News & numbers “Our society stands at the edge of a golden age of medical technology. Congress, industry and
the Food and Drug Administration must step into this bold new world together.” Scott Whitaker, AdvaMed president and CEO
4D Flow MRI
Researchers at UEA have developed a new method to diagnose patients with heart failure in record time. The technology uses magnetic resonance imaging (MRI) to create detailed 4D flow images of the heart. According to the researchers, unlike an MRI scan – which can take up to 20 minutes or more – the new 4D heart MRI scan takes eight minutes. Lead researcher Dr Pankaj Garg, from UEA’s Norwich Medical School and an honorary consultant cardiologist at Norfolk and Norwich University Hospital (NNUH), said: “Heart failure is a dreadful condition resulting from rising pressures inside the heart. The best method to diagnose heart failure is by invasive assessment, which is not preferred as it has risks,” he said. “An ultrasound scan of the heart called echocardiography is routinely used to measure the peak velocity of blood flow through the mitral valve of the heart. However, this method can be unreliable. We have been researching one of the most cutting-edge methods of flow assessment inside the heart called 4D flow MRI. In 4D flow MRI, we can look at the flow in three directions over time – the fourth dimension.” The results provide a precise image of the
heart valves and blood flow inside the heart, helping doctors determine the best course of treatment for patients.
Cardiology patients at the NNUH were the first to trial the new technology. The team hope their work could revolutionise the speed at which heart failure is diagnosed, benefitting hospitals and patients worldwide. PhD student Hosamadin Assadi – also from UEA’s Norwich Medical School – said: “This new technology is revolutionising how patients with heart disease are diagnosed. However, it takes up to 20 minutes to carry out a 4D flow MRI and we know that patients do not like having long MRI scans,” he said. “So, we collaborated with General Electrics Healthcare to investigate the reliability of a new technique that uses super-fast methods to scan the flow in the heart, called Kat-ARC. We found that this halves the scanning time – and takes around eight minutes. We have also shown how this non-invasive imaging technique can measure the peak velocity of blood flow in the heart accurately and precisely.”
The team tested the new technology at the NNUH and at the Sheffield Teaching Hospitals NHS Foundation Trust in Sheffield. ‘Kat-ARC accelerated 4D flow CMR: clinical validation for transvalvular flow and peak velocity assessment’ was published in the journal European Radiology Experimental.
14 A new paradigm
A newly-developed 3D printing technique could be used to produce cost-effective customised microelectromechanical systems (MEMS). Mass-produced in large volumes for hundreds of consumer electronic products, MEMS also provide sensing capabilities to a range of medical devices. Frank Niklaus led research at KTH Royal Institute of Technology into a technique that avoids the limitations of conventional MEMS manufacturing. “The costs of manufacturing, process development and device design optimisations do not scale down for lower production volumes,” he said. “The result is engineers are faced with a choice of suboptimal off-the-shelf MEMS devices or economically unviable start-up costs.” The researchers built on a process called two-photon polymerisation, which can produce high resolution objects on a nano scale but are not capable of sensing functionality. On the 3D-printed structure
they fabricate features with a T-shaped cross-section, which work like umbrellas. They then deposit metal from above and, as a result, the sides of the T-shaped features are not coated with the metal. This means the metal on the top of the T is electrically isolated from the rest of the structure. With this method, he says, it takes only a few hours to manufacture a dozen custom- designed MEMS accelerometers using relatively inexpensive commercial tools. “The new capabilities offered by 3D-printed MEMS could result in a new paradigm in MEMS and sensor manufacturing. Scalability isn’t just an advantage in MEMS production, it’s a necessity. This method would enable fabrication of many kinds of new, customised devices.”
The research led by Niklaus was published in the journal Nature Microsystems & Nanoengineering.
Liquid brain cancer biopsy
A biosensor developed by researchers in Toronto could help physicians precisely diagnose brain cancer from a minute blood sample. To effectively treat brain cancer, physicians need to not only confirm the presence of a malignant tumour, but also identify whether it originated there (primary tumour) or moved to the brain (secondary tumour) from other organs. Physicians also need to know where in the organ the tumour is located. Because no existing diagnostic technique can accomplish this feat without surgery or a painful spinal tap. Bo Tan, professor at the institute for biomedical engineering, science and technology, Toronto Metropolitan University, and her colleagues wanted to develop a non- invasive test using a tiny amount of serum. They used high-intensity laser beams to form 3D nickel-nickel oxide nanolayers on a nickel chip. This resulted in an ultrasensitive biosensor that allowed them to detect minute amounts of tumour-derived materials, such as nucleic acids, proteins and lipids, that made it through the blood-brain barrier into
the circulation. The sensor detected these components using surface-enhanced Raman spectroscopy, which generated molecular profiles, or fingerprints, for each sample. The researchers then analysed these profiles with a deep neural network to find evidence of a brain tumour and define its type, as well as predict its location within the brain. Using the liquid biopsy platform, the researchers managed to detect brain cancer from just five microlitres of blood serum and distinguish it from breast, lung and colorectal cancer with 100% specificity and sensitivity. They had similar success distinguishing primary brain tumours from secondary tumours that had metastasised to the brain from the lung or breast. Profile analysis also allowed determination of which of nine brain compartments the tumour resided with 96% accuracy. The non-invasive nature of the test should allow healthcare specialists to monitor cancer development and make better treatment decisions, the researchers say. The research was published in the journal ACS Nano.
Medical Device Developments /
www.nsmedicaldevices.com
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