Mobile Phone Microscopy

Molecular diagnostics are a pillar of pathology, but as the technologies and methods evolve, we need increasingly complex assays and equipment. Unfortunately, in LMICs, where such diagnostics may be sorely needed, new technology isn’t always tenable. The solution? Smartphones, according to researchers from Sweden and California, who have developed an affordable attachment that transforms a phone into a biomolecular analysis and diagnostics microscope (1).

By combining the device’s optomechanical lasers and algorithmic “brain” with a smartphone’s camera and a special app, the researchers were able to carry out in situ analysis via fluorescence microscopy. Could the instrument’s simplicity and power help bring one of our most essential biomedical tools to the places that need it most?

To find out, we spoke with the lead researchers – Aydogan Ozcan, Professor of Electrical Engineering and Bioengineering at UCLA, and Mats Nilsson, Professor and Scientific Director of the Science for Life Laboratory at Stockholm University.

Why did you focus on smartphones?

AO: There are several aspects that make today’s phones rather unique for conducting, sensing, and diagnostic measurements. The massive quantity of the devices – over eight billion at the time of writing (2) – drives rapid improvements in hardware, software, and high-end imaging/sensing technologies for daily use. This also transforms them into a cost-effective, yet extremely powerful platform able to run various tasks – such as biomedical tests and scientific measurements – that would normally require advanced laboratory instruments. I think this rapidly evolving trend in mobile phones will help us transform how medicine, engineering, and other sciences are practiced and taught globally.

MN: I think it’s a trend in society in general. We’ll see more wireless applications and less need for traditionally large infrastructure. I’ve been involved in other projects where we’ve looked at point-of-care diagnostic approaches, and it seems to be very important that the devices cannot rely on wired electricity or networks to serve not only LMICs but also modern, developed environments – it’s often difficult to find an available power socket in Swedish hospitals.

Did you develop the device particularly with LMICs in mind?

MN: That has definitely been our major objective: to make molecular diagnostics affordable in low-income settings. During our investigation, we demonstrated the molecular diagnosis of tumors with sequencing and KRAS mutations, both in the tissue and in the liquid sample of a tissue – showing the practical utility of the device in regions with few options.

I also think that a more urgent, short-term need for molecular diagnosis is in the field of infectious diseases. That’s another area in which I think this platform is important.

AO: Our work is significant because mobile DNA sequencing and tumor biopsy analysis can greatly decrease the cost of diagnosis and make it more accessible globally. I believe we’ve taken a real step toward the next generation of DNA sequencing and mutation analysis, as well as toward better technologies for point-of-care settings and resource-limited environments. Beyond its current capabilities, I believe our platform could eventually also be used to identify disease-causing microorganisms and measure the genetic signatures of antibiotic resistance.

What’s next for your labs?

AO: We are very much interested in mobile imaging, sensing, diagnostic techniques, and their applications in biomedicine and environmental monitoring. We have several exciting projects that will soon reveal how powerful – and how fit for purpose – these smart mobile systems can get, including in developing countries.

MN: We want to remove the laser from the current sequencer to make it even faster and simpler. We’ll also apply the current setup to infectious disease diagnostics. For example, we could investigate tuberculosis diagnosis – if we develop ways of profiling tuberculosis patients with our platform, we can further add to its use in LMICs.

Just as this collaborative project focused on device size to increase accessibility, others have been heading in the same direction. One example is Oxford Nanopore’s MinION (3), which recently traveled to the International Space Station as a tool for sequencing experiments (4). It’s exciting that such devices appear to be just the start of a portable diagnostic revolution.

But the answer needn’t lie solely with developing new diagnostic tools. Nilsson says, “We probably do need to develop novel diagnostics, but we should also focus on how old diagnostics can be used. If we spend more time and resources on the ways we can best use both old and new methods, it will definitely pay off for pathologists and patients alike.”