Informatics, digital & computational pathology

Advanced microscopy

Augmented reality microscopy (ARM)

Editorial Board Member: Patricia Tsang, M.D., M.B.A.
Editor-in-Chief: Debra L. Zynger, M.D.
Swati Satturwar, M.D.
Liron Pantanowitz, M.D.

Topic Completed: 25 August 2020

Minor changes: 14 May 2021

Copyright: 2020-2021,, Inc.

PubMed Search: Augmented reality microscopy

Swati Satturwar, M.D.
Liron Pantanowitz, M.D.
Page views in 2020: 183
Page views in 2021 to date: 315
Cite this page: Satturwar S, Pantanowitz L. Augmented reality microscopy (ARM). website. Accessed November 27th, 2021.
Definition / general
  • Modified (smart) microscope with an added / attached accessory augmented reality unit / device that enables real time annotation / image analysis / artificial intelligence to be superimposed on a glass slide
Essential features
  • Requires an accessory augmented reality device to be attached to a conventional microscope, which converts this setup into a smart microscope
  • Unit acquires images of a glass slide on the microscope stage in real time, which allows annotations to be superimposed in the microscope's ocular eyepiece or displayed on an attached computer monitor
  • This avoids having to first photograph or scan slides in order to perform measurements, image analysis or run artificial intelligence (AI) based algorithms
  • Augmented reality microscopy (ARM)
  • Smart microscope
Augmented reality
  • Augmented reality (AR) technology combines reality with digital information by superimposing a computer generated digital image onto an object or user's view of the real world; this differs from virtual reality (VR), where a complete digital or computer generated environment gets generated (Med Ref Serv Q 2012;31:212)
  • Examples of nonmicroscope wearable devices: AR (e.g. Google Glass, Microsoft HoloLens), VR (e.g. Oculus Rift, Samsung Gear VR) (Arch Pathol Lab Med 2018;142:638)
  • Introduced into the literature by Chen et al. (Nat Med 2019;25:1453)
  • A smart microscope with an attached AR device can augment additional computer generated digital information / analysis that gets overlain on the original microscopic field of view (FOV) in real time, without having to first digitize a glass slide or majorly alter traditional manual pathology workflow
  • ARM devices are commercially available from Augmentiqs
Design (technology)
  • An ARM unit can be attached to any light microscope where it is inserted between the microscope's objectives and eyepiece unit
  • Computer generated images or annotations from the device get superimposed on the microscope's image visible through the ocular lens or can be displayed on an attached computer monitor
  • Any compatible software application can be used to perform real time image analysis or run an AI based algorithm

Contributed by Augmentiqs

Augmented reality microscope setup

  • AR device can be attached to and enhance almost any conventional light microscope
  • No change to the regular function or optical quality of the microscope
  • No need to digitize / photograph glass slides prior to image analysis
  • Less disruption to routine workflow in a busy pathology practice
  • Permits real time annotation, image analysis and AI based algorithm use
  • Image overlay with AR is an advantage over conventional digital modalities
  • Requires minimal technical skills to operate
  • No associated simulator sickness that may occur with wearable AR / VR devices
  • Possibly quicker and cheaper than a conventional whole slide scanner
  • Permits real time sophisticated annotations to be superimposed on microscopic images (e.g., detection of lymph node metastases of breast carcinoma and prostate cancer detection in prostate specimens) (Nat Med 2019;25:1334)
  • Enables real time image analysis and running of AI based algorithms on glass slides (e.g., Ki67 proliferation index quantification) (J Toxicol Pathol 2018;31:315, Cancer Cytopathol 2020;128:535)
  • Like other traditional digital cameras attached to a microscope, the AR device can be used to acquire digital photos and transmit images (telepathology, teleconsultation, remote frozen section peer review, tumor board presentations)
  • Research and teaching / education
System requirements
  • ARM device by Augmentiqs requires PC Windows 7 or higher and Augmentiqs software installed
  • Currently, there are no standardized guidelines on validation or licensing requirements for use of ARM

Google and ARM

Augmentiqs and ARM

Board review style question #1
Which of the following imaging steps is involved in augmented reality microscopy?

  1. Image archiving and retrieval
  2. Image compression
  3. Rapid slide scanning
  4. Superimposed annotation
  5. Z stacking
Board review style answer #1
D. Superimposed annotation. ARM superimposes computer generated digital annotations / images over the real world view visible in a microscope's eyepiece or on an attached computer monitor. No glass slides are scanned and therefore ARM does not require subsequent image compression and storage.

Comment Here

Reference: Augmented reality microscopy (ARM)
Back to top
Image 01 Image 02