Mobile Imaging Solutions for Medical Diagnosis: Trends and Applications

Malaria remains a leading cause of mortality in resource-limited settings, where expert microscopists are scarce. Automated diagnosis based on microscopy images thus has strong potential to improve care delivery. But for an algorithm to deploy, a necessary requirement is that it meet a suite of non-obvious (from a machine learning (ML) perspective) clinical constraints. Therefore, in close consultation with a national health center we developed a malaria diagnosis pipeline which addresses key requirements listed by the health care center but typically ignored in the ML malaria literature. In particular, it includes: (i) stopping criteria (to reduce image acquisition and time-to-result); (ii) human-in-the-loop functionality (for review and accountability); (iii) multi-species discrimination (since treatment varies by species); (iv) thick film detection (standard for microscopy); (v) computationally-efficient uncertainty calculations (to aid clinician review); and (vi) an edge device platform (since internet can be spotty in this catchment area). The mobile system performs all inference on-device using YOLOv13n deployed via TensorFlow Lite. It detects four species and white blood cells from Giemsa-stained thick blood smear images, aggregating per-image detections into slide-level parasitemia with World Health Organization (WHO)-standard quantification. This paper highlights these various clinical constraints and offers methods to address them. Evaluated on 2,739 annotated images across all four species, the system achieves mAP@0.5 of 0.863, per-image parasite count correlation of r = 0.812, slide-level r = 0.951 (soft counting, 10 images/slide), and runs entirely offline with a pipeline time of 10.27 +- 1.65 s per image.

Diabetic Retinopathy (DR) is one of the leading causes of preventable blindness, yet rural regions often lack the specialists and infrastructure needed for early detection. Although cloud-based deep learning systems offer high accuracy, they face significant challenges in these settings due to high latency, limited bandwidth, and high data transmission costs. To address these challenges, we propose a two-tier edge-cloud cascade on the public APTOS 2019 Blindness Detection dataset. Tier 1 runs a lightweight MobileNetV3-small model on a local clinic device to perform a binary triage between Referable DR (Classes 2-4) and Non-referable DR (Classes 0-1). Tier 2 runs a RETFoundDINOv2 model in the cloud for ordinal severity grading, but only on the subset of images flagged as referable by Tier 1. On a stratified APTOS test split of 733 images, Tier 1 reaches 98.99% sensitivity and 84.37% specificity at a validation-tuned high-sensitivity threshold. The default cascade forwards 49.52% of test images to Tier 2, reducing cloud calls by 50.48% relative to using a cloud-based model for all images. In the deployed 4-class output space (Class 0-1 / Class 2 / Class 3 / Class 4), the cascade obtains 80.49% accuracy and 0.8167 quadratic weighted kappa; the cloud-only baseline obtains 80.76% accuracy and 0.8184 quadratic weighted kappa. On APTOS, the cascade cuts cloud use by about half with a modest drop in grading performance. Index Terms: Diabetic Retinopathy, Edge-Cloud Cascade, MobileNetV3-small, RETFound-DINOv2, Retinal Screening, tele-ophthalmology

Purpose: Early screening for eye diseases is critical in low- and middle-income countries where access to care is limited. We investigate whether a confidence-guided, multi-image diabetic retinopathy diagnosis framework can integrate image filtering with confidence-aware predictions for reliable screening at capture. Methods: We develop a multi-image fusion method that aggregates retinal views to improve confidence and balanced accuracy. Our method uses confidence to identify unreliable predictions, prompting retakes when needed. We compare: (1) a cascaded image-quality and disease diagnosis pipeline using a single image per patient, (2) confidence-based prediction, and (3) our confidence-based multi-image fusion pipeline. All methods are evaluated using a RETFoundGreen backbone on the mBRSET (n = 1,234) and BRSET (n = 7,599) datasets. Results: At 70% coverage, our method achieves 91% balanced accuracy on mBRSET and 97% on BRSET, improvements of ~12% and ~6%, respectively, over cascade filtering. The image-quality cascade reaches sensitivities of 61% on mBRSET and 86% on BRSET, whereas our framework reaches 94% and 96%, respectively, at 50% coverage. Conclusions: Human-annotated quality labels are weakly associated with diagnostic performance, and confidence-based filtering consistently outperforms image quality-based cascaded pipelines. Translational Relevance: Using confidence-based multi-image fusion, patients receive more reliable predictions, reducing incorrect diagnoses during screening. The lightweight backbone and single inference pass per image make the framework compatible with low-latency mobile screening systems in resource-limited settings.