Quantitative Measurements in Medicine
Modern medical diagnosis is based on multi-parametric measurements such as vital signs, blood tests, molecular in-vitro diagnostics and multi-modality imaging data. In the human body all these measurands are related and their measurements need to be accurate, reproducible, comparable and ultimately traceable. These developments are fostered by the trend of precision medicine, which aims at objective medical decisions tailored to individual patients. Although significant effort has been taken over the last decade to support precision medicine with quantitative measurements, these often show a relatively low reproducibility due to technical variations and inter-observer variability. Furthermore uncertainty analysis in biomedical measurements is not straightforward, as there are often many variables, several of them uncontrolled and probably even unknown. Therefore interdisciplinary collaboration between clinical experts, medical physicists, biophysical researchers and industrial developers is necessary.
In the talk a short overview of important developments in quantitative measurements and their biomedical applications are given. Selected examples in for quantitative measurements and analysis in vital signs, in-vitro diagnostics and medical imaging will be shown and discussed.
Tobias Schaeffter studied electrical engineering at TU-Berlin until 1993 and obtained his PhD degree in magnetic resonance (MR) spectroscopic imaging at University Bremen (Prof. Leibfritz) in 1996. From 1996-2006, he worked as a Principal Scientist at the Philips Research Laboratories in Hamburg (Germany), where he was responsible for the development of new MR-acquisition and reconstruction techniques. In April 2006, Professor Schaeffter took up the post as the Philip Harris Professor of Imaging Sciences at King’s College London. A major aim of his research was the investigation of fast and quantitative imaging techniques for cardiovascular applications with a strong focus on translation of biomedical engineering into clinical practice. From 2012 to 2015, he was department head of biomedical engineering and the deputy head of the division in imaging sciences. He taught in the BSc and MSc programmes of Biomedical Engineering and was responsible for the EPSRC doctorial training centre in medical imaging between King’s and Imperial College London. Since 2015 Prof. Schaeffter heads the division of medical physics and metrological information technology at Physikalisch-Technische Bundesanstalt (PTB) in Berlin. He is responsible for the development of new quantitative measurement and reference techniques in medicine. Since January 2019 he is also a Professor in Biomedical Imaging at Technical University Berlin. Prof. Schaeffter has attracted over €10M in grants during the last 5 years and has published over 180 peer-reviewed papers, 10 book chapters, 400 conference abstracts and 30 international patents.
Neural Engineering Opportunities For Treatment of Neurological Disorders: Applications in Neurosurgery
Neuromodulation applications in Neurosurgery include Deep Brain Stimulation, Cortical Stimulation and Epidural Electrical Stimulation. Deep Brain Stimulation is now an established neurosurgical therapy for variety of neurologic and psychiatric disorders. Investigations into the mechanism of action of DBS, using electrochemical recording techniques such as Fast Scan Cyclic Voltammetry (FSCV), has now demonstrated that DBS evokes release of neurotransmitter, including dopamine and adenosine depending on sites of stimulation. FSCV has been an established method for investigating neurochemical changes in animal models and is emerging as a potential method for monitoring neurotransmitter systems in humans undergoing DBS. At the Mayo Clinic, we have developed the WINCS (Wireless Instantaneous Neurotransmitter Concentration Sensing) system and its successor WINCS-Harmoni, a next generation device capable of combining brain stimulation with real-time neurochemical recording in vivo. Recently, we have also developed a novel technique termed multiple cyclic square wave voltammetry (M-CSWV) for quantifying tonic DA concentrations in vivo, which uses cyclic square wave voltammetric waveforms in conjunction with a delayed holding potential period to control adsorption. Here, a review of the technology development of WINCS and the use FSCV for elucidating the mechanism of action of DBS will be presented. Furthermore, we will also review applications of Cortical Stimulation for pain and epilepsy, as well as Epidural Electrical Stimulation for the treatment of paralysis from spinal cord injury.
Kendall H. Lee, M.D., Ph.D., is a consultant in the Department of Neurologic Surgery with joint appointments in the Department of Physiology and Biomedical Engineering and the Department of Physical Medicine and Rehabilitation at Mayo Clinic in Rochester, Minnesota. Dr. Lee serves as enterprise chair for research in the Department of Neurologic Surgery. He joined the staff of Mayo Clinic in 2006 and holds the academic rank of professor of neurosurgery and physiology, Mayo Clinic College of Medicine and Science.
Dr. Lee earned his B.A. in biology with a minor in philosophy from the University of Colorado at Denver. He attended Yale University Graduate School, where he received his Master of Philosophy, M.D. and Ph.D. in neurobiology. He completed an internship in internal medicine at the Hospital of St. Raphael, Yale University School of Medicine and a residency in neurology at Harvard Medical School. He furthered trained at Dartmouth Hitchcock Medical Center, completing an internship in general surgery and a residency and chief residency in neurosurgery.
In his clinical practice, Dr. Lee is an expert on neurological disorders, seeing patients with Parkinson’s disease, Tourette’s syndrome, dystonia and other neurodegenerative diseases. His research focuses on developing deep brain stimulation for the treatment of Parkinson's disease, tremor, depression, obsessive- compulsive disorder and epilepsy. Dr. Lee is fascinated with the possibility of combining sophisticated electrophysiological recordings with miniaturized analytical elements (microprocessors) to augment or repair disrupted function of the brain.
Dr. Lee’s research is funded by National Institutes of Health, National Institute of Neurological Disorders and Stroke, and The Grainger Foundation. His findings have been published in numerous high-impact peer-reviewed journals. He is an internationally recognized speaker and serves on the editorial boards for Journal of Neural Engineering, Biomedical Engineering Letters, Stereotactic and Functional Neurosurgery and Neuromodulation.
In recognition of his work, Dr. Lee has received many awards and honors, including the Phillip Gildenberg Award, conferred by the American Association of Neurological Surgeons, and the Research Early Career Development Award for Clinician Scientists, conferred by Mayo Clinic.
In addition to his clinical and research activities, Dr. Lee is active in education and provides mentorship to many research trainees, research fellows and visiting scientists, among others. He is director of the Mayo Clinic M.D./Ph.D. Program and holds full faculty privileges in Biomedical Engineering at Mayo Clinic Graduate School of Biomedical Sciences. He is also honorary associate professor in the School of Psychology at Deakin University, Geelong, Australia.
Dr. Lee’s professional memberships include the Society for Neuroscience, Congress of Neurological Surgeons, American Association of Neurological Surgeons, and American Society for Stereotactic and Functional Neurosurgery, where he serves on the board. Dr. Lee is also a commander in the United States Navy Reserve.