IEEE transactions on bio-medical engineering
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IEEE Trans Biomed Eng · Apr 2013
Noninvasive intracranial hypertension detection utilizing semisupervised learning.
Intracranial pressure (ICP) monitoring is an established clinical practice in managing patients with risk of acute ICP elevation although the clinically accepted way of measuring ICP remains invasive. However, the invasive nature of ICP measurement obviates its application in many clinical circumstances such as diagnosis of idiopathic intracranial hypertension (IH). We propose a noninvasive diagnostic tool for IH based on the morphological analysis of cerebral blood flow velocity waveforms. ⋯ Although the predictive accuracy is a widely used accuracy measurement, it does not consider clinical consequences of necessary and unnecessary treatments. For this reason, we have adopted the decision curve analysis to address this issue. The decision curve analysis results show that the semisupervised IH detection method is not only more accurate, but also clinically more useful than the supervised IH detection method or the PI-based IH detection method.
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Despite the potential increase in precision and accuracy, laser technology is not widely used in neurological surgery. This in part relates to challenges associated with the early introduction of lasers into neurosurgery. Considerable advances in laser technology have occurred, which together with robotic technology could create an ideal platform for neurosurgical application. ⋯ In preclinical studies, the laser improved microsurgical performance and reduced thermal damage, while neuroArm decreased intra- and intersurgeon variability. Clinical studies demonstrate dutility in meningioma resection (n = 4). Together, laser and robotic technology offered a more consistent, expedient, and precise tool for microsurgery.
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IEEE Trans Biomed Eng · Mar 2013
Surgical robotics through a keyhole: from today's translational barriers to tomorrow's "disappearing" robots.
In the last century, engineering advances have transformed the practice of surgery. Keyhole surgical techniques offer a number of advantages over traditional open approaches including less postoperative pain, fewer wound complications, and reduced length of stay in hospital. However, they also present considerable technical challenges, particularly to surgeons performing new operative approaches, such as those through natural orifices. ⋯ Clinically, however, robotic surgery is still in its infancy, and its use has remained limited to relatively few operations. In the paper, we will discuss the economic-, clinical-, and research-related factors that may act as barriers to the widespread utilization and development of surgical robots. In overcoming these barriers through a synergistic effort of both engineering and medicine, we highlight our future vision of robotic surgery, in both the short and long term.
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IEEE Trans Biomed Eng · Feb 2013
Accuracy limits for the thickness measurement of the hip joint cartilage in 3-D MR images: simulation and validation.
This paper describes a theoretical simulation method for ascertaining the inherent limits on the accuracy of thickness measurement of hip joint cartilage in 3-D MR images. This method can specify where and how thickness can be measured with sufficient accuracy under the certain MR imaging conditions. In the numerical simulation, we present a mathematical model for two adjacent sheet structures separated by a small distance, which simulated the femoral and acetabular cartilage and the joint space width in the hip joint; moreover, we perform the numerical simulation of MR imaging and postprocessing for thickness measurement. ⋯ Also, thickness measurement is performed in MR imaging with isotropic voxel. The results from MR data with isotropic voxels show that accurate measurement of cartilage thickness at location of measured values of the hip joint space width and the cartilage thickness being two times as large as the voxel size or above should be possible. The simulation method is validated by comparison with the actual results obtained from the experiments using three phantoms, five normal cadaver hip specimens, and nine patients with osteoarthritis.
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IEEE Trans Biomed Eng · Feb 2013
The transesophageal echocardiography simulator based on computed tomography images.
Simulators are a new tool in education in many fields, including medicine, where they greatly improve familiarity with medical procedures, reduce costs, and, importantly, cause no harm to patients. This is so in the case of transesophageal echocardiography (TEE), in which the use of a simulator facilitates spatial orientation and helps in case studies. The aim of the project described in this paper is to simulate an examination by TEE. ⋯ The construction of the CT2TEE (Web-based TEE simulator) is also presented. The considerations include ray-tracing and ray-casting techniques in the context of ultrasound beam and artifact simulation. An important aspect of the interaction with the user is raised.