Download Biomedical Imaging and the future of Medicine

Biomedical Imaging of the
Future
Alvin T. Yeh
Department of Biomedical Engineering
Texas A&M University
16 November 2004
Biomedical Imaging
BMEN
Patient management and clinical care
• Qualitative observations
• Physical examinations
Physician experience/expertise
• Quality care
16 November 2004
Biomedical Imaging
BMEN
Biomedical Imaging
• Extension of physician’s ability to observe
• Qualitative
– morphological / structural
– magnification
– allow minimally invasive observations
• Clinical imaging standards
X-ray (CT), Ultrasound, MRI
biopsy (pathology)
16 November 2004
Biomedical Imaging
BMEN
Biomedical Imaging
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Existing Technologies
Maximize information content
Emerging Technologies
Imaging in Early Detection
Image Guided Interventions
Imaging in Therapy
Data management, analysis, interpretation
Informatics
Education / Training
16 November 2004
Biomedical Imaging
BMEN
Existing Technologies
• Tissue / Organ Level
X-ray (CT), Ultrasound, MRI
radionuclide imaging (PET)
– low information content
• (Sub)Cellular Level
Histology  biopsy
Electron microscopy
16 November 2004
Biomedical Imaging
BMEN
Existing Technologies
• Technical advancements (tissue / organ level)
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spatial and temporal resolution
image acquisition time
detectors
contrast
• Higher information content
– functional, more specific
• fundamental understanding of disease
• provide diagnosis more specific to development, selection,
evaluation of therapy
16 November 2004
Biomedical Imaging
BMEN
Existing Technologies
• Higher information content (cont’)
– develop improved contrast enhancement
agents / probes
• physiological processes
normal
disease
– dynamic
• Multi-modal imaging / combinatorial
techniques
• Non-invasive
16 November 2004
Biomedical Imaging
BMEN
Emerging Technologies
• Imaging at the Tissue / Organ Level
snapshots of organs or tissues over time
– radionuclide imaging (PET)
– fMRI, CT
• (Sub)cellular Level
anatomy, cell structure, histopathology of
living tissue
– Optical imaging
• fluorescence
• optical probes / labels
16 November 2004
Biomedical Imaging
BMEN
Emerging Technologies
• Bioluminescence
– real time monitoring in living animals
• tracking and monitoring infectious diseases /
cancer metastasis
• drug delivery, efficacy – toxicology screening
– changing biologic experimental paradigm
16 November 2004
Biomedical Imaging
BMEN
Emerging Technologies
• High information content at high resolution
– functionality / structure—function
– vital indicators
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gene expression
ion concentration
metabolism
membrane potential
• Non-invasive, intravital imaging
– serial biopsies
16 November 2004
Biomedical Imaging
BMEN
Molecular Imaging
• Imaging at the Molecular Level
– cell function
– metabolism
– gene expression
– drug and vector development / delivery
– in vivo protein interactions
– disease specific tracers and probes
• Molecular Probes / Contrast Agents
16 November 2004
Biomedical Imaging
BMEN
Molecular Imaging
• Develop molecular probes & contrast
agents
– links imaging modality with specific biological
processes
• Image specific molecular targets
– capitalize on mapping of human genome
• Drug development
– monitor drug delivery, validation & efficacy,
effects on biological target
16 November 2004
Biomedical Imaging
BMEN
Imaging for Early Detection of
Disease
• Clinical Standards
– PET, fMRI  neurological disease
– MRI  cardiac function imaging
 contrast enhanced imaging for
breast and other cancers
– 3-D Ultrasound  breast cancer
 prenatal exams
 heart function
16 November 2004
Biomedical Imaging
BMEN
Imaging for Early Detection of
Disease
• Develop more specific imaging
– fundamental understanding of disease
– pinpoint signifying events in disease onset
– genetic imaging / origin of disease
• Quantification of imaging
– define biologic characteristics / parameters
– standardization for comparison
– monitor therapy & disease progression
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Biomedical Imaging
BMEN
Imaging in Therapy
• Exploit multiple (complementary) imaging
modalities
– diagnosis
– position of lesion in 3-D
– real time monitoring
• Image Guided Interventions
• Surgical computer aided design
• Distance Medicine
16 November 2004
Biomedical Imaging
BMEN
Image Guided Interventions
Use of real time images for guidance,
navigation and orientation to reach a
specific target for a minimally invasive
patient encounter.
16 November 2004
Biomedical Imaging
BMEN
Image Guided Interventions
• locate targets seamlessly across spatial scales
• intra-operative, real time, 3-D image-guided navigation
for moving / deformable tissues / organs
• full array of anatomical, molecular, functional imaging
• multimodal image guidance w/ cellular resolution
• trajectory planning using image guidance
• plan, guide, affect, monitor treatment
Northwestern University
16 November 2004
Biomedical Imaging
BMEN
Image Guided Interventions
• less invasive
fewer complications
less normal tissue damage
• efficient
• assurance of procedure outcome
• cost
• may add unnecessary complexity
• images over interpreted  unnecessary
procedures / over-diagnosis
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Biomedical Imaging
BMEN
Informatics
• collection and processing of imaging data
for research / medicine
• manage large databases of patient
information  extract information
16 November 2004
Biomedical Imaging
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Informatics
• Methods for image analysis and
segmentation
• Reconstruction methods
– continuous across large spatial scales
3-D
4-D
• Coherent assemblage of massive amounts
of data  readily interpretable picture
16 November 2004
Biomedical Imaging
BMEN
Education and Training
• Multidisciplinary
– chemistry, physics, (molecular) biology,
pharmacology, medicine, biomedical
engineering, bioinformatics, radiology…
– principles of medical imaging, probe targeting
/development, tracer methodologies, normal
physiology, process of disease
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Biomedical Imaging
BMEN
Education and Training
• History: major advances in medical
technology  fundamental discoveries in
basic sciences
• Biomedical Engineer – link various
disciplines – navigate intellectual
landscape
• Know something about everything – be an
expert in something
16 November 2004
Biomedical Imaging
BMEN
Education and Training
• improve health
– promoting fundamental discoveries, design and
development
– translation and assessment of technological
capabilities in biomedical imaging and bioengineering
• translate fundamental or crosscutting
discoveries and developments in information
science, physics, chemistry, mathematics,
materials science, computer sciences
16 November 2004
Biomedical Imaging
BMEN