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While optical microscopy inspection of blood films and bone marrow aspirates by a hematologist is a crucial step in establishing diagnosis of acute leukemia, especially in low-resource settings where other diagnostic modalities are not available, the task remains time-consuming and prone to human inconsistencies. This has an impact especially in cases of Acute Promyelocytic Leukemia (APL) that require urgent treatment. Integration of automated computational hematopathology into clinical workflows can improve the throughput of these services and reduce cognitive human error. However, a major bottleneck in deploying such systems is a lack of sufficient cell morphological object-labels annotations to train deep learning models. We overcome this by leveraging patient diagnostic labels to train weakly-supervised models that detect different types of acute leukemia. We introduce a deep learning approach, Multiple Instance Learning for Leukocyte Identification (MILLIE), able to perform automated reliable analysis of blood films with minimal supervision. Without being trained to classify individual cells, MILLIE differentiates between acute lymphoblastic and myeloblastic leukemia in blood films. More importantly, MILLIE detects APL in blood films (AUC 0.94 ± 0.04) and in bone marrow aspirates (AUC 0.99 ± 0.01). MILLIE is a viable solution to augment the throughput of clinical pathways that require assessment of blood film microscopy.

This article describes a new method (VS-FPM) for analysis of unstained tissues based on the application of supervised machine learning to generate brightfield hematoxylin and eosin (H&E) images from phase images recovered using Fourier ptychographic microscopy (FPM). VS-FPM has several advantages for label-free digital pathology. Capture of complex image information simplifies model training and allows post-capture refocusing. FPM images combine high resolution with a large field of view, and the hardware is low-cost and compatible with many existing brightfield microscope systems. By generating realistic histologically stained images from label-free image data, virtual staining (VS) methods have the potential to streamline clinical workflows, improve image consistency, and enable new ways of visualizing and analyzing histological tissues. We trained a conditional generative adversarial network to translate high-resolution FPM images of unstained tissues to brightfield H&E images and assessed the method using diagnosis of colonic polyps as a test case. We found no statistically significant difference between the spatial resolution of FPM images captured at 4× magnification and images from a pathology slide scanner at 20× magnification. Visual assessment and image similarity metrics showed that VS-FPM images of unstained tissues closely resemble images of chemically H&E-stained tissues. However, the spatial resolution of virtual H&E images was approximately 20% lower than equivalent images of chemically stained tissues. Using VS-FPM, board-certified pathologists were able to accurately distinguish normal from dysplastic tissues and derive correct pathological diagnoses. VS-FPM is a reliable, accessible VS method that also overcomes many other limitations inherent to histopathology microscopy.

While optical microscopy inspection of blood films and bone marrow aspirates by a hematologist is a crucial step in establishing diagnosis of acute leukemia, especially in low-resource settings where other diagnostic modalities might not be available, the task remains time-consuming and prone to human inconsistencies. This has an impact especially in cases of Acute Promyelocytic Leukemia (APL) that require urgent treatment. Integration of automated computational hematopathology into clinical workflows can improve the throughput of these services and reduce cognitive human error. However, a major bottleneck in deploying such systems is a lack of sufficient cell morphological object-labels annotations to train deep learning models. We overcome this by leveraging patient diagnostic labels to train weakly-supervised models that detect different types of acute leukemia. We introduce a deep learning approach, Multiple Instance Learning for Leukocyte Identification (MILLIE), able to perform automated reliable analysis of blood films with minimal supervision. Without being trained to classify individual cells, MILLIE differentiates between acute lymphoblastic and myeloblastic leukemia in blood films. More importantly, MILLIE detects APL in blood films (AUC 0.94+/-0.04) and in bone marrow aspirates (AUC 0.99+/-0.01). MILLIE is a viable solution to augment the throughput of clinical pathways that require assessment of blood film microscopy.

Optoelectronic tweezer-driven microrobots (OETdMs) are a versatile micromanipulation technology based on the use of light induced dielectrophoresis to move small dielectric structures (microrobots) across a photoconductive substrate. The microrobots in turn can be used to exert forces on secondary objects and carry out a wide range of micromanipulation operations, including collecting, transporting and depositing microscopic cargos. In contrast to alternative (direct) micromanipulation techniques, OETdMs are relatively gentle, making them particularly well suited to interacting with sensitive objects such as biological cells. However, at present such systems are used exclusively under manual control by a human operator. This limits the capacity for simultaneous control of multiple microrobots, reducing both experimental throughput and the possibility of cooperative multi-robot operations. In this article, we describe an approach to automated targeting and path planning to enable open-loop control of multiple microrobots. We demonstrate the performance of the method in practice, using microrobots to simultaneously collect, transport and deposit silica microspheres. Using computational simulations based on real microscopic image data, we investigate the capacity of microrobots to collect target cells from within a dissociated tissue culture. Our results indicate the feasibility of using OETdMs to autonomously carry out micromanipulation tasks within complex, unstructured environments.