Modi Suny S, Ramamurthy Satheesh, Balasubramanian S, Kumar Sunil, Daruwala Feral
Department of Nephrology, Vishesh - Jupiter Hospital, Indore, Madhya Pradesh, India.
Department of Interventional Radiology, Apollo Hospitals, Chennai, Tamil Nadu, India.
Indian J Nephrol. 2024 May-Jun;34(3):233-236. doi: 10.4103/ijn.ijn_323_23. Epub 2023 Nov 6.
The utilization of smartphone-assisted evaluation is emerging in the field of histopathology. This technique improves the adequacy of samples at the bedside, avoids procedure-related complications, reduces unnecessary repeat biopsies, and saves the cost of the procedure. This study aims to compare the number of glomeruli in a renal biopsy specimen obtained by an ultrasound-guided percutaneous needle biopsy, counted at the bedside using a smartphone fitted with a 16-megapixel macro lens (Bedside method) with that observed under a light microscope after the processing of the biopsy specimen (LM method).
In this prospective cohort study, 24 consecutive adult patients (48 kidney biopsy samples) who underwent kidney biopsies were enrolled. All specimens were extracted by an ultrasound-guided percutaneous renal biopsy from the lower pole of the left kidney. Patients' demographics and clinical data were prospectively collected. The number of glomeruli in all the biopsy specimens was counted using a smartphone fitted with a 16-megapixel macro lens at the bedside (Bedside method) and subsequently under a light microscope by a pathologist after processing the biopsy specimen (LM method). Seven or more glomeruli in the specimen were considered adequate in our study.
The mean age of patients at biopsy was 46.9 ± 16 years with slightly male predominance (54.2%). A total of 47 specimens were obtained from 24 patients. Of the 24 patients, 22 had native kidney biopsy and 2 had renal allograft biopsy. The average number of cores obtained per patient was 1.96. The length of core specimens ranged from 1.5 to 2 cm. A good agreement was found between bedside adequacy and slide adequacy, =0.684, = 0.000. The positive agreement rate and negative agreement rate were 91.4% and 23.1%, respectively.
In the modern era of technology, the smartphone is a good tool to evaluate the adequacy of biopsy specimens at the bedside.
智能手机辅助评估在组织病理学领域正逐渐兴起。这项技术提高了床边样本的充足性，避免了与操作相关的并发症，减少了不必要的重复活检，并节省了操作成本。本研究旨在比较通过超声引导经皮肾穿刺活检获得的肾活检标本中肾小球的数量，使用配备1600万像素微距镜头的智能手机在床边计数（床边法）与活检标本处理后在光学显微镜下观察到的数量（光学显微镜法）。
在这项前瞻性队列研究中，纳入了24例连续接受肾活检的成年患者（48个肾活检样本）。所有标本均通过超声引导经皮肾穿刺活检从左肾下极获取。前瞻性收集患者的人口统计学和临床数据。使用配备1600万像素微距镜头的智能手机在床边对所有活检标本中的肾小球数量进行计数（床边法），随后病理学家在处理活检标本后在光学显微镜下计数（光学显微镜法）。在我们的研究中，标本中有七个或更多肾小球被认为是充足的。
活检时患者的平均年龄为46.9±16岁，男性略占优势（54.2%）。共从24例患者中获得47个标本。在24例患者中，22例进行了自体肾活检，2例进行了同种异体肾移植活检。每位患者获得的芯样平均数量为1.96个。芯样标本长度为1.5至2厘米。床边充足性与玻片充足性之间发现了良好的一致性，κ=0.684，P=0.000。阳性一致率和阴性一致率分别为91.4%和23.1%。
在现代技术时代，智能手机是床边评估活检标本充足性的良好工具。
