advanced hospitals for further consultation and evaluation, a role important enough that a medical communication standard (DICOM [1]) has been widely adopted for the handling of digital images. Much of the power of light microscopy, especially fluorescence imaging and the opportunity for remote consultation and electronic record keeping, remains inaccessible in rural and developing areas due to prohibitive equipment and training costs. This is especially problematic since the diagnosis, screening, and monitoring of treatment for many diseases and infections endemic to such areas – e.g. tuberculosis (TB), malaria, and sickle cell disease – depend on light microscopy as a screening tool or a definitive diagnostic test [2,3,4,5,6]. An additional advantage to using a phone-based microscope is that mobile phones are essentially computers that can be used for digital image processing as well as electronic medical record keeping and communication
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