I saw on the news today that an insurance company declined to pay for MRI scanning of a woman who has high probability of having breast cancer until she brought this up to Fox News. According to the article, mammogram is an important screening tool for detecting breast cancer. But experts say for some women a mammogram may not be enough. In women who have very dense breast tissue, a mammogram may not be able to pick up early tumors. That is why many doctors recommend an MRI for certain patients. But an MRI can cost 10 times more than a mammogram, so some insurance companies may be reluctant to cover the cost [1].

From my own research I know that MRI has high anatomical resolution and contrast. Its superior soft tissue discrimination enables the identification of cancerous lesions. However, this imaging modality not only cost a fortune, it is also very time consuming. A complete volume usually takes up 10min, so an entire procedure may last hours. I guess there are advantages and draw backs for each imaging modality, but for high risk patients I believe better imaging quality is more important than anything else. So when it comes to insurance companies, one needs to make sure it has to be reliable.

[1] http://www.myfoxny.com/dpp/health/090316_MRI_Screening_for_Breast_Cancer

Tags: MRI, breast cancer

This article starts up with a descriptive description on knee replacement surgery. Then it goes on talking about the long term goal about remote computer assisted surgery, which is to develop a way to perform surgery remotely on soldiers in battle or astronauts in space. It says computers assisted surgery is more accurate and precise. These surgical advances are not limited to orthopedics but also provide similar advantages across the board from brain surgery to gynecology [1].

Robotic surgery goes a step beyond computer-assisted surgery as the surgeon performs the operation through the mechanical arms of a robot (surgical cart). The doctor controls the arms from a separate console in the operating room that has a three dimensional view of the operating field [1]. This includes the da Vinci which I blogged about earlier. This article gave a good brief summary of the capabilities of computer aided surgery and the advancement in the field. I believe one drawback of this is the lack of hepatic feedback to the surgeons during operation. However many researchers are working hard on this problem now and I hope there will be a good solution to that in the near future.

[1] http://news.medill.northwestern.edu/chicago/news.aspx?id=119933

Tags: computer assisted surgery, remote surgery

Patient Safety Technologies, Inc. announced that the Northern Indiana region of the Sisters of St. Francis Health Services, Inc. has adopted the Safety-Sponge System. The Safety-Sponge System is a computer-assisted sponge counting system proven to increase patient safety and reduce healthcare costs through the virtual elimination of retained surgical sponges.  The system will be implemented in all 33 operating rooms as well as the labor and delivery departments [1].

When I was taking a computer assisted surgery related course last year, I remember my professor saying that surgeons would often accidently leave surgical tools in patients. The most common tools that get left behind in patient are sponges. The Safety-Sponge System would eliminate this problem. The article did not go into details of how the system works, but as long as it makes the surgery safer and does not create more complications, I think it’s a great idea.

[1] http://www.marketwatch.com/news/story/patient-safety-technologies-inc-announces/story.aspx?guid={FD58DCCC-B9BF-44F4-8BFC-ADA6C3DDA268}&dist=msr_7

Tags: surgery safety, Safety-Sponge System

My friend sent me a video on Microsoft’s future vision on health care. It can be found on . The video portrays a world integrated with multi touch surfaces, seamless authorizing and data transfer, which makes personalized health care extremely easy, fast and convenient. The technology not only benefits the patients but also the doctors. They are empowered with a view of health records across multiple sources and have fast access to powerful imaging tools and resources.

I assume most people would think the video is cool, but I question the reality of the idea. The cost of this system would be tremendous and serious security issues will rise. However, it’s hard to predict exactly how technology will unfold. We are constantly looking forward and gathering insights to imaging how technology investments today can improve people’s way of life in the future [1].

[1] www.vimeo.com/3079840

 Tags: Microsoft, health care

I learned about spine injections in my computer aided interventional oncology systems and applications class today, so I decided to read more about it. Minimal access spinal surgery (MASS) is the latest high tech options for spinal surgery.

The aim of MASS is to reduce 'collateral damage' to muscles, ligaments and soft tissues that is typically associated with traditional open spinal surgery whilst obtaining the same clinical outcomes as traditional open spinal surgery. Some benefits include reduced blood loss and post-operative incisional pain, minimized respiratory difficulties, improved mobilization, early discharge from hospital, and enhanced rehabilitation and early return to activities and work [1].

From what I learned so far, this is a good procedure to consider for those that need spinal surgery. Spine contains critical nerve systems and minimal invasive procedures are recommended. Computer assisted operative surgery (CAOS) can be used to increase accuracy,  however more surgeon training is required.

[1]  http://www.pharmiweb.com/pressreleases/pressrel.asp?ROW_ID=5760

Tags: spinal surgery, MASS, CAOS

I recently came across another article on CT scan for dental implants. However, this time they’re bringing this technology into the operation room. Computer-aided implantation using intra-operative CT scans is currently limited to a few major neurosurgical academic centers and has not been applied to any dental surgery offices in the US. It proves real-time tracking of surgical results. The technology uses a Cone Beam CT, as oppose to conventional CT, which provides 3-D radiographic imaging, on-site, while reducing radiation 90% compared to hospital-based computer-assisted tomography [1].

I think there is still a lot of work to be done before this comes into practice because real time tracking does not always perform as well as it is expected. Although there is a chance for increased accuracy, the patient is also exposed to more radiation. Accuracy evaluations of the procedures are also crucial step in this developing process.

[1] http://www.dentalofficemag.com/display_article/353728/54/none/none/IndNw/Interventional-CT-scanner-for-dental-implants-comes-to-U.S.

Tags: dental implant, CT

Providence Regional Medical Center in Everett has recently bought a 1.5 million dollar da Vinci surgical system, and over a dozen operations have already been performed by it without complications [1].

I heard a lot about da Vinci in my undergrad, mostly because it’s one of the most widely used surgical robotic system. The article says that there are approximately 750 of them in the US. Da Vinci is famous for allowing specially trained surgeons to perform minimally invasive laparoscopic procedures. But what was interesting is that it mentions the robot is most useful in prostate surgery. My supervisor and his research team are currently working on prostate cancer treatment interventions. I’ve read many previous researches on ultrasound and MRI, but I have never heard of this being performed by da Vinci.

Perhaps this procedure is more costly and therefore is less common. The article gives no further information about how the surgery is being done or any comparison with other surgical instruments. So it’s hard for me to have any opinions. However, judging by its popularity, even if it’s not the best choice for prostate cancer, it’s definitely good for other treatments.

[1] http://www.snohomishcountybusinessjournal.com/article/20090130/SCBJ02/701299650/-1/SCBJ

Tag: da Vinci, prostate cancer, laparoscopic procedures, robotics

From the EurekAlert website this week, I encountered a familiar topic. Physical therapists at UT Southwestern Medical Center are evaluating a new mechanical arm that allows people recovering from neurological injuries such as strokes and traumatic brain injury to enter a virtual world where they can repeatedly practice movements needed to regain arm strength and movement [1].

I did my undergrad thesis on a related topic: robotic stroke assessment using a device called KINARM. We used the robot to assess the severity of stroke by evaluating patient performance on a number of tasks. During the project, I also read into robots that aid patients during rehabilitation to improve their repaired movements, but none of them were as interesting as the Armeo in this article. It seems like they took the idea to the next level by incorporating entertainment into the program. The patients in the article compared it to a video game. It gave them a goal and is provided more fun than a regular therapy. A computer records speed and frequency of repetitions to track progress.

The studies I read before showed a significant difference between stroke patients who underwent robotically assisted rehabilitation. The Armeo from UT Southwestern Medical Center not only achieves this purpose but also making the process more enjoyable.

[1] http://www.eurekalert.org/pub_releases/2009-01/usmc-ptt012709.php

This week, I came across an article on computer-aided dental implant planning.  It describes how Nobel Biocare's Procera surgical planning software converts a patient's double CT scan data into a virtual three-dimensional model of the alveolar bone and overlying prosthesis. Using these images, the practitioner virtually places implants in the bone in precise relation to their position in the final prosthesis. This increases the predictability of replacing missing teeth in partially and fully edentulous cases [1].

I have seen many other research areas that use the CT volume for planning surgical operations, but I never encountered any computer aided procedures in my dentist’s office. I would be very interested to see a demonstration of how this is done. From my knowledge, CT scans can provide good images of bone structures and it gives a 3D volume of the patient’s anatomy. A lot of information can be extracted from the raw data by image processing techniques. I think it’s a great idea to use it for dental purposes or just as a simple training tool. The procedure can be customized and is more accurate and less time consuming than the standard operation. It seems to be a good idea and also has a high market demand. 

[1] http://www.find-health-articles.com/rec_pub_18805228-computer-aided-dental-im...

Tags: dental implant, CT, Procera

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