Medical Computing

1. Medical Computing By Tuyen T Nguyen University of Wisconsin-Platteville Spring 2006

2. Introduction • Medical Computing in the US in the past 30 years. • Remarkable revolution • Result obtained from technology evolution are sophisticated • No surgery on every case • Noninvasive procedures • Required less time • More accurate results • Cost less

3. Introduction… • The use of computer technology such as: • CAT • Ultrasound • MRI • ENDOSCOPY • Pacemaker • Photoshop CS2 • Nuclear magnetic

4. History of Computer Imaging • Early computer graphics (1960’s-1970’s) were based on devices that drew vectors (straight lines) and that was all. • Perhaps the most important advantage relevant to medical applications is that the interior of the objects are accessible to the viewer • Given surgeon a much better view

5. AbioCor Artificial Heart • The AbioCor Implant able replacement heart is the first completely self-contained artificial heart • It is expected to at least double the life expectancy of heart patients compare without a heart implant • On July 2, 2001 Dr. William Devries at Jewish Hospital in Louisville, Kentucky performed a first artificial heart transplant.

6. Jarvik Artificial Heart • Dr. William Devries implanted the Jarvik-7 into several patients. • One patient implanted Jarvik-7 survived 620 days. • Artificial hearts are used only on a temporary basis until a human heart becomes available.

7. Artificial Heart Continue… • Internal Controller Unit – This small electronic device is implanted in the patient’s abdominal wall. It monitors and controls the pumping speed of the heart.

8. Sensorized Artificial Heart • Next Generation Artificial Heart • With noninvasive sensors to realize the safety treatment and effective control for the patients.

9. Sensorized Artificial Heart… • Tsukuba Bio-Telemetry System • Observe the condition of the patients • Driving condition of artificial heart from a remote place on-line.

10. Ultrasound • A basic ultrasound machine has the following parts: - transducer probe - central processing unit (CPU) - transducer pulse controls - display - keyboard/cursor - disk storage device - printer

11. Ultrasound… • Central processing unit (CPU)- computer that does all of the calculations and contains the electrical power supplies for itself and the transducer probe. • The CPU is the brain of the ultrasound machine. It is a computer that contains the microprocessor, memory, amplifiers and power supplies for the microprocessor and transducer probe.

12. Ultrasound … • The machine calculates the distance from the probe to the tissue or organ (boundaries) using the speed of sound in tissue and the time of each echo’s return.

13. Ultrasound … • Ultrasound is use to check on the developing baby or determine the due date. • If one is having problems with blood circulation in a limb or heart, a Doppler ultrasound can check on the blood flow. • Ultrasound has been a popular medical imaging technique for many years.

14. 3D Ultrasound Imaging • Ultrasound machines capable of three-dimensional imaging have been developed. • In these machines, several two-dimensional images are acquired by moving the probes across the body surface or rotating inserted probes. • The two-dimensional scans are then combined by specialized computer software to form 3D images.

15. X-rays • X-rays are basically the same thing as visible light rays. Both are wavelike forms of electromagnetic energy carried by particles called photons. • The difference between X-rays and visible light rays is the energy level of the individual photons.

16. X-rays Continue … • X-rays let doctors peer inside a patient without any surgery at all. • Computer aided detection, or CAD, takes either an x-ray or digital mammogram image and with the press of a button marks areas of concern – like calcifications subtle abnormalities that a radiologist may have missed.

17. Computerized Axial Topography Scan • CAT scan takes the idea of conventional x-ray imaging to a new level. Instead of finding the outline of bones and organs, a CAT scan machine forms a full three-dimensional computer model of a patient’s insides. • Doctors can even examine the body one narrow slice at a time to pinpoint specific areas.

18. CAT Continue … • In a CAT scan machine, the x-ray beam moves all around the patient, scanning from hundreds of different angles. • The computer takes all this information and puts together a 3-D image of the body.

19. CAT Continue … • This figure shows a scanned liver slice. • Since they examine the body slice by slice, from all angles, CAT scans are much more comprehensive than conventional x-rays.

20. Magnetic Resonance Image (MRI) Scan • MRI, medical diagnostic technique that creates images of the body using the principles of nuclear magnetic resonance. • MRI can generate thin-section images of any part of the body – including the heart, arteries, and veins – from any angle and direction, without surgical invasion and in a relatively short period of time.

21. MRI Scan … • The main magnet immerses the patient in a stable and very intense magnetic field, and the gradient magnets create a variable field. • The rest of an MRI system consists of a very powerful computer system, some equipment that allows us to transmit RF (radio frequency) pulses into the patient’s body while they are in the scanner, and many order secondary components.

22. MRI … • This image set is comparing a young individual (left) with an athletic male in his 80’s (center) and with a person of similar age having Alzheimer’s disease (right), all imaged at the same level.

23. Computer Technology in Endoscopy • The endoscope has revolutionized the field of gastroenterology. Through it, doctor can directly examine almost any part of the intestinal tract. • Biopsies can also be obtained • Here is the picture of the normal stomach.

24. Endoscopy… • A thin, flexible, lighted tube called an endoscope will insert through the mouth or rectum. • The endoscope transmits an image of the inside of the esophagus, stomach, and duodenum, so the physician can examine the lining of these organs.

25. Endoscopy … • The scope also blows air into the stomach; this expands the folds of tissue and makes it easier for the physician to examine the stomach. • The physician can see abnormalities, like inflammation or bleeding, through the endoscope that don’t show up well on X-rays. • The physician can also insert instruments into the scope to treat bleeding abnormalities or remove samples of tissue (biopsy) for further tests.

26. Pacemaker • Pacemakers are prescribed for people of all ages whose hearts beat too slowly. • Pacemakers detect the slow heart rate and send electrical impulses to the heart to stimulate the heart muscle to beat faster. • Well over 2 million pacemakers have been implanted worldwide since 1960.

27. System for Programming and Monitoring Implanted Devices • This specialized computer system is used to communicate with implanted devices such as pacemakers and defibrillators through the skin. • Using this computer, the doctor can read information from the device’s memory to determine if abnormal cardiac episodes occurred, such as cardiac arrest.

28. Monitoring Implanted Devices … • To interact with a pacemaker or defibulator device, a doctor places a magnetic wand over the device. This allow the system to: - Receive information from the device. Based on this information, the doctor or nurse may want to change the therapy. - Send instructions to the device. When the therapy needs to change, the doctor can send the new instructions to the device without any surgery.

29. Monitoring Implanted Devices … • The use of the computer system represents a big step in using remote and internet-based technology in the management of cardiac patients. • The remote viewing capability allows clinicians to access real-time clinical expertise at a different location quickly over standard telephone lines. • The clinical experts are able to see the exact data being seen on the computer, thus increasing efficiency and facilitating improved consulting and troubleshooting sessions.

30. Nuclear magnetic resonance technology • Was first described by Felix Bloch and Edward Mills Purcell in 1946. Both shared the Nobel Prize in physics in 1952 for their discovery. • Uses high magnetic fields and ratio-frequency pulses to manipulate the spin states of nuclei, and reflect the position of nucleic within the molecule.

31. Nuclear Magnetic Continue … • Most famous use is in magnetic resonance imaging for medical diagnosis. • Provides anatomical definition of normal and abnormal tissues. • Also use to diagnostic imaging of the breast and regions of the abdomen.

32. Nuclear Magnetic Continue … • In several respects, NMR spectroscopy offers a technique complementary to X-ray crystallography and neutron diffraction. • An important consideration is that NMR structures typically are obtained from proteins in solution, with no requirement that the protein be crystallizable.

33. Adobe Photoshop CS2 • What is Adobe Photoshop CS2? • The professional image-editing • Can achieve an amazing result

34. Adobe Photoshop CS2 … • System requirement: • Intel Xeon • Intel Centino • Pentium III or 4 processor • 320 MB of RAM • 650 of available hard-disk space

35. Adobe Photoshop CS2 … • Who need this? • Anyone who want a professional result when creating, editing, and retouching a processing digital images • Wisely use in plastic surgery image!

36. Adobe Photoshop CS2 … • Who want to look 10 years younger virtually? May be 5 years? • You can use Adobe Photoshop to make you look good AND feel good!

37. Adobe Photoshop CS2 … • Limitation: • Only in 2D for graphics and photos • Can be in 3D with text • Can do many ‘real’ cool things

38. Conclusion • Computer technology has penetrates all aspect of human life: internet access to medical to military control defense system. • Advance technology from networking to computer image provide the great tools for medical field. • Offer great support in the diagnostic stage and draw conclusion in a short period of time • It truly contributes a quality decision analysis in healthcare system.

39. Reference • [1]Andrew Millman, Nicholas Lee, Andrew Brooke. BMJ 1995; 311:800-802(23 • September). ABC of Medical Computing: Computers in General Practices. Retrieved March 31, 2006, from • http://bmj.bmjjournals.com/cgi/content/full/311/7008/800 • [2] Advantech- ePlatform Services in Medical Computing. Retrieved April 1, 2006 from • www.advantech.com.tw/ePlatform/Med/introduction.asp • [3] Hadjiyski, L. Ph.D., Sahiner, B. Ph.D., Chan, H. Ph.D., Bogot, N. M.D., Cascade, P. M.D., Kazerooni, E. M.D. (2004, November 29). New computer-aided diagnosis (CAD) methods for cancer. News-Medical.Net. Retrieved April 1, 2006, from • http://www.news-medical.net/?id=6495 • [4] Photoshop Tutorials – Absolute Cross. Retrieved April 1, 2006 from • http://www.absolutecross.com/tutorials/photoshop/ • [5] Nuclear magnetic resonance – Wikipedia, the free encyclopeda. Retrieved April 1, 2006 from • en.wikipedia.org/wiki/Nuclear_magnetic_resonance • [6] Nuclear Magnetic Resonance. Retrieved April 1, 2006 from • http://hyperphysics.phy-astr.gsu.edu/hbase/nuclear/nmr.html • [7] Jan Nissl, RN, BS. Paul D. Traughber, MD – Radiology. Kenneth B. Sutherland, DC, BSc, MD, FRCPC – Diagnostic Radiology. Article: Magnetic Resonance Imaging (MRI). Retrieved March 31, 2006 from • http://www.bchealthguide.org/kbase/topic/medtest/hw214278/descrip.htm

40. Reference… • [8] Medical Dictionary: Magnetic resonance imaging. Retrieved March 31, 2006 • http://www.wrongdiagnosis.com/medical/magnetic_resonance_imaging.htm • [9] Article: Coronary Artery Disease Screening Tests. Retrieved April 1, 2006 • http://www.medicinenet.com/coronary_artery_disease_screening_tests_cad/article.htm • [10] Andy Anderson. Steve Johnson. Perspection. Inc. Adobe Photoshop CS • [11] McGraw-Hill - Concise Encyclopedia of engineering • [12] Eric J. Light – President. The Internal Medical Spa Association. Retrieved April 1, 2006 from • www.medicalspaassociation.org/vocabulary.htm • [13] How stuff works. Retrieved April 2, 2006 from • www.howstuffworks.com/ultrasound.htm

41. Thank you for listening • Any Questions?