Testing feasibility of an accurate microscopic assessment of macrovesicular steatosis in liver allograft biopsies by smartphone add-on lenses

Microsc Res Tech. 2018 Jan;81(1):58-63. doi: 10.1002/jemt.22956. Epub 2017 Oct 17.

Abstract

Light microscopy is an essential tool in histological examination of tissue samples. However, the required equipment for a correct and rapid diagnosis is sometimes unavailable. Smartphones and mobile phone networks are widespread, and could be used for diagnostic imaging and telemedicine. Macrovesicular steatosis (MS) is a major risk factor for liver graft failure, and is only assessable by microscopic examination of a frozen tissue section. The aim of this study was to compare the microscopic assessment of MS in liver allograft biopsies by a smartphone with eyepiece adaptor (BLIPS device) to standard light microscopy. Forty liver graft biopsies were evaluated in transmitted light, using an Iphone 5s and 4 different mini-objective, add-on lenses. A significant correlation was reported between the two different approaches for graft MS assessment (Spearman's correlation coefficient: rs = 0.946; p < .001). Smartphone with eyepiece adaptor had similar discriminatory power to identify MS in liver grafts than standard light microscopy. Based on these findings, a smartphone integrated with a low-cost eyepiece adaptor can achieve adequate accuracy in the assessment of MS in liver graft, and could be used as an alternative to standard light microscope when unavailable.

Keywords: eyepiece adaptor; liver steatosis; pathology; smartphone.

Publication types

  • Comparative Study

MeSH terms

  • Allografts / pathology*
  • Allografts / standards
  • Biopsy
  • Fatty Liver / diagnostic imaging*
  • Fatty Liver / pathology
  • Frozen Sections
  • Humans
  • Lenses / classification*
  • Lenses / standards
  • Liver / diagnostic imaging
  • Liver / pathology*
  • Liver Transplantation / standards*
  • Microscopy / instrumentation
  • Microscopy / methods
  • Smartphone / instrumentation*