Point-of-care and point-of-procedure optical imaging technologies for primary care and global health

Optical imaging technologies can improve frontline health care in low- and high-resource settings, resulting in more rapid and accurate diagnoses and more immediate and appropriate therapies. Leveraging advances in consumer electronics and wireless telecommunications, low-cost, portable optical imaging devices have the potential to improve screening and detection of disease at the point of care in primary health care settings in both low- and high-resource countries. Similarly, real-time optical imaging technologies can improve diagnosis and treatment at the point of procedure by circumventing the need for biopsy and analysis by expert pathologists, who are scarce in developing countries. Although many optical imaging technologies have been translated from bench to bedside, industry support is needed to commercialize and broadly disseminate these from the patient level to the population level to transform the standard of care. This review provides an overview of promising optical imaging technologies, the infrastructure needed to integrate them into widespread clinical use, and the challenges that must be addressed to harness the potential of these technologies to improve health care systems around the world.

[1]  Yee-Wei Lim,et al.  Reducing the global burden of acute lower respiratory infections in children: the contribution of new diagnostics , 2006, Nature.

[2]  Vasilis Ntziachristos,et al.  Translational optical imaging. , 2012, AJR. American journal of roentgenology.

[3]  Thomas D. Wang,et al.  Targeted Imaging of Esophageal Neoplasia with a Fluorescently Labeled Peptide: First-in-Human Results , 2013, Science Translational Medicine.

[4]  Kelsey M. Kennedy,et al.  Needle optical coherence elastography for the measurement of microscale mechanical contrast deep within human breast tissues , 2013, Journal of biomedical optics.

[5]  Uretz J. Oliphant,et al.  Optical Coherence Tomography: The Intraoperative Assessment of Lymph Nodes in Breast Cancer , 2010, IEEE Engineering in Medicine and Biology Magazine.

[6]  John Newell,et al.  SMART MOVE - a smartphone-based intervention to promote physical activity in primary care: study protocol for a randomized controlled trial , 2013, Trials.

[7]  Mark C. Pierce,et al.  High-Resolution Microendoscopy for the Detection of Cervical Neoplasia in Low-Resource Settings , 2012, PloS one.

[8]  Guoan Zheng,et al.  Imaging and Identification of Waterborne Parasites Using a Chip-Scale Microscope , 2014, PloS one.

[9]  Effect of Thin Prep® imaging system on laboratory rate and relative sensitivity of atypical squamous cells, high-grade squamous intraepithelial lesion not excluded and high-grade squamous intraepithelial lesion interpretations , 2013, CytoJournal.

[10]  Ji Yi,et al.  Spatially resolved optical and ultrastructural properties of colorectal and pancreatic field carcinogenesis observed by inverse spectroscopic optical coherence tomography , 2014, Journal of biomedical optics.

[11]  W. Bishai,et al.  Diagnostic point-of-care tests in resource-limited settings. , 2014, The Lancet. Infectious diseases.

[12]  Rebecca Richards-Kortum,et al.  Devices for Low-Resource Health Care , 2013, Science.

[13]  Michael L Wilson,et al.  Improvement of pathology in sub-Saharan Africa. , 2013, The Lancet. Oncology.

[14]  B. Zheng,et al.  Reduction of false-positive recalls using a computerized mammographic image feature analysis scheme , 2014, Physics in medicine and biology.

[15]  Mark C. Pierce,et al.  Portable, Battery-Operated, Low-Cost, Bright Field and Fluorescence Microscope , 2010, PloS one.

[16]  C. Adebamowo,et al.  Optimisation of breast cancer management in low-resource and middle-resource countries: executive summary of the Breast Health Global Initiative consensus, 2010. , 2011, The Lancet. Oncology.

[17]  V. Pikov,et al.  Raman Spectrometer System for Remote Measurement of Cellular Temperature on a Microscopic Scale , 2022 .

[18]  Allan Tucker,et al.  Local Failure and Margin Status in Early‐Stage Breast Carcinoma Treated with Conservation Surgery and Radiation Therapy , 1993, Annals of surgery.

[19]  Zachary J Smith,et al.  Single-step preparation and image-based counting of minute volumes of human blood. , 2014, Lab on a chip.

[20]  David Hsiang,et al.  Baseline tumor oxygen saturation correlates with a pathologic complete response in breast cancer patients undergoing neoadjuvant chemotherapy. , 2012, Cancer research.

[21]  J. Colford,et al.  Rapid point‐of‐care HIV testing in pregnant women: a systematic review and meta‐analysis , 2007, Tropical medicine & international health : TM & IH.

[22]  Rajaraman Swaminathan,et al.  Effect of visual screening on cervical cancer incidence and mortality in Tamil Nadu, India: a cluster-randomised trial , 2007, The Lancet.

[23]  Guoan Zheng,et al.  Color sub-pixel resolving optofluidic microscope and its application to blood cell imaging for malaria diagnosis , 2011 .

[24]  Vadim Backman,et al.  Association between rectal optical signatures and colonic neoplasia: potential applications for screening. , 2009, Cancer research.

[25]  Eugenio Paci,et al.  European Breast Cancer Service Screening Outcomes: A First Balance Sheet of the Benefits and Harms , 2014, Cancer Epidemiology, Biomarkers & Prevention.

[26]  S. S. Olmsted,et al.  Requirements for high impact diagnostics in the developing world , 2006, Nature.

[27]  Federico Girosi,et al.  Developing and interpreting models to improve diagnostics in developing countries , 2006, Nature.

[28]  Enrico Gratton,et al.  Assessing tumor contrast in radiographically dense breast tissue using Diffuse Optical Spectroscopic Imaging (DOSI) , 2013, Breast Cancer Research.

[29]  Jeehyun Kim,et al.  Optical coherence tomography for advanced screening in the primary care office , 2014, Journal of biophotonics.

[30]  Wei Yang,et al.  Feasibility of confocal fluorescence microscopy for real-time evaluation of neoplasia in fresh human breast tissue , 2013, Journal of biomedical optics.

[31]  Surgeon recommendations and receipt of mastectomy for treatment of breast cancer. , 2009, JAMA.

[32]  Aydogan Ozcan,et al.  Computational imaging, sensing and diagnostics for global health applications. , 2014, Current opinion in biotechnology.

[33]  Aydogan Ozcan,et al.  Imaging without lenses: achievements and remaining challenges of wide-field on-chip microscopy , 2012, Nature Methods.

[34]  R. Pleijhuis,et al.  Obtaining Adequate Surgical Margins in Breast-Conserving Therapy for Patients with Early-Stage Breast Cancer: Current Modalities and Future Directions , 2009, Annals of Surgical Oncology.

[35]  Peter L. Choyke,et al.  Rapid Cancer Detection by Topically Spraying a γ-Glutamyltranspeptidase–Activated Fluorescent Probe , 2011, Science Translational Medicine.

[36]  Mark D. Perkins,et al.  Performance of Three LED-Based Fluorescence Microscopy Systems for Detection of Tuberculosis in Uganda , 2010, PloS one.

[37]  J. Quincy Brown,et al.  Optical Spectral Surveillance of Breast Tissue Landscapes for Detection of Residual Disease in Breast Tumor Margins , 2013, PloS one.

[38]  Jeffrey Wasserman,et al.  Global health diagnostics , 2006, Nature.

[39]  Fiona J Gilbert,et al.  Use of new imaging techniques to predict tumour response to therapy. , 2010, The Lancet. Oncology.

[40]  Sidhartha R Sinha,et al.  Health technologies and innovation in the global health arena. , 2011, The New England journal of medicine.

[41]  Michael R. Reich,et al.  Access: How Do Good Health Technologies Get to Poor People in Poor Countries? , 2009 .

[42]  Integrating Cancer Control into Global Health , 2011, Science Translational Medicine.

[43]  Daniel A. Fletcher,et al.  Quantitative Imaging with a Mobile Phone Microscope , 2014, PloS one.

[44]  Cac T. Nguyen,et al.  Noninvasive in vivo optical detection of biofilm in the human middle ear , 2012, Proceedings of the National Academy of Sciences.

[45]  J. Orem,et al.  From Knowledge to Policy: Lessons from Africa , 2014, Science Translational Medicine.

[46]  Min-Ying Su,et al.  Optical imaging correlates with magnetic resonance imaging breast density and reveals composition changes during neoadjuvant chemotherapy , 2013, Breast Cancer Research.

[47]  K. Miles,et al.  Predicting tumour response , 2013, Cancer imaging : the official publication of the International Cancer Imaging Society.

[48]  Rashid Bashir,et al.  Microfluidic CD4+ and CD8+ T Lymphocyte Counters for Point-of-Care HIV Diagnostics Using Whole Blood , 2013, Science Translational Medicine.

[49]  Steve Wheeler,et al.  How smartphones are changing the face of mobile and participatory healthcare: an overview, with example from eCAALYX , 2011, Biomedical engineering online.

[50]  Guoan Zheng,et al.  Color-capable sub-pixel resolving optofluidic microscope for on-chip cell imaging , 2010, IEEE Winter Topicals 2011.

[51]  Brett E. Bouma,et al.  Tethered capsule endomicroscopy enables less-invasive imaging of gastrointestinal tract microstructure , 2012, Nature Medicine.

[52]  G. G. Stokes "J." , 1890, The New Yale Book of Quotations.

[53]  E. Moriyama,et al.  Optical Molecular Imaging: From Single Cell to Patient , 2008, Clinical pharmacology and therapy.

[54]  E. Bender Developing world: Global warning , 2014, Nature.

[55]  R. Richards-Kortum,et al.  A Fiber-Optic Fluorescence Microscope Using a Consumer-Grade Digital Camera for In Vivo Cellular Imaging , 2010, PloS one.

[56]  Rebecca Richards-Kortum,et al.  High-resolution Fiber-optic Microendoscopy for in situ Cellular Imaging , 2011, Journal of visualized experiments : JoVE.

[57]  James Clements,et al.  Foldscope: Origami-Based Paper Microscope , 2014, PloS one.

[58]  Vadim Backman,et al.  Nanoscale markers of esophageal field carcinogenesis: potential implications for esophageal cancer screening , 2013, Endoscopy.

[59]  A. Darzi,et al.  Image-guided robotic interventions for prostate cancer , 2013, Nature Reviews Urology.

[60]  G. Cooke,et al.  Tracking the progress of HIV: the impact of point-of-care tests on antiretroviral therapy , 2013, Clinical epidemiology.

[61]  Rebecca Richards-Kortum,et al.  A Pilot Study of Low-Cost, High-Resolution Microendoscopy as a Tool for Identifying Women with Cervical Precancer , 2012, Cancer Prevention Research.

[62]  Jeehyun Kim,et al.  Handheld Optical Coherence Tomography Scanner for Primary Care Diagnostics , 2011, IEEE Transactions on Biomedical Engineering.

[63]  B. Tromberg,et al.  Imaging in breast cancer: Diffuse optics in breast cancer: detecting tumors in pre-menopausal women and monitoring neoadjuvant chemotherapy , 2005, Breast Cancer Research.

[64]  Gavin Yamey,et al.  Global health 2035: a world converging within a generation , 2013, The Lancet.

[65]  Beverly George-Gay,et al.  Understanding the complete blood count with differential. , 2003, Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses.

[66]  C. V. D. van de Velde,et al.  Real-time intraoperative detection of breast cancer using near-infrared fluorescence imaging and Methylene Blue. , 2014, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[67]  J. Justman,et al.  Developing Laboratory Systems and Infrastructure for HIV Scale-Up: A Tool for Health Systems Strengthening in Resource-Limited Settings , 2009, Journal of acquired immune deficiency syndromes.

[68]  A. Godavarty,et al.  Three-dimensional fluorescence tomography of human breast tissues in vivo using a hand-held optical imager , 2013, Physics in medicine and biology.

[69]  Ali Khademhosseini,et al.  Nano/Microfluidics for diagnosis of infectious diseases in developing countries. , 2010, Advanced drug delivery reviews.

[70]  Hongying Zhu,et al.  Optofluidic fluorescent imaging cytometry on a cell phone. , 2011, Analytical chemistry.

[71]  R. Peeling,et al.  Rapid tests for sexually transmitted infections (STIs): the way forward , 2006, Sexually Transmitted Infections.

[72]  B. Stewart,et al.  World Cancer Report , 2003 .

[73]  Rebecca Richards-Kortum,et al.  Chromatography paper as a low-cost medium for accurate spectrophotometric assessment of blood hemoglobin concentration. , 2013, Lab on a chip.

[74]  R. Jagsi,et al.  Asia's ascent--global trends in biomedical R&D expenditures. , 2014, The New England journal of medicine.

[75]  David N Breslauer,et al.  Mobile Phone Based Clinical Microscopy for Global Health Applications , 2009, PloS one.

[76]  Timothy R. Rebbeck,et al.  Challenges and opportunities in cancer control in Africa: a perspective from the African Organisation for Research and Training in Cancer. , 2013, The Lancet. Oncology.

[77]  Freddy T. Nguyen,et al.  Intraoperative evaluation of breast tumor margins with optical coherence tomography. , 2009, Cancer research.

[78]  S. Shevkoplyas,et al.  Simple paper-based test for measuring blood hemoglobin concentration in resource-limited settings. , 2013, Clinical chemistry.

[79]  M. Rajadhyaksha,et al.  Confocal microscopy-guided laser ablation for superficial and early nodular Basal cell carcinoma: a promising surgical alternative for superficial skin cancers. , 2014, JAMA dermatology.