Mobile microscopy as a screening tool for oral cancer in India: A pilot study

Abstract

Oral cancer is the most common type of cancer among men in India and other countries in South Asia. Late diagnosis contributes significantly to this mortality, highlighting the need for effective and specific point-of-care diagnostic tools. The same regions with high prevalence of oral cancer have seen extensive growth in mobile phone infrastructure, which enables widespread access to telemedicine services. In this work, we describe the evaluation of an automated tablet-based mobile microscope as an adjunct for telemedicine-based oral cancer screening in India. Brush biopsy, a minimally invasive sampling technique was combined with a simplified staining protocol and a tablet-based mobile microscope to facilitate local collection of digital images and remote evaluation of the images by clinicians. The tablet-based mobile microscope (CellScope device) combines an iPad Mini with collection optics, LED illumination and Bluetooth-controlled motors to scan a slide specimen and capture high-resolution images of stained brush biopsy samples. Researchers at the Mazumdar Shaw Medical Foundation (MSMF) in Bangalore, India used the instrument to collect and send randomly selected images of each slide for telepathology review. Evaluation of the concordance between gold standard histology, conventional microscopy cytology, and remote pathologist review of the images was performed as part of a pilot study of mobile microscopy as a screening tool for oral cancer. Results indicated that the instrument successfully collected images of sufficient quality to enable remote diagnoses that show concordance with existing techniques. Further studies will evaluate the effectiveness of oral cancer screening with mobile microscopy by minimally trained technicians in low-resource settings.

Multiclass classification of autofluorescence images of oral cavity lesions based on quantitative analysis

“…This distortion is observed in histopathological examinations [9,10]. The most frequently used method for early diagnosis is oral screening [11][12][13]. Although biopsies and histopathological examinations are the gold standard for diagnosing oral cancer [14], biopsy is an invasive and time consuming.…”

Development and characterization of portable smartphone‐based imaging device

“…For faster and accurate detection of oral cancer with CellScope, a cloud-based system could be integrated with an application. The application captures around 100 images from various regions of the stained sample and using deep learning algorithms, positive tests are confirmed (Skandarajah et al, 2017). The integration of cloud helps in storing the images and can be used for further study and modification of the algorithm.…”

“…However, due to the cost and size of the microscope, they are not available to the masses for routine testing. This leads to the fatalities due to improper treatment and delays in the detection or diagnosis of diseases mainly in remote areas and developing countries (Skandarajah et al, 2017). With the increase in diagnostic cost and requirement of a specialized technician for the visual examination, delivering diagnostic reports of the histopathological test may not possible in remote areas.…”

“…Other than their typical diagnostic role, these smartphone-based devices are also used for analysis at a molecular level like detection of mutation with the help of a fluorescence-based hand-held microscope (Punitha, Logeshwari, Sivaranjani, & Priyanka, 2017). Smartphone-based diagnostic devices along with deep learning algorithms have also been used for air quality monitoring (Wu et al, 2017), automated semen analysis (Kanakasabapathy et al, 2017), and for detection of different types of carcinomas (Skandarajah et al, 2017). Apart from developing a standalone device, recent development has shown that image resolution, as well as magnification comparable to an optical microscope, could be achieved by attaching an add-on lens to the smartphone camera.…”

Telemedizinische Methoden in der Hals-Nasen-Ohrenheilkunde

“…In this context, telemedical solutions have been developed to support symptom control [177], to increase the quality of life [178] of patients suffering from head and neck cancer, and to early detect neoplasms in the oral cavity [179]. According to an online survey [180], the highest need for supporting measures for patients with cancer diagnosis (N = 212) arises in the field of body care (66 %), of supporting healthy lifestyle (54 %), social (43 %) and psychological aid (38 %) as well as with regard to programs that refer to questions of life (24 %).…”