Although a reliable method for detection of cancer cells in blood would be an important tool for diagnosis and monitoring of solid tumors in early stages, current technologies cannot reliably detect the extremely low concentrations of these rare cells. The preferred method of detection, automated digital microscopy (ADM), is too slow to scan the large substrate areas. Here we report an approach that uses fiber-optic array scanning technology (FAST), which applies laser-printing techniques to the rare-cell detection problem. With FAST cytometry, laser-printing optics are used to excite 300,000 cells per sec, and emission is collected in an extremely wide field of view, enabling a 500-fold speed-up over ADM with comparable sensitivity and superior specificity. The combination of FAST enrichment and ADM imaging has the performance required for reliable detection of early-stage cancer in blood.O ccult tumor cells (OTCs) shed from tumors can travel through the blood stream to anatomically distant sites and form metastatic disease, the major cause of cancer-related death in patients with solid tumors. These disseminated cells are present in circulation in extremely low concentrations, estimated to be in the range of one tumor cell in the background of 10 6 -10 7 normal blood cells and are occult to routine imaging and laboratory studies (1). Automated digital microscopy (ADM) using image analysis for recognition of specifically labeled tumor cells has been demonstrated to be the most reliable method currently available for OTC detection (2-5).However, at the typical scan rate of 800 cells per sec, ADM is too slow to screen for a statistically valid number of OTCs (6). This slow scan rate is a result of two factors. One is the substantial latency associated with stepping the sample under the microscopy objective. This stepping results from the lens' small field of view. The other factor is the long exposure time that is due to the low level of excitation from broadband illumination sources and the lack of sensitivity of the charge-coupled device detector used for imaging.Here we report a scanning instrument using fiber-optic array scanning technology (FAST) that can locate OTCs at a rate that is 500 times faster than ADM, with comparable sensitivity and improved specificity. The exposure time is reduced by using a laser source for higher illumination levels and a more sensitive photomultiplier detector. However, our key innovation is providing an optical system with an exceptionally large field of view (50 mm) without a loss of collection efficiency. By collecting the fluorescence in an array of optical fibers that forms a wide collection aperture, the FAST cytometer has a 100-fold increase in field of view over ADM. Although this increase in field of view comes with a reduction in instrument resolution, the resolution is still sufficient for the identification of fluorescently labeled cells. This field of view is large enough to eliminate the need to step the sample under the collection optics, and hence there is no s...

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We report the fabrication of enthalpy arrays and their use to detect molecular interactions, including protein-ligand binding, enzymatic turnover, and mitochondrial respiration. Enthalpy arrays provide a universal assay methodology with no need for specific assay development such as fluorescent labeling or immobilization of reagents, which can adversely affect the interaction. Microscale technology enables the fabrication of 96-detector enthalpy arrays on large substrates. The reduction in scale results in large decreases in both the sample quantity and the measurement time compared with conventional microcalorimetry. We demonstrate the utility of the enthalpy arrays by showing measurements for two proteinligand binding interactions (RNase A ؉ cytidine 2 -monophosphate and streptavidin ؉ biotin), phosphorylation of glucose by hexokinase, and respiration of mitochondria in the presence of 2,4-dinitrophenol uncoupler.U nderstanding the thermodynamics of molecular interactions is central to biology and chemistry. Although a number of methods are available, calorimetry is the only universal assay for the complete thermodynamic characterization of these interactions. Under favorable circumstances, the enthalpy, entropy, free energy, and stoichiometry of a reaction can be determined (1, 2). In addition, calorimetry does not require any labeling or immobilization of the reactants and hence offers a completely generic method for characterizing the interactions. Indeed, titration calorimetry is widely used in both drug discovery and basic science, but its use is severely constrained to a small number of very high-value measurements by the large sample requirements and long measurement times. No currently available methods for calorimetric measurements lend themselves to modern approaches in which large libraries of compounds, ranging from small molecules in combinatorial libraries to proteins and other macromolecules, are studied.Here we report a low-cost nanocalorimetry detector that can be used as a high-throughput assay tool to detect enthalpies of binding interactions, enzymatic turnover, and other chemical reactions. The detectors are made by using microscale fabrication technology, resulting in a nearly 3 orders of magnitude reduction in both the sample quantity and the measurement time over conventional microcalorimetry. The fabrication technology is low-cost and enables fabrication of 96-detector arrays, which we call enthalpy arrays, on large substrates. Accordingly, the technology will scale to high-volume production of disposable arrays. This increase in performance and reduction in cost promises to enable calorimetry to be used to investigate a substantial number of samples. Nanocalorimetry in the enthalpy array format has valuable applications in proteomics for protein interaction and protein chemistry research and in high-throughput screening and lead optimization for drug discovery. Materials and MethodsDevice Fabrication. The schematic cross section of a nanocalorimeter detector is shown in Fig. 1a. The d...