Towards ultra-low-cost smartphone microscopy.

The outbreak of COVID-19 exposed the inadequacy of our technical tools for home health surveillance, and recent studies have shown the potential of smartphones as a universal optical microscopic imaging platform for such applications. However, most of them use laboratory-grade optomechanical components and transmitted illuminations to ensure focus tuning capability and imaging quality, which keeps the cost of the equipment high. Here, we propose an ultra-low-cost solution for smartphone microscopy. To realize focus tunability, we designed a seesaw-like structure capable of converting large displacements on one side into small displacements on the other (reduced to ∼9.1%), which leverages the intrinsic flexibility of 3D printing materials. We achieved a focus-tuning accuracy of ∼5 𝜇m, which is 40 times higher than the machining accuracy of the 3D-printed lens holder itself. For microscopic imaging, we used an off-the-shelf smartphone camera lens as the objective and the built-in flashlight as the illumination. To compensate for the resulting image quality degradation, we developed a learning-based image enhancement method. We used the CycleGAN architecture to establish the mapping from smartphone microscope images to benchtop microscope images without pairing. We verified the imaging performance on different biomedical samples. Except for the smartphone, we kept the full costs of the device under 4 USD. We think these efforts to lower the costs of smartphone microscopes will benefit their applications in various scenarios, such as point-of-care testing, on-site diagnosis, and home health surveillance. RESEARCH HIGHLIGHTS: We propose a solution for ultra-low-cost smartphone microscopy. Utilizing the flexibility of 3D-printed material, we can achieve focusing accuracy of ∼5 𝜇m. Such a low-cost device will benefit point-of-care diagnosis and home health surveillance.

Assessment of Generative Adversarial Networks for Synthetic Anterior Segment Optical Coherence Tomography Images in Closed-Angle Detection.

Purpose: To develop generative adversarial networks (GANs) that synthesize realistic anterior segment optical coherence tomography (AS-OCT) images and evaluate deep learning (DL) models that are trained on real and synthetic datasets for detecting angle closure. Methods: The GAN architecture was adopted and trained on the dataset with AS-OCT images collected from the Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, synthesizing open- and closed-angle AS-OCT images. A visual Turing test with two glaucoma specialists was performed to assess the image quality of real and synthetic images. DL models, trained on either real or synthetic datasets, were developed. Using the clinicians' grading of the AS-OCT images as the reference standard, we compared the diagnostic performance of open-angle vs. closed-angle detection of DL models and the AS-OCT parameter, defined as a trabecular-iris space area 750 µm anterior to the scleral spur (TISA750), in a small independent validation dataset. Results: The GAN training included 28,643 AS-OCT anterior chamber angle (ACA) images. The real and synthetic datasets for DL model training have an equal distribution of open- and closed-angle images (all with 10,000 images each). The independent validation dataset included 238 open-angle and 243 closed-angle AS-OCT ACA images. The image quality of real versus synthetic AS-OCT images was similar, as assessed by the two glaucoma specialists, except for the scleral spur visibility. For the independent validation dataset, both DL models achieved higher areas under the curve compared with TISA750. Two DL models had areas under the curve of 0.97 (95% confidence interval, 0.96-0.99) and 0.94 (95% confidence interval, 0.92-0.96). Conclusions: The GAN synthetic AS-OCT images appeared to be of good quality, according to the glaucoma specialists. The DL models, trained on all-synthetic AS-OCT images, can achieve high diagnostic performance. Translational Relevance: The GANs can generate realistic AS-OCT images, which can also be used to train DL models.

Assessment of Generative Adversarial Networks Model for Synthetic Optical Coherence Tomography Images of Retinal Disorders.

Purpose: To assess whether a generative adversarial network (GAN) could synthesize realistic optical coherence tomography (OCT) images that satisfactorily serve as the educational images for retinal specialists, and the training datasets for the classification of various retinal disorders using deep learning (DL). Methods: The GANs architecture was adopted to synthesize high-resolution OCT images trained on a publicly available OCT dataset, including urgent referrals (37,206 OCT images from eyes with choroidal neovascularization, and 11,349 OCT images from eyes with diabetic macular edema) and nonurgent referrals (8617 OCT images from eyes with drusen, and 51,140 OCT images from normal eyes). Four hundred real and synthetic OCT images were evaluated by two retinal specialists (with over 10 years of clinical retinal experience) to assess image quality. We further trained two DL models on either real or synthetic datasets and compared the performance of urgent versus nonurgent referrals diagnosis tested on a local (1000 images from the public dataset) and clinical validation dataset (278 images from Shanghai Shibei Hospital). Results: The image quality of real versus synthetic OCT images was similar as assessed by two retinal specialists. The accuracy of discrimination of real versus synthetic OCT images was 59.50% for retinal specialist 1 and 53.67% for retinal specialist 2. For the local dataset, the DL model trained on real (DL_Model_R) and synthetic OCT images (DL_Model_S) had an area under the curve (AUC) of 0.99, and 0.98, respectively. For the clinical dataset, the AUC was 0.94 for DL_Model_R and 0.90 for DL_Model_S. Conclusions: The GAN synthetic OCT images can be used by clinicians for educational purposes and for developing DL algorithms. Translational Relevance: The medical image synthesis based on GANs is promising in humans and machines to fulfill clinical tasks.