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논문분류	춘계학술대회 초록집
제목	Diagnostic Equivalence of Low-Voltage Electron Microscopy and High-voltage Transmission Electron Microscopy in Renal Pathology: Implications for Global Accessibility in Low-Resource Settings
저자	Beom Jin Lim
출판정보	2026; 2026(1):
키워드	Low-voltage electron microscopy, Transmission electron microscopy, Renal pathology, Ultrastructural diagnosis, Amyloid fibrils
초록	Objectives: Transmission electron microscopy (TEM) is essential for diagnosing renal pathology, but its complexity, cost, and facility requirements limit its use, especially in low-resource settings. Low-voltage electron microscopy (LVEM) offers a lower-cost, more accessible alternative. While LVEM has demonstrated potential for generating diagnostically meaningful images, direct comparison with existing high-voltage TEM systems (HVEM) using identical clinical samples is limited. This study aimed to determine if LVEM can reproduce critical ultrastructural findings of conventional HVEM and support diagnosis where traditional EM is unavailable. Methods: We re-examined renal biopsy thin sections, previously imaged with HVEM (80 kV), using a LVEM system (LVEM 25E, Delong Instruments), operating at accelerating voltages of 10-25 kV). We used standard osmium-fixed, uranyl acetate- and lead-stained sections, placed on 3-mm grids, and imaged them at various magnifications. We qualitatively compared principal diagnostic structures: glomerular basement membrane (GBM) changes, electron-dense deposits, and podocyte foot processes. For amyloidosis, we measured fibril diameters and compared them with reference values. Results: LVEM produced diagnostic-quality images comparable to HVEM in all specimens. Electron-dense deposits, GBM changes, and foot process effacement were clearly discernible at high magnification. In amyloid-positive specimens, fibril diameters measured on LVEM micrographs (about 9–12 nm) matched the ~10-nm range known for amyloid fibrils. Conclusion: LVEM reproduced key ultrastructural findings from TEM, including well-defined images of diagnostic deposits and podocyte abnormalities, as well as precise measurement of amyloid fibrils. Its simpler setup, lower cost, and compact design suggest LVEM is not only an alternative in well-funded labs but also a practical solution for renal pathology in developing countries lacking full-scale EM facilities. These results support further validation of LVEM as a globally accessible diagnostic platform.
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