A Novel Smartphone-Microscope Camera Adapter: An Option for Cytology Consultation in Low-Resource Environments

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Introduction

The use of static images for telecytology, though not ideal, has been shown to be an effective means of rapid consultation that is especially useful in low-resource environments. One barrier to broader implementation of telecytology is the prohibitive cost of specialized microscope-mounted cameras. A lower cost alternative would be appealing if it could produce similar quality images. We compared the images from a SkyLight smartphone-microscope camera adapter, a relatively inexpensive eyepiece-mounted apparatus that enables digital photographs to be taken of a microscopic image using a smartphone camera, to an Olympus DP70 digital microscope-mounted camera.

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Materials and Methods

Twenty (20) cases were selected consisting of 10 gynecologic Pap tests and 10 non-gynecologic Pap-stained slides. The original diagnosis for each case was used as the gold standard. One diagnostic field from each case was photographed at the same magnification by both the Olympus camera and the SkyLight adapter with an Apple iPhone 4S smartphone camera. The images were then randomized and reviewed by five separate cytotechnologist examiners who assigned a diagnosis to each case based on the

Results

Two hundred (200) total images were reviewed; 40 images for each of the five examiners. The forty images represented 20 cases, and each case had one image from both camera modalities. An example of the images used are seen in Figure 1, Figure 2. Overall, the accuracy of the examiners' diagnoses by images from both modalities was somewhat low (67% by both SkyLight/iPhone 4S and Olympus DP70; see Table 1), however this is likely due to the inherent difficulty in arriving at a diagnosis based on a

Conclusions

A digital photograph of a microscopic image is a practical means of obtaining a quick consult for cytology cases. Although the Olympus DP70 camera produced slightly better results when in direct comparison with the SkyLight adapter with a smartphone camera, the difference was not statistically significant. Both methods were limited in their diagnostic accuracy based on a single static image. However, in a low-resource setting, the SkyLight smartphone-microscope camera adapter with smartphone

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