Here at CellScope, Inc. we are proud of our laboratory roots and remain connected to the Fletcher Lab at UC Berkeley, a leader in the mobile microscope development space. In fact, this is where Co-Founders Erik Douglas and Amy Sheng met (our founding story). While we are busy working on creating a digital toolkit for the home here in San Francisco, across the bay in Berkeley the Fletcher Lab continues to focus on new diagnostic applications for the CellScope mobile microscopes.
Like a proud family member, we wanted to highlight other cool projects coming out of the Fletcher Lab. Recently Arunan Skandarajah (a BioEngineering PhD student from the Fletcher Lab) traveled to Bangalore, India with an iPad-based CellScope for diagnosis of oral cancer. We interviewed Arunan to find out more about the exciting project and here’s what he shared.
CellScope (CS): How long have you worked in the Fletcher Lab?
Arunan Skandarajah (AS): I joined the lab in Spring 2010 and transitioned to CellScope related projects in Spring 2012, after working on more basic biophysical problems.
CS: What was the purpose of the visit?
AS: The purpose was to train clinical partners on the use of the iPad-based CellScope mobile microscope for oral cancer diagnosis, collect feedback on necessary features or adjustments to the instrument for an upcoming trial. Additionally, we wanted to finalize protocols, demonstrate a more highly automated instrument and collect feedback for development for a later field trial.
CS: Who were your partners in the India?
AS: Siemens technology development office and local clinical collaborators.
CS: What did you learn on the trip?
AS: We learned several things. In particular, we learned that users in this context prioritize the ease of interaction, viewing, and sharing that are provided by a tablet screen, even at the cost of portability, compared to a mobile phone. Secondly, there is a need to physically mark suspicious slide locations for further review. Thirdly, we determined what auxiliary information, aside from microscopy images collected directly by the CellScope, would be valuable to collect and link with the patient for accurate diagnosis. Lastly, we also became aware of some practical lessons about the complexities of sample preparation, a necessary step that has to be in place before imaging is possible.
CS: What are the next steps or actions you (or the team) will be working on?
AS: We’ll be preparing a set of field-deployable iPad-based microscopes with adaptations for slide marking. We’ll be working with our test sites, other pathologists, and collaborators in Romania to ensure that the user interface collects the right information.
We’ll also be working on training documentation, in traditional forms and potentially integrated into the application, to aid in-country users when utilizing the instrument.
CS: Any additional stories to share?
AS: Aside from time we spent in tertiary-level medical centers, which were excellent and well-equipped (though very busy!), one of the most interesting experiences we had was traveling with dentists and town health workers during house-to-house follow-ups on oral conditions. Since oral cancer is strongly linked with behaviors like chewing tobacco and smoking, it was really rewarding to see that the check-ups were causing real behavior change which resulted in visible reduction in inflammation in the patients’ mouths. We also saw that a picture of a lesion, which can get incredibly large with minimal pain because of the anesthetic effects of chewing tobacco, can surprise patients into action.
We found out, even our harmless 3D-printed microscopes can inspire a lot of questions – as well as a customs check or two. Being able to illustrate the range of things you can do with a mobile microscope can be pretty helpful when talking to a customs official, especially when you can get them to say “You should be doing that type of work in India!” And it turns out having an official business letter of invitation helps, too.
Many thanks to Arunan for taking the time to share some of the recent work being done in the field and from the Fletcher Lab. The world needs more mobile diagnostics tools, keep up the good work!