The present invention relates to apparatus for biologic fluid analyses in general, and to cartridges for acquiring, processing, and containing biologic fluid samples for analysis in particular.
Historically, biologic fluid samples such as whole blood, urine, cerebrospinal fluid, body cavity fluids, etc. have had their particulate or cellular contents evaluated by smearing a small undiluted amount of the fluid on a slide and evaluating that smear under a microscope. Reasonable results can be gained from such a smear, but the cell integrity, accuracy and reliability of the data depends largely on the technician's experience and technique.
Another known method for evaluating a biologic fluid sample involves diluting a volume of the sample, placing it within a chamber, and manually evaluating and enumerating the constituents within the diluted sample. Dilution is necessary if there is a high concentration of constituents within the sample, and for routine blood counts several different dilutions may be required because it is impractical to have counting chambers or apparatus which can examine variable volumes as a means to compensate for the disparities in constituent populations within the sample. In a sample of whole blood from a typical individual, for example, there are about 4.5×106 red blood cells (RBCs) per microliter (μl) of blood sample, but only about 0.25×106 of platelets and 0.007×106 white blood cells (WBCs) per μl of blood sample. To determine a WBC count, the whole blood sample must be diluted within a range of about one part blood to twenty parts diluent (1:20) up to a dilution of approximately 1:256 depending upon the exact dilution technique used, and it is also generally necessary to selectively lyse the RBCs with one or more reagents. Lysing the RBCs effectively removes them from view so that the WBCs can be seen. To determine a platelet count, the blood sample must be diluted within a range of 1:100 to about 1:50,000. Platelet counts do not, however, require a lysis of the RBCs in the sample. Disadvantages of evaluating a whole blood sample in this manner include the dilution process is time consuming and expensive, increased error probability due to the diluents within the sample data, etc.
Another method for evaluating a biologic fluid sample is impedance or optical flow cytometry, which involves circulating a diluted fluid sample through one or more small diameter orifices, each employing an impedance measurement or an optical system that senses the different constituents in the form of scattered light as they pass through the hydrodynamically focused flow cell in single file. In the case of whole blood, the sample must be diluted to mitigate the overwhelming number of the RBCs relative to the WBCs and platelets, and to provide adequate cell-to-cell spacing and minimize coincidence so that individual cells may be analyzed. Disadvantages associated with flow cytometry include the fluid handling and control of a number of different reagents required to analyze the sample which can be expensive and maintenance intensive.
Another modern method for evaluating biologic fluid samples is one that focuses on evaluating specific subtypes of WBCs to obtain a total WBC count. This method utilizes a cuvette having an internal chamber about 25 microns thick with one transparent panel. Light passing through the transparent panel scans the cuvette for WBCs. Reagents inside the cuvette cause WBCs to fluoresce when excited by the light. The fluorescing of the particular WBCs provides an indication that particular types of WBCs are present. Because the red blood cells form a partly obscuring layer in this method, they cannot themselves be enumerated or otherwise evaluated, nor can the platelets.
What is needed is a method and an apparatus for evaluating a sample of substantially undiluted biologic fluid, one capable of providing accurate results, one that does not use a significant volume of reagent(s), one that does not require sample fluid flow during evaluation, one that can perform particulate component analyses, and one that is cost-effective.
According to an aspect of the present invention, a biological fluid sample analysis cartridge is provided. The cartridge includes a housing, a fluid module, and an analysis chamber. The fluid module includes a sample acquisition port and an initial channel, and is connected to the housing. The initial channel is sized to draw fluid sample by capillary force, and is in fluid communication with the acquisition port. The initial channel is fixedly positioned relative to the acquisition port such that at least a portion of a fluid sample disposed within the acquisition port will draw into the initial channel. The analysis chamber is connected to the housing, and is in fluid communication with the initial channel.
According to another aspect of the present invention, a biological fluid sample analysis cartridge is provided. The cartridge includes a housing, a fluid module, and an imaging tray. The fluid module includes a sample acquisition port and an initial channel. The fluid module is connected to the housing, and the initial channel is in fluid communication with the acquisition port. The imaging tray includes an analysis chamber. The tray is selectively positionable relative to the housing in an open position and a closed position. In the closed position, the analysis chamber is in fluid communication with the initial channel.
According to another aspect of the present invention, a biological fluid sample analysis cartridge is provided. The cartridge includes a sample acquisition port, a channel, one or more flow disruptors, and an analysis chamber. The acquisition port is attached to a panel, and the channel is disposed in the panel. The channel is in fluid communication with the acquisition port. The flow disrupters are disposed within the channel. The analysis chamber in fluid communication with the channel.
The features and advantages of the present invention will become apparent in light of the detailed description of the invention provided below, and as illustrated in the accompanying drawings.
Referring to
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The sample acquisition port 30 is disposed at the intersection of the exterior edge 46 and the second lateral side 52. The acquisition port 30 includes one or both of a bowl 54 and an edge inlet 64. The bowl 54 extends between an upper surface 56 and a base surface 58. The acquisition port 30 further includes a sample intake 60, a bowl-to-intake channel 62, and an edge inlet-to-intake channel 66. In alternative embodiments, the acquisition port 30 and the sample intake may be located elsewhere in the fluid module 24; e.g., the acquisition port 30 may be located inwardly from an exterior edge and the sample intake 60 may be positioned in direct communication with the bowl 54 rather than having an intermediary channel connecting the bowl 54 and intake 60.
In the embodiment shown in
The bowl-to-intake channel 62 is disposed in the base surface 58 of the bowl 54, and provides a passage through which fluid deposited into the bowl 54 can travel from the bowl 54 to the sample intake 60. In some embodiments the bowl-to-intake channel 62 has a cross-sectional geometry that causes sample disposed within the channel 62 to be drawn through the channel 62 toward the sample intake 60 by capillary force. For example, the bowl-to-intake channel 62 may have a substantially rectilinear cross-sectional geometry, with a side wall-to-side wall separation distance that allows capillary forces acting on the sample to draw the sample through the channel 62. A portion of the channel 62 adjacent the sample intake 60 includes a curved base surface to facilitate fluid sample flow into the intake 60.
The edge inlet 64 is disposed proximate the intersection of the exterior edge 46 and the second lateral side 52. In the embodiment shown in
The exterior edge inlet-to-intake channel 66 extends between the edge inlet 64 and the sample intake 60. In some embodiments the edge inlet-to-intake channel 66 has a cross-sectional geometry that causes sample disposed within the channel 66 to be drawn through the channel 66 toward the sample intake 60 by capillary force; e.g., a substantially rectilinear cross-sectional geometry, with a side wall separation distance that allows capillary forces acting on the sample to draw the sample through the channel 66. A portion of the channel 66 adjacent the sample intake 60 includes a curved base surface to facilitate fluid sample flow into the intake 60.
The sample intake 60 is a passage that provides fluid communication between the initial channel 34 and the channels 62, 66 extending between the bowl 54 and the edge inlet 64. In the embodiment shown in
The initial channel 34 extends between the sample intake 60 and the secondary channel 38. The volume of the initial channel 34 is large enough to hold a volume of fluid sample adequate for the analysis at hand, and in some embodiments is large enough to permit mixing of the sample within the initial channel. The cross-sectional geometry of the initial channel 34 is sized to permit sample fluid disposed within the initial channel 34 to be drawn through the channel from the intake 60 via capillary forces. In some embodiments, one or more reagents 67 (e.g., heparin, EDTA, etc.) are deposited within the initial channel 34. As the sample fluid is drawn through the initial channel 34, the reagent 67 is at least partially admixed with the sample. The end of the initial channel 34 opposite the sample intake 60 opens to the secondary channel 38, thereby providing a fluid communication path from the initial channel 34 into the secondary channel 38.
In some embodiments, one or more flag ports 39 (see
In some embodiments, the initial channel 34 (or the flag port 39) includes a sample magnifier 41 (see
The secondary channel 38 extends between the initial channel 34 and distal end which can include an exhaust port 68. The cross-sectional geometry of the intersection between the secondary channel 38 and the initial channel 34 is configured such that capillary forces will not draw sample from the initial channel 34 into the secondary channel 38. In some embodiments, the secondary channel 38 includes a sample metering port 72. The secondary channel 38 has a volume that is large enough to permit the movement of sample back and forth within the secondary channel 38, which fluid movement can be used to mix sample constituents and/or reagents within the sample. In some embodiments, a gas permeable and liquid impermeable membrane 74 is disposed relative to the exhaust port 68 to allow air within the secondary channel 38 to exit the channel 38, while at the same time preventing liquid sample from exiting the channel 38 via the port 68.
The sample metering port 72 has a cross-sectional geometry that allows sample to be drawn out of the secondary channel 38 by capillary force. In some embodiments, the volume of the sample metering port 72 is a predetermined volume appropriate for the analysis at hand; e.g., substantially equal to the desired volume of sample for analysis. The metering port 72 extends from the secondary channel 38 to an exterior surface of the tray 24 (which, as will be described below, is aligned with an exterior surface of a panel 122 portion of sample analysis chamber 118 when the tray is in the closed position).
The valve 36 is disposed within the fluid module 24 at a position to prevent fluid flow (including airflow) between a portion of the initial channel 34 and the sample intake 60. The valve 36 is selectively actuable between an open position and a closed position. In the open position, the valve 36 does not impede fluid flow between the sample intake 60 and a portion of the initial channel 34 contiguous with the secondary channel 38. In the closed position, the valve 36 at least substantially prevents fluid flow between at least a portion of the initial channel 34 and the sample intake 60.
In the embodiment shown in
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In some embodiments, the air pressure source 42 (e.g., see
The external air port 44 is disposed within the fluid module 24 adjacent the air pressure source 42 (see
In some embodiments, the cartridge 20 includes one or more sample flow disrupters configured in, or disposed within, one or both of the initial channel 34 and the secondary channel 38. In the embodiments shown in
In some embodiments (see
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The overflow channel 90, initial channel 34, airways 82, 84, and the secondary channel 38 are disposed internally, and are therefore enclosed, within the fluid module 24. The present invention fluid module 24 is not limited to any particular configuration. For example, the fluid module 24 may be formed from two mating panels joined together. Any or all of the aforesaid channels 34, 90, 38, and airways 82, 84 can be formed in one panel, both panels, or collectively between the panels. The fluid module 24 shown in
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The imaging tray 26 includes at least one latch member 112 that operates to selectively secure the imaging tray 26 within the housing 28. In the embodiment shown in
A sample analysis chamber 118 is attached to the imaging tray 26, aligned with the chamber window 108. The chamber 118 includes a first panel 120 and a second panel 122, at least one of which is sufficiently transparent to permit a biologic fluid sample disposed between the panels 120, 122 to be imaged for analysis purposes. The first and second panels 120, 122 are typically substantially parallel one another, are substantially aligned with one another, and are separated from each other by a distance extending between the opposing surfaces of the two panels 120,122. The alignment between the panels 120, 122 defines an area wherein light can be transmitted perpendicular to one panel and it will pass through that panel, the sample, and the other panel as well, if the other panel is also transparent. The separation distance between the opposing panel surfaces (also referred to as the “height” of the chamber) is such that a biologic fluid sample disposed between the two surfaces will be in contact with both surfaces. One or both panels 120, 122 are attached (e.g., by welding, mechanical fastener, adhesive, etc.) to the shelf 110 disposed around the imaging tray window 108.
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Examples of acceptable panel materials include transparent plastic film, such as acrylic, polystyrene, polyethylene terphthalate (PET), cyclic olefin copolymer (COC) or the like. One of the panels (e.g., the panel 122 oriented to be the bottom) may be formed from a strip of material with a thickness of approximately fifty microns (50μ), and the other panel (e.g., the panel 120 oriented to be the top panel) may be formed from the same material but having a thickness of approximately twenty-three microns (23μ). Examples of acceptable separators 124 include polystyrene spherical beads that are commercially available, for example, from Thermo Scientific of Fremont, Calif., U.S.A., catalogue no. 4204A, in four micron (4 μm) diameter. The present cartridge is not limited to these examples of panels and/or separators.
The chamber 118 is typically sized to hold about 0.2 to 1.0 μl of sample, but the chamber 118 is not limited to any particular volume capacity, and the capacity can vary to suit the analysis application. The chamber 118 is operable to quiescently hold a liquid sample. The term “quiescent” is used to describe that the sample is deposited within the chamber 118 for analysis, and is not purposefully moved during the analysis. To the extent that motion is present within the blood sample, it will predominantly be due to Brownian motion of the blood sample's formed constituents, which motion is not disabling of the use of this invention. The present cartridge is not limited to this particular chamber 118 embodiment.
Now referring to
The valve actuating feature 138 extends out into the housing internal cavity at a position where the valve actuator 78 attached to the fluid module 24 will encounter the feature 138 as the fluid module 24 is slid into the housing 28. In a similar manner, the air source actuating feature 140 extends out into the internal cavity at a position where the pressure source actuator 80 attached to the fluid module 24 will encounter the feature 140 as the fluid module 24 is slid into the housing 28.
The imaging tray 26 is inserted into or out of the housing 28 through the tray aperture 134. Guide surfaces attached to (or formed in) one or both of the base 128 and the cover 130 guide linear movement of the imaging tray 26 relative to the housing 28 and permit relative sliding translation. The housing 28 includes one or more tabs 142, each aligned to engage an aperture 114 disposed within a latch member 112 of the imaging tray 26. The housing 28 further includes an access port 144 adjacent each tab 142. An actuator (incorporated into the analysis device 22) extending through each access port 144 can selectively disengage the latch member 112 from the tab 142 to permit movement of the imaging tray 26 relative to the housing 28.
As stated above, the present biologic fluid sample cartridge 20 is adapted for use with an automated analysis device 22 having imaging hardware and a processor for controlling processing and analyzing images of the sample. Although the present cartridge 20 is not limited for use with any particular analytical device 22, an analysis device 22 similar to that described in U.S. Pat. No. 6,866,823 is an example of an acceptable device. To facilitate the description and understanding of the present cartridge 20, the general characteristics of an example of an acceptable analysis device 22 are described hereinafter.
The analysis device 22 includes an objective lens, a cartridge holding and manipulating device, a sample illuminator, an image dissector, and a programmable analyzer. One or both of the objective lens and cartridge holding device are movable toward and away from each other to change a relative focal position. The sample illuminator illuminates the sample using light along predetermined wavelengths. Light transmitted through the sample, or fluoresced from the sample, is captured using the image dissector, and a signal representative of the captured light is sent to the programmable analyzer, where it is processed into an image. The image is produced in a manner that permits the light transmittance (or fluorescence) intensity captured within the image to be determined on a per unit basis.
An example of an acceptable image dissector is a charge couple device (CCD) type image sensor that converts an image of the light passing through (or from) the sample into an electronic data format. Complementary metal oxide semiconductor (“CMOS”) type image sensors are another example of an image sensor that can be used. The programmable analyzer includes a central processing unit (CPU) and is connected to the cartridge holding and manipulating device, sample illuminator and image dissector. The CPU is adapted (e.g., programmed) to receive the signals and selectively perform the functions necessary to perform the present method.
The present cartridge 20 is initially provided with the fluid module 24 set (or positionable) in an open position as is shown in
A clinician or other end-user introduces a biological fluid sample (e.g., blood) into the inlet edge 64 or the bowl 54 from a source such as a syringe, a patient finger or heel stick, or from a sample drawn from an arterial or venous source. The sample is initially disposed in one or both of the channels 62, 66 and/or bowl 54, and is drawn into the sample intake 60 (e.g., by capillary action). In the event the amount of sample deposited into the bowl 54 is sufficient to engage the overflow passage inlet 88, capillary forces acting on the sample will draw the sample into the overflow channel 90. The sample will continue to be drawn into the shunt overflow passage 32 until the fluid level within the bowl 54 drops below the overflow passage inlet 88. Sample drawn into the overflow passage 32 will reside in the overflow channel 90 thereafter. The overflow exhaust port 92 allows air to escape as the sample is drawn into the channel 90.
Sample within the bowl 54 is drawn by gravity into the bowl-to-intake channel 62 disposed within the bowl base surface 58. Once the sample has entered the bowl-to-intake channel 62, and/or the inlet edge-to-intake channel 66, one or both of gravity and capillary forces will move the sample into the sample intake 60, and subsequently into the initial channel 34. Sample drawn into the initial channel 34 by capillary forces will continue traveling within the initial channel 34 until the front end of the sample “bolus” reaches the entrance to the secondary channel 38. In those embodiments where the initial channel 34 and/or a flag port 39 are visible to the end-user (including those assisted by a magnifier 41), the end-user will be able to readily determine that a sufficient volume of sample has been drawn into the cartridge 20. As indicated above, in certain embodiments of the present cartridge 20 one or more reagents 67 may be disposed around and within the initial channel 34 (e.g., heparin or EDTA in a whole blood analysis). In those embodiments, as the sample travels within the initial channel 34, the reagents 67 are admixed with the sample while it resides within the initial channel 34. The end-user subsequently slides the fluid module 24 into housing 28.
As the fluid module 24 is slid into the housing 28, a sequence of events occurs. First, the valve actuator 78 engages the valve actuating feature 138 as the fluid module 24 is slid inwardly. As a result, the valve 36 is actuated from the open position to the closed position, thereby preventing fluid flow between the sample intake 60 and initial channel 34. As the fluid module 24 is slid further into the housing 28, the pressure source actuator 80 engages the air source actuating feature 140 which causes the air pressure source 42 to increase the air pressure within the airway 82. The now higher air pressure acts against the fluid sample disposed within the initial channel 34, forcing at least a portion of the fluid sample (and reagent in some applications) into the secondary channel 38. The closed valve 36 prevents the sample from traveling back into the sample intake 60. As the fluid module 24 is slid completely into the housing 28, the tab 100 disposed at the end of each latch 40 engages the features 98 attached to the housing 28, thereby locking the fluid module 24 within the housing 28. In the locked, fully inserted position, the bowl cap 136 covers the sample intake 60. The fluid module 24 is thereafter in a tamper-proof state in which it can be stored until analysis is performed. The tamper-proof state facilitates handling and transportation of the sample cartridge 20. In those embodiments without an air pressure source 42, the sample may reside within the initial channel 34 during this state.
After the end-user inserts the cartridge 20 into the analysis device 22, the analysis device 22 locates and positions the cartridge 20. There is typically a period of time between sample collection and sample analysis. In the case of a whole blood sample, constituents within the blood sample (e.g., RBCs, WBCs, platelets, and plasma) can settle and become non-uniformly distributed. In such cases, there is considerable advantage in mixing the sample prior to analysis so that the constituents become substantially uniformly distributed within the sample. To accomplish that, the external air port 44 disposed in the fluid module 24 is operable to receive an external air source probe provided within the analysis device 22. The external air source provides a flow of air that increases the air pressure within the airways 82, 84 and initial channel 34, and consequently provides a motive force to act on the fluid sample. The external air source is also operable to draw a vacuum to decrease the air pressure within the airways 82, 84 and initial channel 34, and thereby provide a motive force to draw the sample in the opposite direction. The fluid sample can be mixed into a uniform distribution by cycling the sample back and forth within either or both of the initial channel 34 and the secondary channel 38. In those embodiments that include one or more disrupters 146 configured in, or disposed within, one or both of the initial channel 34 and the secondary channel 38. The flow disrupter facilitates the mixing of the constituents (and/or reagents) within the sample. Depending upon the application, adequate sample mixing may be accomplished by passing the sample once past the flow disrupter 146. In other applications, the sample may be cycled as described above.
In some embodiments, adequate sample mixing may be accomplished by oscillating the entire cartridge at a predetermined frequency for a period of time. The oscillation of the cartridge may be accomplished for example, by using the cartridge holding and manipulating device disposed within the analysis device 22, or an external transducer, etc.
After a sufficient amount of mixing, the external air source is operated to provide a positive pressure that pushes the fluid sample to a position aligned with the metering port 72 and beyond, toward the distal end of the secondary channel 38. The gas permeable and liquid impermeable membrane 74 disposed adjacent the exhaust port 68 allows the air within the chamber 38 to escape, but prevents the fluid sample from escaping. As the fluid sample travels within the secondary channel 38 and encounters the sample metering port 72, capillary forces draw a predetermined volume of fluid sample into the sample metering port 72. The pressure forces acting on the sample (e.g., pressurized air within the channel that forces the sample to the distal end of the channel) cause the sample disposed within the metering port 72 to be expelled from the metering port 72.
When both the imaging tray 26 and the fluid module 24 are in a closed position relative to the housing 28 (e.g., see
The imaging tray latch member 112 is subsequently engaged by an actuator incorporated into the analysis device 22 to “unlock” the imaging tray 26, and the imaging tray 26 is pulled out of the housing 28 to expose the now sample-loaded analysis chamber 118 for imaging. Once the image analysis is completed, the imaging tray 26 is returned into the cartridge housing 28 where it is once again locked into place. The cartridge 20 can thereafter be removed by an operator from the analysis device 22. In the closed position (see e.g.,
In an alternative embodiment, the imaging tray can be “locked” and “unlocked” using a different mechanism. In this embodiment, the latch member(s) 112 also cantilevers outwardly from the shelf 110 and includes the aperture 114 for receiving the tab 142 (or other mechanical catch) attached to the interior of the housing 28. In this embodiment, the latch member further includes a magnetically attractable element. A magnetic source (e.g., a magnet) is provided within the analysis device 22. To disengage the latch member 112, the magnetic source is operated to attract the element attached to the latch 112. The attraction between the magnetic source and the element causes the cantilevered latch to deflect out of engagement with the tab 142, thereby permitting movement of the imaging tray 26 relative to the housing 28.
While the invention has been described with reference to an exemplary embodiment, it will be understood by those skilled in the art that various changes may be made and equivalents may be substituted for elements thereof without departing from the scope of the invention. In addition, many modifications may be made to adapt a particular situation or material to the teachings of the invention without departing from the essential scope thereof. Therefore, it is intended that the invention not be limited to the particular embodiment(s) disclosed herein as the best mode contemplated for carrying out this invention. As an example of such a modification, the present cartridge 20 is described as having an external air port 44 disposed within the fluid module 24 for receiving an external air source. In alternative embodiments, a source of air pressure could be included with the fluid module 24; e.g., a gas bladder disposed within the fluid module 24 that can produce positive and negative air pressures when exposed to a thermal source. As another example of a modification, the present invention cartridge is described above as having a particular embodiment of an analysis chamber 118. Although the described cartridge embodiment is a particularly useful one, other chamber configurations may be used alternatively. As a still further example of a modification, the present cartridge is described above as having particular latch mechanisms 40, 112. The invention is not limited to these particular latch embodiments.
This application is a continuation of U.S. patent application Ser. No. 15/420,388 filed Jan. 31, 2017, which is a divisional of U.S. patent application Ser. No. 12/971,860 filed Dec. 17, 2010, which is entitled to the benefit of and incorporates by reference essential subject matter disclosed in the following U.S. Provisional Patent Applications: Serial Nos. 61/287,955, filed Dec. 18, 2009; and 61/291,121, filed Dec. 30, 2009.
Number | Date | Country | |
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61291121 | Dec 2009 | US | |
61287955 | Dec 2009 | US |
Number | Date | Country | |
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Parent | 12971860 | Dec 2010 | US |
Child | 15420388 | US |
Number | Date | Country | |
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Parent | 15420388 | Jan 2017 | US |
Child | 16004676 | US |