Several modern medical marvels that might be just months away
By James Laskaris
New medical innovations are hitting American healthcare just about daily, and several more jaw-dropping technologies might be just a few months away. Here are a few technologies to be on the lookout for in 2018.
Wideband Medical Radar
Painful mammograms requiring the patient to stand while her breast is compressed in an x-ray machine might soon be a thing of the past. Current mammography techniques are not only painful but expensive, and may expose the patient and clinicians to ionizing radiation.
But medical radar is now being developed for imaging breast cancers, using radio waves instead of sound or radiation. Medical radar uses electromagnetics similar to a microwave oven or cell phone, but at extremely low power. Plus, the process takes less than a minute, and both breasts can be scanned while the patient lies comfortably on a table.
Further, the system is designed to use multiple antennae, which scan the breast at frequencies of 4GHz to 10GHz. Initial designs allow the patient to lie flat on a table as opposed to standing. The resulting 3D image, similar to current breast tomosynthesis, gives physicians a highly detailed view of the breast. Medical radar is also suitable for imaging dense breasts. As opposed to ultrasound, it has the ability to penetrate deeply within the body and is not obstructed by bone or other barriers such as air pockets.
One company that is investigating this technology is U.K.-based Micrima Ltd., which was tasked with developing the microwave radar breast-imaging technology pioneered by the University of Bristol. In fact, the company’s MARIA system received European regulatory approval in 2015 and is currently being deployed in clinical trials throughout the United Kingdom.
A key reason that may propel its usage? Conventional equipment for digital breast x-rays might cost close to a quarter-million dollars, whereas a medical radar unit will cost one-tenth as much.
3-D Bioprinting of Human Tissue
The promise of 3D bioprinting of human tissue is almost too much to imagine. A fully functioning kidney created from the patient’s own cells might be decades away, but the first steps in that direction are already being taken.
The process is based on liquefying cells from either the patient or a donor in order to provide oxygen and nutrients. The cells are then deposited on a scaffold, layer by layer, based on a predetermined configuration customized to the patient. Then, the bioprinted structure is incubated until it becomes viable tissue.
Several universities have created their own bioprinters, and manufacturers such as the Swiss-based regenHU Ltd. and German Envision TEC are selling 3D bioprinting equipment and materials.
Moreover, Calif.-based Organovo and some other companies are currently providing functional human tissue for pharmaceutical testing—and, in December 2016, Organovo presented the first data showing survival and sustained functionality of its 3D bioprinted human liver tissue when implanted into animal models. Organovo aims to submit such therapeutic liver tissue to the U.S. FDA in as soon as three years.
Even more incredible is the progress of Russian 3D Bioprinting Solutions, which printed a functioning thyroid in a mouse model and claims to be ready to do the same in humans.
Perhaps a more realistic near-term hope than creating whole organs is to print tissue for simple transplant parts, such as blood vessels, heart muscle patches, or nerve grafts. After all, printing repair cells grown with a patient’s own cells would offer a surgeon the option of repairing organs with tissue that is a perfect match, as opposed to replacing them with completely foreign tissue.
Smart Probes and Scalpels
Smart probes and smart scalpels are designed to be tissue-selective, targeting a specific type of tissue such as cancerous, vascular, or nerve tissue. The technology is for use in microsurgical procedures, including repair of cerebral aneurysms, anastomosis of blood vessels or nerves, brain tumor resection, and acoustic neuroma removal.
Image components can include spectroscopy, MRI, and mechanical and electrical impedance. Therapeutics could include radiation, high-intensity focused ultrasound, acoustic, and radiofrequency mechanical energy.
The current technology from research centers, such as Livermore, Calif.-based Lawrence Livermore National Laboratory, the Massachusetts Institute of Technology, and the Sandia National Laboratory, is being spun off to start-up companies. Moreover, Livermore has partnered with San Jose-based BioLuminate, Inc., to develop Smart Probe, which is designed to distinguish between healthy and cancerous tissue.
During a procedure, the probe is inserted into the tissue and guided to the location of the tumor. What’s more, sensors on the tip of the probe measure optical, electrical, and chemical properties that are known to differ between the tissues. Smart Probe can detect five to seven known indicators of breast cancer.
One distinct advantage is that tissue measurements are made in real time in both normal and suspicious tissue.
The Smart Scalpel, developed at Sandia, is based on the same principle of detecting cancer cells as a surgeon cuts away a tumor obscured by blood, muscle, and fat. A dime-sized device called a biological microcavity laser employs an optical reflectance spectroscopy as part of a line scan imaging system to identify and selectively target blood vessels in a vascular lesion for thermal treatment with a focused laser beam. The goal? To help surgeons more accurately cut away malignant growths while minimizing the amount of healthy tissue removed.
Electromagnetic Acoustic Imaging
Electromagnetic acoustic imaging, or EMAI, is an emerging imaging technology that combines bioelectromagnetism with acoustics. The result is an ultrasound device that’s safer than a CT and can provide images that approach MRI quality. It offers physicians the ability to distinguish between malignant and benign lesions at a fraction of the cost of higher-end systems, such as MRI or PET.
The science is based on dissimilar tissues reacting differently to outside stimuli. Each layer of tissue will vibrate at its own unique frequency when stimulated. This can be measured and converted into an image by means of ultrasound detectors. Specifically, researchers have used light, ultrasound, and electromagnetic energy for stimulating tissue.
Moreover, cancerous tissue is 50 times more electrically conductive than normal tissue, and electromagnetic energy is also able to penetrate much deeper into the body than light. This makes electromagnetic acoustic imaging an excellent technology for diagnosing a whole range of tumors despite their location.
Studies have shown that the low levels of electromagnetic energy required for the body are safe and can detect tumors as small as 2mm in diameter. Plus, not only is EMAI effective, less expensive, and safe, it’s fast and the equipment is portable.
One company that has developed an EMAI system is Italian device manufacturer Medielma. With Medielma’s ESO Prost 9, for instance, physicians can diagnose prostate cancers while patients simply lie on the couch—without requiring them to disrobe or undergo physical exams or x-rays. The technology is currently being utilized in Europe.
Treating Stroke with “Nanobots”
Nanotherapeutics—aka: treating disease on the molecular level—is already being used in the treatment of cancer and infections. Now, emerging targets of nanobots are breaking up stroke-causing blood clots and the precision delivery of drugs for reversing the effects of stroke—the No.5 killer in the United States.
Scientists have been studying platelet-sized nanobots coated with a tissue plasminogen activator (tPA), one of the most effective clot-busting drugs known. These nanobots are fabricated as aggregates of multiple smaller nanoparticles. The microscale aggregates remain intact when flowing in blood under normal conditions, but break up into individual nanoscale components when exposed to the blocked artery.
The result can be faster delivery of the drug, quicker clot-busting, and fewer side effects from the tPA such as bleeding or hemorrhaging, since less tPA is delivered to the non-clotting vessels in the body. In fact, tests conducted on mice in 2013 proved dramatically effective.
Not only can the patient’s life be saved, but recovery time is slashed and treatment costs are greatly reduced. The best part: These nanobots to treat stroke might only be two or three years away.
“Viral” Blood Filters
Blood infections can be caused by a wide range of pathogens, parasites, and toxins, and can often be fatal when a patient is already in a compromised state. They’re also extremely expensive to treat, costing an average of $45,000 per patient.
Moreover, blood filters have been used in dialysis, blood transfusions, and bypass systems for years. And scientists are now developing “viral” filter technology designed to remove infections, circulating tumor cells, and toxins from the bloodstream in order to allow drug therapies to be more effective.
Several designs are being studied. One promising technology, the Spleen-on-a-Chip—developed by the Wyss Institute for Biologically Inspired Engineering in Boston—is focused on using magnetic nano beads that target a wide variety of pathogens. The magnetic nano beads bind to pathogens in the patient’s blood. The blood is then passed through microchannels in an external filter system that removes the nano beads before the blood is returned to the patient.
The Aethlon Hemopurifier, developed by San Diego-based Aethlon Medical, is another system currently in clinical trials in the U.S. Its first target is to remove pathogens such as HIV, hepatitis C, and other viruses from a patient’s bloodstream. The Hemopurifier is based on using cyanovirin, a plant-derived antibody that attracts the virus in the blood, allowing the larger cells to pass.
The company is also developing membranes to target cancer cells. And early studies show that the technology has decreased hepatitis C volume in dialysis patients by 57%.
Minimally invasive surgical and image-guidance technologies have allowed for more procedures to be performed faster and with less trauma to the patient. However, one important limitation with minimally invasive surgery is the absence of true tactile feel, which is a key factor in helping surgeons distinguish between tissue types and improve safety.
The di Vinci Surgical System, manufactured by Sunnyvale, Calif.-based Intuitive Surgical, is one innovation in minimally invasive surgery and allows surgery to be performed using robotic manipulators. But one possible challenge with this system is that surgeons must rely on vision and judgment, since they are not directly touching the surgical instruments, according to an FDA report .
The next generation of surgical robotics and instrumentation, however, is focused on incorporating tactile feel and adding “intelligence” into the system. After all, tactile feel is a primary key to adding more safety to the procedure by allowing the surgeon more natural pressure feedback on critical structures.
Several technologies are being developed to provide tactile feedback. Basic versions use color display screens that give the surgeon a visual presentation of the force being applied. And one design even uses force-sensing technology on the working end of the instrumentation, with the force on a device then mimicked on a transducer that a surgeon can sense.
More advanced systems provide direct feedback to the joystick. The promise of tactile feel will assist surgeons in distinguishing tissue types along with improving outcomes. In other words, tactile technology promises to have a major impact on outcomes and cost reduction.
James Laskaris, EE, BME, is a senior emerging technology analyst and serves as the primary analyst of high-end operating room technology at MD Byline, which provides hospitals with strategic sourcing data and advisory services in purchased services, capital equipment and technology, and consumables.