From the flow cytometers and PET scanners that confirm a cancer diagnosis to the proton therapy cyclotrons and bioengineered chemotherapy agents that deliver the treatment, oncology is a field driven by cutting edge technology. The proposition, then, that a consumer smartphone could somehow become part of the diagnostic toolkit of an oncologist may seem ridiculous. There are, however, many researchers and start-ups that would disagree.
Satish Misra, MD, Managing Editor, iMedicalApps Dr. Ralph Weissleder and a team of researchers at Harvard Medical School described a micro-NMR device last year in the Science Translational Magazine that pairs with a smartphone to analyze biologic samples. Designed as a low-cost, point-of-care device, the device uses magnetic nanoparticles targeted to markers of interest to analyze a sample for a cell population of interest. The device is currently undergoing trials for, among other things, detection of malignant cells in peripheral blood. Its not hard to imagine the potential implications of this device. With the right markers, one could potentially diagnose renal and bladder cancers from urine samples, hematologic malignancies from peripheral blood, or oropharyngeal malignancies from saliva - regardless of whether the patient is at the Mayo Clinic or in the Saharan desert. It could also offer an alternative, particularly in resource poor settings, where biopsies may be feasible but traditional analytic tools are unavailable.
A camera attachment that does more than post to Twitter
Coming off a series of awards is Dr. Manu Prakash of Stanford's Biological Engineering Department and his lab's OScan device. This device uses fluorescent imaging, using a simple attachment to a camera phone device, to analyze visible soft tissue in the oropharynx and assess for malignant tissue. Enabling the detection of oral malignancies, a particular problem in many resource-poor areas, this device could enable far earlier detection and, as a result, earlier intervention. With OScan, the image is generated, analyzed, and then transmitted wirelessly to a remote physician for further management. As many resource poor settings are nevertheless rich in wireless coverage, this device has a lot of potential. Application of this technology with, for example, eyeNETRA's $2 smartphone attachment for vision assessment could even further broaden the reach and impact.
Using smartphones to key an eye on skin lesions
For most cutaneous malignancies, the key to effective therapy is early diagnosis. However, appropriately evaluating and tracking concerning lesions isn't always easy. The mobile dermascope, from Cellscope or Handyscope, may soon change that. A simple, low-cost attachment for smartphones using their native cameras, the dermascope can not only capture high resolution images but can also wirelessly transmit the images to a dermatologist for screening. While teledermatology does have its tradeoffs, its not hard to imagine how this device could be valuable in tracking suspicious lesions, particularly in under-served areas. Add on software that can analyze the image and predict a malignancy risk, this tool could become quite powerful.
Sniffing out malignancy in the "lab"
The lab-on-a-chip concept is gaining popularity, with even NASA jumping into the mix with a peripheral to "sniff" out disease. Other groups are using similar peripherals to diagnose disease from biologic samples, such as one that uses urine to diagnose ovarian cancer on a smartphone. The potential applications are broad, limited only by the ability of researchers to find sensitive and specific markers of disease.
Thanks to the race between smartphone manufacturers to pack ever more processing power and functionality into their devices, the smartphone is a natural platform on which to build a wide range of tools. These devices, however, are all in their earliest phases of application, meaning that there is a long way to go before they find their place in the diagnostic toolkit of a practicing oncologist. But the day when oncologists reach for their smartphone to diagnose cancer is probably not all that far off.
