A mobile-phone based high-resolution microendoscope to image cervical precancer
基于高精度显微内窥镜的智能手机用于早期宫颈癌成像

Benjamin D. Grant, Timothy Quang, et al.    原文链接
产品图

摘要:
  近90%的子宫颈癌病例和死亡发生在中低收入国家,这些国家缺乏全面的国家HPV免疫和子宫颈癌筛查项目。在这些情况下,由于缺乏基础设施和训练有素的人员,很难实施筛选项目。在一些资源不足的环境中,已经成功地实施了基于乙酸(VIA)可视化检查的筛选项目。然而,VIA的特效性较差,90%接受阳性检查的患者都被过度治疗。许多研究表明,高分辨率的宫颈成像可以通过更好地区分癌前病变和良性病变来改善体内核形态。为了在低资源环境下实现高分辨率成像,我们开发了一种便携式、低成本、高分辨率的微内窥镜,该内窥镜使用手机检测和显示带有亚细胞分辨率的宫颈上皮的图像。该设备的制造成本不到2000美元,使用的是商用光学元件,包括滤波器、LED和三联透镜,这些光学元件组装在3d打印的光学机械支架上。我们发现,移动式高分辨率微内窥镜实现了与以前报道的使用传统相机和计算机检测和显示图像的高分辨率微内窥镜系统相似的分辨率和信噪比。最后,我们展示了移动式高分辨率显微内窥镜在巴西巴雷托斯的妇科推荐诊所对正常和癌前宫颈鳞状上皮进行成像的能力。

Abstract:
Nearly 90% of cervical cancer cases and deaths occur in low- and middle-income countries that lack comprehensive national HPV immunization and cervical cancer screening programs. In these settings, it is difficult to implement screening programs due to a lack of infrastructure and shortage of trained personnel. Screening programs based on visual inspection with acetic acid (VIA) have been successfully implemented in some low-resource settings. However, VIA has poor specificity and up to 90% of patients receiving treatment based on a positive VIA exam are over-treated. A number of studies have suggested that high-resolution cervical imaging to visualize nuclear morphology in vivo can improve specificity by better distinguishing precancerous and benign lesions. To enable high-resolution imaging in low-resource settings, we developed a portable, low-cost, high-resolution microendoscope that uses a mobile phone to detect and display images of cervical epithelium in vivo with subcellular resolution. The device was fabricated for less than $2,000 using commercially available optical components including filters, an LED and triplet lenses assembled in a 3D-printed opto-mechanical mount. We show that the mobile high-resolution microendoscope achieves similar resolution and signal-to-background ratio as previously reported high-resolution microendoscope systems using traditional cameras and computers to detect and display images. Finally, we demonstrate the ability of the mobile high-resolution microendoscope to image normal and precancerous squamous epithelium of the cervix in vivo in a gynecological referral clinic in Barretos, Brazil.

光路图