A mobile-phone based high-resolution microendoscope to image cervical precancer

PLoS One. 2019 Feb 6;14(2):e0211045. doi: 10.1371/journal.pone.0211045. eCollection 2019.

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Brazil
  • Cell Phone*
  • Cervix Uteri / diagnostic imaging
  • Cervix Uteri / pathology
  • Colposcopy / economics
  • Colposcopy / instrumentation
  • Colposcopy / methods*
  • Developing Countries
  • Equipment Design
  • Feasibility Studies
  • Female
  • HeLa Cells
  • Health Resources / supply & distribution
  • Humans
  • Image Processing, Computer-Assisted / instrumentation
  • Image Processing, Computer-Assisted / methods
  • Intravital Microscopy / economics
  • Intravital Microscopy / instrumentation
  • Intravital Microscopy / methods*
  • Mass Screening / economics
  • Mass Screening / instrumentation
  • Mass Screening / methods
  • Mobile Applications
  • Physical Examination / economics
  • Physical Examination / instrumentation
  • Physical Examination / methods
  • Printing, Three-Dimensional
  • Sensitivity and Specificity
  • Uterine Cervical Dysplasia / diagnostic imaging*
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / prevention & control*