Advice on physician microscope

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Vyatar
Posts: 2
Joined: Sat May 09, 2020 2:53 pm

Advice on physician microscope

#1 Post by Vyatar » Sun May 10, 2020 9:05 am

Hi All,

I am a Pathologist in Eastern Canada looking to purchase a scope for a home office. I've received quotes for the Leica DM1000, Nikon Ci-L, Olympus BX3, and Zeiss Axiolab 5. All are within a small price range except for the Leica which is about 3k cheaper. I was just wondering if there was any significant differences or issues between the brands and if one of these models would be recommended above the rest. I have used a variety of models/manufacturers over the years except for Zeiss and have not really found any one that stood out but never really paid too much attention as they were always provided for me at work (currently use a Nikon 80i). Now that i am looking to purchase my own for home, I am hoping to avoid any if they have quality or support/service issues, etc. Any help would be greatly appreciated. Thank you!

PeteM
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Joined: Tue Dec 06, 2016 6:22 am
Location: N. California

Re: Advice on physician microscope

#2 Post by PeteM » Sun May 10, 2020 6:55 pm

One of this forum's members spent a career in pathology and swears by Olympus. Perhaps Tom will chime in.

I've had some experience with Leica, Nikon, and Olympus infinity systems - though a generation back from the latest. They all seemed excellent to me -- and if you're getting a manual scope without the complexities of automation, confocal, etc. -- all should be relatively trouble free. Far as I can tell, service seems a function of your nearest authorized dealer - highly variable - and also hard for these businesses to find just the right line between serving their customers well and staying in business.

The biggest advance in each of these brands, to me, is moving from plan achromat to plan fluorite objectives - perhaps worth including those in the magnifications you use most frequently.

Don't know what level of image capture you'll want or need, but that's another consideration. Also don't know what level of automaton best suits a pathologist. I'd be interested, and I'm sure others, to know what the requirements are for viewing methods, automation, etc.

The Nikon Plan Fluor and Plan Apo CFI objectives, with their longer parfocal distance, do give more working distance. And since you apparently already have experience and support for Nikon at work, that might sway the decision. There's also a $1000+savings available now in buying a near-new 20x Plan Apo DIC Nikon objective for a bit over $100 on Ebay. It's easily a $1500++ objective -- but now cheap because hundreds were apparently built to be used in gene sequencers that proved quickly obsolete.

The Leica DM1000, while a nice scope, won't easily upgrade to things like DIC if that's a consideration. You'd need to move up in the line (and lose that lower price) to do so.

Like you, I don't know Zeiss. Several local university researchers love their inverted Zeiss scopes with multiple viewing modes; but those cost both an arm and a leg and get bought on research grants.

Scarodactyl
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Joined: Sat Mar 03, 2018 9:09 pm

Re: Advice on physician microscope

#3 Post by Scarodactyl » Sun May 10, 2020 9:07 pm

What lighting methods do you need? It's possible an older system might give you everything you need at a much lower price point.

apochronaut
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Re: Advice on physician microscope

#4 Post by apochronaut » Sun May 10, 2020 11:39 pm

What branch of pathology do you work in?

Tom Jones
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Re: Advice on physician microscope

#5 Post by Tom Jones » Mon May 11, 2020 2:30 am

PeteM is right. My vote is for the Olympus BX series. I was a clinical lab supervisor in the second busiest trauma center in California for a long time. In 1999, when we built a new hospital, we switched from AO's and Olympus BH-2s, to Olympus BX-40's in the clinical lab (micro, UA, and hematology). At the same time the pathologists went with Olympus BX-50's. All the objectives were Olympus UPlanFluorites. After the last BH-2 power supply died, even the blood bank went with BX-40's and fluorites.

Not long after the initial switch, I got my own BX-40 with UPlanFluorites from the PI in a research lab that closed.

The lab never had any problems with the BX scopes for the ten years I was there after the switch, and a recent question to a supervisor friend who is still there indicated they haven't had any issues in the 11 years since then. Obviously they get the required PM's. They don't get as much use in Hemo and UA now due to all the automated differentials and UA micros though, but the other departments haven't changed usage. In my view they're nearly bullet proof, and I'd put their image quality up against anything. Obviously oil immersion was used a lot, and we never had an objective leak oil. Never any delamination either.

After I retired, I worked part-time at a community hospital for a few years. We bought a BX-43 LED scope, with UPlanFluorites, to replace a Nikon Labophot II. We had a couple of newer Nikons as well, but they weren't my favorites, so I talked them into the Olympus. They already had a BX-40 they liked in micro.

I wasn't really a fan of the color balance of the LED on the BX-43, even though most of the other techs liked it. Too many years with regular incandescent and halogen bulbs I guess. Diffs and body fluids were fine, but I found the difficult gram stains were a bit harder to interpret. The rest of the scope though was wonderful. If you think you want to go with the BX-43 LED, have the Olympus rep loan you a scope for a couple of weeks so you can see for yourself if you like the color balance with the work you do.

And just to add a bit of additional perspective, I like the BX series enough I have upgraded my BX-40 to a BX-50, and bought two additional BX-50's. One is set up as normal bright field and dark field, but with all UPlanApos, one is for DIC with UPlanApos, and the other is set up for phase with UPlanFluorites (I don't like to swap parts back and forth if I don't have to). I also have a BX-60 with a full polarization set up, epi bright field, dark field, and DIC, all with fluorites.

They're easy to set up for photography, too.

Vyatar
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Joined: Sat May 09, 2020 2:53 pm

Re: Advice on physician microscope

#6 Post by Vyatar » Mon May 11, 2020 5:46 pm

Wow, you guys are fantastic! Thanks so much for the help.

Image capturing is something that I may upgrade to down the road as things move more towards digital pathology and the ability to share diagnostic images off site develops. From what you guys knows, is there much differences in the quality of the software, ease of use, and the image quality among the manufacturers? The Nikon Ci and Zeiss Axiolab 5 have image capture buttons integrated into the stand. The brochure for the Zeiss seems to really emphasize this but seems to somewhat gloss over the other attributes of the scope.

As of right now, I am not looking for automation as i don't think its necessary for my use and I feel this opens up the possibility of more to go wrong. I mainly do Brightfield work in histopathology and cytopathology and have further training in Uropathology. I'll use polarization on occasion to mainly identify amyloid, calcium oxalate crystals in breast specimens, and foreign body material. I've considered holding off on getting any polarization capabilities to reduce the price as I can always view those cases while at work but it would certainly be more convenient to have that covered on my home scope so not sure yet.

I have considered going the used route but it seems i'd have to spend some time putting the various pieces together on Ebay or be patient to see if something comes up. I don't mind doing that especially if there is a big cost advantage. Just a bit weary of it i guess. Are there other places to obtain a used scope, one which would be feasible for Canada?

Given the differences in servicing/support, I will be asking each rep specifically about this. Not sure if I should be concerned about the degree of plastics being used on the scopes versus metal. Anyone find issues with this or more on one manufacturer versus another?

I think having the ability to test out the scopes beforehand might prove to be worthwhile. In our lab out here, as mentioned, I am using an Nikon 80i. In addition, we have several BX45s (with the lower stage) being used by our cytotechs while one of them uses a Nikon 50i and another a Leica DM2000. There's also a Nikon E400 and an old Olympus BH-2 kicking around in the Heme wing. I quickly tested some of these out but given they are regularly being used by others, I wasn't able to get a real good feel for them so perhaps having them loaned out for a period of time would really be helpful. Plus none of those had LED illumination. It is nice to hear the favourable things regarding Olympus, plus the Olympus rep has been quite helpful and responsive.

Want to thank everyone again for their replies, seems like there's a very eager and passionate group here.

Scarodactyl
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Re: Advice on physician microscope

#7 Post by Scarodactyl » Mon May 11, 2020 6:28 pm

If all you need is brightfield and simple pol you could save a lot of money buying used and probably have a more capable instrument at the end of the day.
For instance on a Nikon labophot (160mm finite era) the attachments for simple pol (the one designed ie for differentiating gout and pseudogout) can be had for about 250usd if you don't find a scope with them already attached and don't want to wait on a deal.
Not saying you have to go this route by any means, just that you can probably get everything you want for a lot less while still having a quality, maintainable scope.

Hobbyst46
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Joined: Mon Aug 21, 2017 9:02 pm

Re: Advice on physician microscope

#8 Post by Hobbyst46 » Mon May 11, 2020 6:31 pm

If you consider buying a new microscope:
1. The Olympus BX series are certainly excellent, mechanically and optically. New Zeiss microscopes are sometimes expensive relative to those from other brands just because of the name.
2. More importantly, IMHO, if your activity involves scientific-level image analysis, and is best done with software from the microscope maker, I would take that into consideration. Such software (including the Olympus microscopy software) is very expensive. So, If such software, from a microscope brand, is a must, I would seek a deal where the software is bundled with the microscope, or at the most sold for a lower price.
Truly, dedicated microscope software is most important in automated systems, where the software recognizes the objective, controls focusing etc...
Zeiss Standard GFL+Canon EOS-M10, Olympus VMZ stereo

PeteM
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Joined: Tue Dec 06, 2016 6:22 am
Location: N. California

Re: Advice on physician microscope

#9 Post by PeteM » Mon May 11, 2020 6:50 pm

Simple polarization (just the contrast, not the ability to measure angles) should be a relatively affordable add-on. For the BH2 series, I know Olympus makes a combination polarizer and gout tint plate that shows up used for around $300-400. Just the polarizer and intermediate piece, maybe $200 for either Olympus or Nikon (used). Another $100 for a polarizer on the field lens. So, $500 and usually available.

If all you'll ever want is brightfield and polarization one of the earlier generation finite microscopes, like the Olympus BHS or Nikon Optiphot II used elsewhere at work would likely do. You should be able to get one in very good condition, equipped with good objectives, a trinocular head, and polarization for under $2000 (depending upon objectives) used. That's likely a big spread from buying new; with not likely a significant difference in image quality at any given level of objectives comparing used vs. new (Plan Achro, Plan Fluor, Plan Apo) - but a big difference in price at the high end. These will be all manual scopes.

You'd be looking up anything from a C mount to full frame camera and learning how to use that quickly would take some time. Plenty of documentation, but a day or two learning curve. Camera and fittings will add another $500 to $1000++ for something good enough for simple viewing and documentation. You'd likely be hooking up the camera to a laptop for imaging, and using the camera's software to take pictures. If you're a photographer already, this is even more likely and option.

So, if that seems an option you might try the older Olympus BH2/BHTU/BHT/BHS and Nikon Labophot/Optiphot models at work and see if you like the ergonomics. Both can be had with ergo trinocular heads, but it adds maybe $500 to the price. I'd recommend the top of the (then) line models with brighter lamps - the Olympus BHS and the Nikon Optiphot I or II. It would be fairly affordable to have everything you might want.

With respect to used infinity scopes (Nikon Eclipse, Olympus BX, Leica DM) I've found it easier to hook after market cameras to the first two, not so much the Leica. There seem to be more information and more used adapters available for Olympus and Nikon. Something like a used BX45 with fluorite objectives -- or the equivalent in Nikon - might be the best balance of all between like-new capabilities and several thousand saved.

If you want the latest software, though, then new is likely the way to go.

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