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It is unfortunate that much of what we need to do to the human body to treat it requires that we cut it open, as this creates a whole set of risks and complications for science and medicine. Thankfully, science and technology march on in the quest to reduce our dependence on invasive surgeries. An interesting Economist article takes a look into some of the more unconventional tools that are being explored as potential non-invasive replacements.

Let’s take a classic problem which often has a surgical solution: the removal of a cancerous tumor. How could we solve this without resorting to the use of a scalpel?

• Of course, there’s radiation – which, as we’ve discussed before, is potentially dangerous if the radiation dosage isn’t calculated sufficiently well.
• The use of ultrasound as a means to visualize what’s going on under the skin is commonly known. But a small startup in Washington called Mirabilis Medica came up with a means to use ultrasound not only to see a tumor or blood clot, but also to focus it and generate enough heat to destroy the tumor/blood clot (what they’ve called High-Intensity Focused Ultrasound or HIFU; explanatory diagram below).

• Professor Weihong Tan at the University of Florida published a paper in PNAS in early 2009 a means of using light as a way of non-invasively activating blood clotting. The system is described in the picture below, but relies on a means of inhibiting the activity of Thrombin (a protein that helps control blood clotting) with short stretches of DNA (which they’ve cutely termed “Thrombin-binding Aptamers” or TBA) that have been chemically modified to be able to change shape in the light (cis-trans isomerization under photon stimulation). The vision is to one day be able to inject a patient with these Thrombin-TBA “molecular clasps” and hit the patient with a light source, cutting off the blood flow to the tumor and all without needing invasive surgery!

These only scratch the surface of what new technologies and scientific advances might be capable of. Son et lumiere (sound and light) as surgical tools indeed!

(Image credit) (Image credit – Mirabilis Medica) (Image credit – PNAS publication)

When I heard that GE’s CEO and Chairman Jeffrey Immelt was going to be at this year’s Web 2.0 Summit, I expected an “old business” CEO weakly touting all the ways that his company was embracing social media. I did not expect him to come to demonstrate a portable ultrasound device ‘with the works’:

GE’s new Vscan pocket ultrasound device is reminiscent of the mobile phone-powered portable ultrasound and light microscope that we’ve covered before, but while those mobile phone attachments felt more like demonstrations of mobile phone/medical technology mashup curiosities, the Vscan feels like its in an entirely separate category:

• pushed by a major healthcare technology company
• fits in the palm of your hand
• thumb operated UI to adjust gain or look at a color-doppler scan
• high quality display
• real-time imaging capability
• preset modes to fit what doctors are most likely to use
• support for WiFi transmission of information
• ability to annotate with voice recorder
• Immelt: “could be the Stethoscope of the 21st century”

Medical technology blog Medgadget captured a fascinating preview on YouTube:

In his presentation at the Web 2.0 Summit, Immelt captures what I perceive to be the real significance behind the VScan:

“This has the same power and image quality of an ultrasound from 2-3 years ago that cost $250,000! This is Moore’s Law in action. To get this image scale in 1995, you had a product that weighed several hundred pounds!”

On a medical level, this opens up new doors for physicians to study illnesses and treat patients in a wider range of regions, but even beyond that, it underscores the ability of technological innovation to

increase the ability of doctors, scientists, consumers, and patients all over the world to access the latest in scientific and medical technology.

(Image credit – Immelt and Vscan from GE website)

A few weeks ago I wrote a post about the development of the Standoff Patient Triage Tool, an impressive use of lasers in order to make health critical readings of patients from a distance. Well one of the best things about science is that many people can utilize the same tools to come up with unique methods and solutions for any given problem. In this case, researchers have used lasers to develop a technology that could someday revolutionize imaging procedures in medicine.

Photoacoustic imaging of melanoma in vivo.

Photoacoustic tomography is the basis behind a new imaging technology being developed in hopes of providing more flexible and cost effective devices for physicians. The technique takes advantage of ultrasonic emissions produced when a non-ionizing laser pulse is directed towards a tissue. The emissions, resulting from transient thermoelastic expansion of the target tissue due to absorption of the laser energy, are detected and analyzed with various algorithms to construct an image (2D or 3D) of the targeted area. This differs from the reliance on the doppler shift produced by the reflected laser beam in the SPTT.

Images of vasculature like the one seen on the right can be produced by using photoacoustic tomography without the injection of contrast as differences between the molecular composition of the target can be used instead. In the example to the right, the difference between oxygenated and deoxygenated blood is an effective natural contrast. Photoacoustic tomography also presents other benefits over traditional imaging techniques as explained by The Economist:

CT scans also involve potentially harmful ionising radiation. And MRI and CT scans are very expensive, using machines that cost millions of dollars and require dedicated staff to operate them. Photoacoustic tomography, by contrast, could eventually be performed using portable hand-held devices, similar to those used for ultrasound scanning. This would allow doctors to diagnose and monitor patients in clinics, and reduce the need to refer them to consultants.

The adaptability of this nascent technology is also impressive as researchers are already looking at using it to detect specific ailments such as brain lesions and cancer. In the case of cancer, the ability to accurately image vasculature could allow doctors to monitor patients for the development of new blood vessels (angiogenesis) a hallmark of cancer development.

While there are some issues to work out with this new technique, such as the lack of imaging depth (ultrasound signal emitted is reduced the deeper the tissue lies) and ultrasound distortion from varying tissue types within the human body (e.g. bone vs muscle), photoacoustic imaging is a very promising new technology.

(Source)

When most people think of laboratory/medical equipment, they think of massive machines full of sophisticated electronics and gear. But, thanks to Moore’s Law (which helps electronics get smaller, cheaper, and more power efficient), equipment that formerly required massive machinery, may be duplicated in the form of handheld devices, like this USB ultrasound gear from Laborie Medical Technologies (FDA approved):

LMT bundles software with their ultrasound probes to deliver images on PCs running Windows XP, but to use it on a phone you’ll need software from William Richard’s group from Washington University in St. Louis, who, with funding from Microsoft, have created a client allowing you to access ultrasound images on Windows Mobile devices! They’ve even released an SDK to help other enterprising researchers create other applications which can make use of these portable UltraSound devices and have them work on any Windows Mobile phone with a USB interface!

Such gear could bring ultrasound access to countries or regions lacking significant healthcare infrastructure, and similar devices could dramatically change how biomedical research is conducted.

For more information, read the presentation that David M. Zar gave at the Medical Records Institute’s TEPR+ (Towards the Electronic Patient Record) conference, and check out the live video demonstration as well as the UltraSoundUSB page on YouTube:

Let’s hope this is only the first in a long line of portable electronics interfacing with readily available mobile phone technology.

(Image credit – The Daily What)