Use of a smartphone camera for bedside evaluation of adequacy of kidney biopsies

Blogged by Amélie Dendooven

Pathology diagnostics is dependent on adequate tissue sampling. Generally speaking, a kidney biopsy should contain at least 10 glomeruli for being considered representative. A large proportion of kidney biopsies now are performed by radiologists. Also, smaller biopsy needles are being used. In this setting, it is especially important to have good bedside evaluation of tissue adequacy, so that, when needed, an extra biopsy core can be immediately obtained to ensure biopsy adequacy.
In a recent study from Singh et al., smartphones were used as a means to assess adequacy of kidney biopsy samples at the bedside. A picture of the biopsy core – taken by a smartphone camera- is put on a larger pc screen and zoomed in. In this fashion, one easily obtains a zoomed-in image where glomeruli can be readily identified without the need for additional (microscopy) equipment. The study shows a good correlation between this bedside smartphone approach and the microscopic evaluation of biopsy adequacy by trained staff in the pathology laboratory. However, the study is limited in sample size and should be followed by larger studies for validation. Also, as pathologists we would like to add a warning to prevent the biopsy from drying out while doing this bedside assessment (e.g. by keeping it moist).