Detection of circulating tumor cells in samples from colorectal cancer patients using digital fluorescent microscopy and image cytometry

Recently enhanced focus is set on the rare cells of the human organ (circulating tumor cells, physiologic and pathologic stem cells, fetal cells). Circulating tumor cells can be detected in peripheral blood samples by cytometry. Slide based image cytometers provide similar data as flow cytometry by digitally processing the cell images. For the detection of circulating tumor cells, they have several advantages over FCM. In the recent years brightfield whole slide imaging became commercially available and starts to be established in pathology.;We created an imaging cytometer system called Scanning Fluorescent Microscope (SFM) by using a motorized fluorescent microscope, special scanning and image processing algorithms and a fluorescently stained compensation slide. We showed that this system is capable of quantitative and stoichiometric measurements and it provides comparable results to other well established cytometry solutions on large cell populations. We showed that SFM detects rare cells more reliably as flow or laser scanning cytometry.;We extended the commercially available MIRAX MIDI whole slide imager with fluorescent scanning capability and used it with the SFM methodology. We showed that the fluorescent whole slide imaging is possible and using the SFM methodology, it provides even better results as the SFM system due to the technical advancements in illumination and camera technology.;The automated slide loading, sample detection and scanning capabilities of whole slide imaging systems combined with image cytometer software make possible the clinical screening for colorectal cancer patients.