Telemedicine

Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios

Technology utilization program report, 1974

The adaptation of various technological innovations from the NASA space program to industrial and domestic applications is summarized

Progress Report No. 14

Progress report of the Biomedical Computer Laboratory, covering period 1 July 1977 to 30 June 1978

Use of advanced echocardiography imaging techniques in the critically ill

Background: Critical care echocardiography has become standard of care in the ICU. New technologies have been developed and have shown potential clinical utility to elucidate myocardial dysfunction not seen with conventional imaging. We sought to determine the feasibility and potential clinical benefit of these techniques in common situations seen in the ICU. Hypothesis: Advanced echo techniques would be feasible in the majority of critically ill patients and have prognostic significance, clinical utility and diagnose cardiac abnormalities, potentially in a more sensitive manner than conventional techniques. Results: (a) Speckle tracking echocardiography (STE) Left ventricle and RV analysis with STE was feasibly in ~80% of patients. More dysfunction was found using STE vs conventional analysis. RV dysfunction assessed by STE held significant prognostic relevance in those with septic shock and highlighted subtle dysfunction induced by mechanical ventilation, both in animal and human studies. (b) 3D transthoracic echocardiography (3D TTE) Despite finding 3D TTE feasible in mechanically ventilated ICU patients (LV 72% and RV 55%), it lacked necessary low variability and high precision vs standard measures. (c) Myocardial contrast perfusion echocardiography (MCPE) Assessing acute coronary artery occlusion in the ICU patient is challenging. Troponin elevation, acute ECG changes, regional wall motion analysis on echo and overall clinical acumen often lack diagnostic capabilities. MCPE was found to be feasible in the critically ill and had better association predicting acute coronary artery occlusion vs clinical acumen alone. Conclusions: STE, 3D TTE and MCPE are feasible in the majority of ICU patients. STE may show dysfunction not recognised by conventional imaging. 3D TTE for volumetric analysis is likely not suitable for clinical use at this stage. MCPE may help guide interventions in acute coronary artery occlusion

Development of Optical Devices for Digital Medicine

Department of Biomedical EngineeringAdvances of technology have made a revolution that interconnects industrial devices and fuses the boundaries of digital, physical and biological spaces. These technologies such as cloud computing, 3D printing technology, big data, internet of things (IOT), artificial intelligence (AI), and maturity of system integrations have been improved every year, changing our daily life quickly in intelligent and convenient ways. In this days, these explosions of technology, changing the way we live and think, is referred to 4th industrial revolution. As we know, every industry is affected by the new waves of technologies, digitalization and connectivity, and the biomedical or medical field is no exception. Healthcare fields have benefited mostly from recent technical improvements, revolutionizing the medical systems in many terms in cost-effective ways. Particularly, ???digital medicine??? has been recently came into the limelight as one of the uprising fields. In digital medicine, traditional medical devices and diagnostic programs have become miniaturized, digitalized, and automated. As taking advantages of digital medicine, specific fields related to digital pathology, point-of-care (POC) diagnostics, and application of deep learning or machine learning technologies have shown the great potentials not only in biomedical academia but also in the revenues of their markets. It allows to connect devices, hospital equipment, and to accelerate efficiencies in health service such as diagnosis, and to reduce the cost of services. Moreover, interconnection between advanced technologies has been improved the access of healthcare to the places where hospital or medical services are limited. Furthermore, artificial intelligence has shown promising results related to disease screening especially using medical images. Although fields in digital medicine are prospering, still there are limitations that needs to be overcome in order to provide further advanced health services to patients in the various situations. In digital pathology, improvements of microscopic technologies, internets, and storage capabilities have reduced the time-consuming processes. The simple transformation of microscopic image to digital have successfully alternated many limitations in the analogue histopathology workflow to efficient and cost saving ways. However, tissue staining is currently referred as one of the bottleneck that makes workflow still lengthy, labor-intensive, and costly. In the POC diagnostic fields, various digitalized portable smartphone-based diagnostic devices have been introduced as alternatives to conventional medical services. These devices have provided the quality assurance of diagnostics by taking advantages of sharing, and quantitative analysis of digital information. However, most of these works have been focused on replacing diagnostic process which mostly done in laboratory settings. As medical imaging devices and trained clinicians or practitioners are limited, there are also high demands on clinical imaging-based diagnostics in developing countries. In this thesis, computational microscope using patterned NIR illumination was developed for label-free quantitative differential phase tissue imaging to bypass the staining process of the pathology workflow. This system overcame the limitations found in the conventional quantitative differential phase contrast in a LED array microscope, allowing to captured light scattering and absorbing specimen while maintaining weak object approximation. Moreover, portable endoscope system was developed integrating the additive production technologies (3D printing), ICT, and optics for POC diagnostics. This innovative POC endoscope demonstrated comparable imaging capability to that of commercialized clinical endoscope system. Furthermore, deep learning and machine learning models have been trained and applied to each devices, respectively. Generative adversarial network (GAN) was applied to our NIR-based QPI system to virtually stain the label-free QPI which look comparable to image that is captured from bright field microscope using labeled tissue. Lastly, POC automated cervical cancer screening system was developed utilizing smartphone-based endoscope system as well as training the machine learning algorithm. 3-5% of acetic acid was applied to the suspicious lesion and its reaction was captured before and after application using smartphone endoscope. This screening system enables to extract the features of cancers and informs the possibility of cancer from endoscopic images.clos

Progress Report No. 12

Progress report of the Biomedical Computer Laboratory, covering period 1 July 1975 to 30 June 1976

Advances in Biomedical Applications and Assessment of Ultrasound Nonrigid Image Registration.

Image volume based registration (IVBaR) is the process of determining a one-to-one transformation between points in two images that relates the information in one image to that in the other image quantitatively. IVBaR is done primarily to spatially align the two images in the same coordinate system in order to allow better comparison and visualization of changes. The potential use of IVBaR has been explored in three different contexts. In a preliminary study on identification of biometric from internal finger structure, semi-automated IVBaR-based study provided a sensitivity and specificity of 0.93 and 1.00 respectively. Visual matching of all image pairs by four readers yielded 96% successful match. IVBaR could potentially be useful for routine breast cancer screening and diagnosis. Nearly whole breast ultrasound (US) scanning with mammographic-style compression and successful IVBaR were achieved. The image volume was registered off-line with a mutual information cost function and global interpolation based on the non-rigid thin-plate spline deformation. This Institutional Review Board approved study was conducted on 10 patients undergoing chemotherapy and 14 patients with a suspicious/unknown mass scheduled to undergo biopsy. IVBaR was successful with mean registration error (MRE) of 5.2±2 mm in 12 of 17 ABU image pairs collected before, during or after 115±14 days of chemotherapy. Semi-automated tumor volume estimation was performed on registered image volumes giving 86±8% mean accuracy compared with a radiologist hand-segmented tumor volume on 7 cases with correlation coefficient of 0.99 (p<0.001). In a reader study by 3 radiologists assigned to mark the tumor boundary, significant reduction in time taken (p<0.03) was seen due to IVBaR in 6 cases. Three new methods were developed for independent validation of IVBaR based on Doppler US signals. Non-rigid registration tools were also applied in the field of interventional guidance of medical tools used in minimally invasive surgery. The mean positional error in a CT scanner environment improved from 3.9±1.5 mm to 1.0±0.3 mm (p<0.0002). These results show that 3D image volumes and data can be spatially aligned using non-rigid registration for comparison as well as quantification of changes.Ph.D.Applied PhysicsUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/64802/1/gnarayan_1.pd