CoreView imaging on needle: Rapid core-needle biopsy imaging for point-of-care breast cancer diagnosis

Breast cancer (BC) is one of the most prevalent malignancies worldwide, with early and rapid diagnosis playing a critical role in improving patient outcomes. Core-needle biopsies (CNBs) are the current gold standard for minimally invasive BC diagnoses. However, in low-resource and rural settings, access to CNB diagnostics is limited by infrastructural constraints, long histopathology turnaround times, as well as financial and geographical barriers. To address these challenges, we developed the CoreView imaging on needle (ION), an affordable, integrated imaging system designed to provide rapid, and point-of-care diagnostic assessment of CNB samples. The CoreView ION integrates microscopy with ultraviolet surface excitation technology, enabling the imaging of tissue biopsy surfaces within 5 min, significantly reducing diagnostic delays. This study presents the design, fabrication, and verification of the CoreView ION prototype operation, including its imaging workflow, staining protocols, and tissue compression testing. Our results demonstrate that the system can successfully generate histology-grade images of porcine and murine fresh biopsies, preserving cellular and nuclear detail of normal and tumor tissue. By streamlining CNB imaging and incorporating mainly manual low-cost components, the CoreView ION has the potential to improve BC diagnostics in low-resource settings, ultimately enhancing early detection and patient care.
- Wilkinson L, Gathani T. Understanding breast cancer as a global health concern. Br J Radiol. 2021;95(1130):202111033. doi: 10.1259/bjr.20211033
- WHO. Breast Cancer. World Health Organization; 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/breast-cancer [Last accessed on 2025 Sep 08].
- Menon G, Alkabban FM, Ferguson T. Breast Cancer. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2024.
- Kantelhardt EJ, Assefa M, McCormack V, Cubasch H, Jemal A, Pace LE. Expert discussion: Breast cancer in low-resource countries. Breast Care (Basel). 2020;15(3):310-313. doi: 10.1159/000508693
- Unger-Saldaña K. Challenges to the early diagnosis and treatment of breast cancer in developing countries. World J Clin Oncol. 2014;5(3):465-477. doi: 10.5306/wjco.v5.i3.465
- Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-E386. doi: 10.1002/ijc.29210
- Ohene-Yeboah M, Adjei E. Breast cancer in Kumasi, Ghana. Ghana Med J. 2012;46(1):8-13.
- VanderLaan PA. Fine-needle aspiration and core needle biopsy: An update on 2 common minimally invasive tissue sampling modalities. Cancer Cytopathol. 2016;124(12):862-870. doi: 10.1002/cncy.21742
- American Cancer Society. Core Needle Biopsy of the Breast. Stereotactic Breast Biopsy; 2022. Available from: https://www. cancer.org/cancer/types/breast/cancer/screening/tests/and/ early/detection/breast/biopsy/core-needle-biopsy-of-the-breast.html [Last accessed on 2025 Sep 08].
- Sun T, Zhang H, Gao W, Yang Q. The appropriate number of preoperative core needle biopsy specimens for analysis in breast cancer. Medicine (Baltimore). 2021;100(14):e25400. doi: 10.1097/md.0000000000025400
- Wilson ML, Fleming KA, Kuti MA, Looi LM, Lago N, Ru K. Access to pathology and laboratory medicine services: A crucial gap. Lancet. 2018;391(10133):1927-1938. doi: 10.1016/S0140-6736(18)30458-6
- Ramedani S, George DR, Leslie DL, Kraschnewski J. The bystander effect: Impact of rural hospital closures on the operations and financial well-being of surrounding healthcare institutions. J Hosp Med. 2022;17(11):901-906. doi: 10.1002/jhm.12961
- Tfayli A, Temraz S, Abou Mrad R, Shamseddine A. Breast cancer in low- and middle-income countries: An emerging and challenging epidemic. J Oncol. 2010;2010:490631. doi: 10.1155/2010/490631
- Silva E, Meschter S, Tan MP. Breast biopsy techniques in a global setting-clinical practice review. Transl Breast Cancer Res. 2023;4:14. doi: 10.21037/tbcr-23-12
- Ssentongo P, Oh JS, Amponsah-Manu F, et al. Breast cancer survival in eastern region of Ghana. Front Public Health. 2022;10:880789. doi: 10.3389/fpubh.2022.880789
- Anim JT. The pathologist in Ghana and potential for research. Ghana Med J. 2018;52(2):103-111. doi: 10.4314/gmj.v52i2.7
- Falahkheirkhah K, Mukherjee SS, Gupta S, et al. Accelerating cancer histopathology workflows with chemical imaging and machine learning. Cancer Res Commun. 2023;3(9):1875-1887. doi: 10.1158/2767-9764.crc-23-0226
- Dey S. Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal. World J Clin Oncol. 2014;5(3):509-519. doi: 10.5306/wjco.v5.i3.509
- Anyigba CA, Awandare GA, Paemka L. Breast cancer in sub-Saharan Africa: The current state and uncertain future. Exp Biol Med (Maywood). 2021;246(12):1377-1387. doi: 10.1177/15353702211006047
- Okyere Asante PG, Gowusu AY, Oppong JR, Amegah KE, Nketiah-Amponsah E. An assessment of the direct and indirect costs of breast cancer treatment in leading cancer hospitals in Ghana. PLoS One. 2024;19(5):e0301378-e0301378. doi: 10.1371/journal.pone.0301378
- Ginsburg O, Yip CH, Brooks A, et al. Breast cancer early detection: A phased approach to implementation. Cancer. 2020;126(S10):2379-2393. doi: 10.1002/cncr.32887
- Fereidouni F, Harmany ZT, Tian M, et al. Microscopy with ultraviolet surface excitation for rapid slide-free histology. Nat Biomed Eng. 2017;1(12):957-966. doi: 10.1038/s41551-017-0165-y
- Voskuil FJ, Vonk J, Van Der Vegt B, et al. Intraoperative imaging in pathology-assisted surgery. Nat Biomed Eng. 2022;6(5):503-514. doi: 10.1038/s41551-021-00808-8
- Liu Y, Rollins AM, Levenson RM, Fereidouni F, Jenkins MW. Pocket MUSE: An affordable, versatile and high-performance fluorescence microscope using a smartphone. Commun Biol. 2021;4(1):334. doi: 10.1038/s42003-021-01860-5
- Cooper DJ, Huang C, Klavins DA, et al. CoreView: Fresh tissue biopsy assessment at the bedside using a millifluidic imaging chip. Lab Chip. 2022;22(7):1354-1364. doi: 10.1039/d1lc01142a
- Zhang Y, Song X, Xie J, et al. Large depth-of-field ultra-compact microscope by progressive optimization and deep learning. Nat Commun. 2023;14(1):4118. doi: 10.1038/s41467-023-39860-0
- Borowsky AD, Levenson RM, Gown AM, et al. A pilot validation study comparing fluorescence-imitating brightfield imaging, a slide-free imaging method, with standard formalin-fixed, paraffin-embedded hematoxylin-eosin-stained tissue section histology for primary surgical pathology diagnosis. Arch Pathol Lab Med. 2024;148: 345-352. doi: 10.5858/arpa.2022-0432-oa
- World Health Organization. Cancer Today; 2022. Available from: https://gco.iarc.fr/today/en [Last accessed on 2025 Sep 08].
- Pillay TS, Khan AI, Yenice S. Artificial intelligence (AI) in point-of-care testing. Clin Chim Acta. 2025;574:120341. doi: 10.1016/j.cca.2025.120341
- Ahn JS, Shin S, Yang SA, et al. Artificial intelligence in breast cancer diagnosis and personalized medicine. J Breast Cancer. 2023;26(5):405-435. doi: 10.4048/jbc.2023.26.e45
- Umirzakova S, Muksimova S, Baltayev J, Cho YI. Force map-enhanced segmentation of a lightweight model for the early detection of cervical cancer. Diagnostics (Basel). 2025;15(5):513. doi: 10.3390/diagnostics15050513
- Zhu M. Artificial intelligence in pathologic diagnosis, prognosis and prediction of prostate cancer. Am J Clin Exp Urol. 2024;12(4):200-215. doi: 10.62347/jsae9732