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Early detection is the key to the prevention of cervical cancer. There is an urgent need for a portable, affordable, and easy-to-use device for cervical pre-cancer detection, especially in low-resource settings. We have developed a dual-modality fiber-optic endoscope system (SmartME) that integrates high-resolution fluorescence imaging (FLI) and quantitative diffuse reflectance spectroscopy (DRS) onto a smartphone platform. The SmartME consists of a smartphone, a miniature fiber-optic endoscope, a phone attachment containing imaging optics, and a smartphone application (app). FLI is obtained by painting the tissue with a contrast agent (e.g., proflavine), illuminating the tissue and collecting its fluorescence images through an imaging bundle that is coupled to the phone camera. DRS is achieved by using a white LED, attaching additional source and detection fibers to the imaging bundle, and converting the phone camera into a spectrometer. The app collects images/spectra and transmits them to a remote server for analysis to extract the tissue parameters, including nuclear-to-cytoplasm ratio (calculated from FLI), concentrations of oxyhemoglobin (HbO2) and deoxyhemoglobin (Hb) as well as scattering (measured by DRS). These parameters can be used to detect cervical dysplasia. Our preliminary studies have demonstrated that the SmartME can clearly visualize the nuclei in living cells and in vivo biological samples, with a high spatial resolution of ~3.1μm. The device can also measure tissue absorption and scattering properties with comparable accuracy to those of a benchtop DRS system. The SmartME has great potential to provide a compact, affordable, and ‘smart’ solution for early detection of neoplastic changes in cervix.
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