An Investigation of the Diagnostic Potential of Autofluorescence Lifetime Spectroscopy and Imaging for Label-Free Contrast of Disease

The work presented in this thesis aimed to study the application of fluorescence lifetime spectroscopy (FLS) and fluorescence lifetime imaging microscopy (FLIM) to investigate their potential for diagnostic contrast of diseased tissue with a particular emphasis on autofluorescence (AF) measurements of gastrointestinal (GI) disease. Initially, an ex vivo study utilising confocal FLIM was undertaken with 420 nm excitation to characterise the fluorescence lifetime (FL) images obtained from 71 GI samples from 35 patients. A significant decrease in FL was observed between normal colon and polyps (p = 0.024), and normal colon and inflammatory bowel disease (IBD) (p = 0.015). Confocal FLIM was also performed on 23 bladder samples. A longer, although not significant, FL for cancer was observed, in paired specimens (n = 5) instilled with a photosensitizer. The first in vivo study was a clinical investigation of skin cancer using a fibre-optic FL spectrofluorometer and involved the interrogation of 27 lesions from 25 patients. A significant decrease in the FL of basal cell carcinomas compared to healthy tissue was observed (p = 0.002) with 445 nm excitation. A novel clinically viable FLS fibre-optic probe was then applied ex vivo to measure 60 samples collected from 23 patients. In a paired analysis of neoplastic polyps and normal colon obtained from the same region of the colon in the same patient (n = 12), a significant decrease in FL was observed (p = 0.021) with 435 nm excitation. In contrast, with 375 nm excitation, the mean FL of IBD specimens (n = 4) was found to be longer than that of normal tissue, although not statistically significant. Finally, the FLS system was applied in vivo in 17 patients, with initial data indicating that 435 nm excitation results in AF lifetimes that are broadly consistent with ex vivo studies, although no diagnostically significant differences were observed in the signals obtained in vivo.Open Acces

Urological Cancer 2021

Cancer of the urological sphere is a disease continuously increasing in numbers in the statistics of tumor malignancies in Western countries. Although this fact is mainly due to the contemporary increase of life expectancy of the people in these geographic areas, many other factors do contribute as well to this growth. Urological cancer is a complex and varied disease of different organs and mainly affects the male population. In fact, kidney, prostate, and bladder cancer are regularly included in the top-ten list of the most frequent neoplasms in males in most statistics. The female population, however, has also increasingly found itself affected by renal and bladder cancer in the last decade. Considering these altogether, urological cancer is a problem of major concern in developed societies. This Topic Issue of Cancers intends to shed some light into the complexity of this field and will consider all useful and appropriate contributions that scientists and clinicians may provide to improve urological cancer knowledge for patients’ benefit. The precise identification of the molecular routes involved, the diagnostic pathological criteria in the grey zones, the dilemma of T1G3 management, and the possible treatment options between superficial, nonmuscle-invasive and muscle-invasive diseases will be particularly welcomed in this Issue

An investigation of the surgical treatment of endometriosis

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

Aquisição, tratamento, arquivo e difusão de exames de endoscopia

Dissertação de mestrado integrado em Engenharia BiomédicaDe entre os diversos tipos de exames de endoscopia, a esofagogastroduodenoscopia assume um papel preponderante devido a ser o método ideal para examinar a mucosa do trato digestivo alto, bem como para detetar inúmeras patologias gastrenterológicas. O resultado deste tipo de exames é, geralmente, um relatório composto por um conjunto de frames capturados durante o exame, eventualmente acompanhado por um vídeo. Hoje em dia, apenas as imagens juntamente com o relatório endoscópico, são arquivadas. O facto de o vídeo não ser arquivado pode conduzir a um incómodo no bem-estar do paciente, assim como a um acréscimo de custos e tempo despendido, pois frequentemente o mesmo é necessário para revisão e validação da hipótese de diagnóstico, bem como para comparação de segmentos do vídeo com exames futuros. Mesmo nos casos em que a informação é arquivada, a falta de reutilização e partilha de informação e vídeos entre entidades contribui, mais uma vez, para uma repetição desnecessária de exames. A existência de um arquivo de vídeos endoscópicos seria uma mais-valia, pois além de resolver os problemas referidos ainda possibilitaria a sua utilização para fins de pesquisa e investigação, além de disponibilizar exames para servirem como referência para estudo de casos similares. Neste trabalho é proposta uma solução abrangente para a aquisição, tratamento, arquivo e difusão de exames de endoscopia. O objetivo passa por disponibilizar um sistema capaz de gerir toda a informação clínica e administrativa (incluindo conteúdo audiovisual) desde o seu processo de aquisição até ao processo de pesquisa de exames antigos, para comparação com novos casos. De forma a garantir a compatibilidade lexical da informação partilhada no sistema, foi utilizado um vocabulário endoscópico estandardizado, o Minimal Standard Terminology (MST). Neste contexto foi planeado um dispositivo (MIVbox) orientado à aquisição do vídeo endoscópico, independentemente da câmara endoscópica utilizada. Toda a informação é armazenada de forma estruturada e normalizada, possibilitando a sua reutilização e difusão. Para facilitar este processo de partilha, o vídeo sofre algumas etapas de processamento, de forma a ser obtido um vídeo reduzido e as respetivas características do conteúdo. Deste modo, a solução proposta contempla um sistema de anotação que habilita a pesquisa por conteúdo, servindo assim como uma ferramenta versátil para a investigação nesta área. Este sistema é ainda dotado de um módulo de streaming, no qual é transmitido, em tempo real, o exame endoscópico, disponibilizando um canal de comunicação com vídeo unidirecional e áudio bidirecional, permitindo que os profissionais ausentes da sala do exame deem a sua opinião remotamente.Among the different kinds of endoscopic procedures, esophagogastroduodenoscopy plays a major role because it is the ideal method to examine the upper digestive tract, as well as to detect numerous gasteroentologic diseases. The result of such procedures is usually a written report that comprises a set of frames captured during the examination, sometimes complemented with a video. Nowadays only the images are stored along with the endoscopic report. Not storing the video may lead to discomfort concerning the patient’s well-being, as well as an increase of costs and time spent, because it is often necessary to review and validate the diagnostic hypothesis, and compare video segments in future exams. Even in the cases in which the information is stored, the lack of reutilization and share of information and videos among entities contributes, once again, for an unnecessary repetition of exams. Besides solving the problems mentioned above, the existence of an endoscopic video archive would be an asset because it would enable research and investigation activities. Furthermore it would make available exams to serve as a reference for the study of similar cases. In this work, an extended solution of acquisition, processing, archiving and diffusion of endoscopic procedures is proposed. The aim is to provide a system capable of managing all the administrative and clinical information (including audiovisual content) from its acquisition process to the searching process of previous exams, for comparison with new cases. In order to ensure compatibility of lexical information shared in the system, a standardized endoscopic vocabulary, the Minimal Standard Terminology (MST) was used. In this context, a device for the acquisition of the endoscopic video was designed (MIVbox), regardless of the endoscopic camera that is used. All the information is stored in a structured and standardized way, allowing its reuse and sharing. To facilitate this sharing process, the video undergoes some processing steps in order to obtain a summarized video and the respective content characteristics. The proposed solution provides an annotation system that enables content querying, thus becoming a versatile tool for research in this area. This system is also provided with a streaming module in which the endoscopic video is transmitted in real time. This process uses a communication channel with one-way video and two-way audio, allowing professionals absent from the exam room to give their opinion remotely