2. OFR2008 2
Computer evolutionComputer evolution
Moore’s LawMoore’s Law
Bell’s Corollary on Computer Class FormationBell’s Corollary on Computer Class Formation
UMPC=UltramobilePersonalcomputers
SPOT=SmartPersonalobjecttechnology
Nanosensor
sprays
El viaje fantastico
2004
Glucowatch
Foglet 5μ
Creation
Levitation
Manipulation
Teleportation
Hitachi 50μ RFID
TINYcomputers
3. OFR2008 3
Bell´s lawBell´s law
toto
CyberspacCyberspac
ee
New computer classesNew computer classes require new platforms,require new platforms,
networks, and cyberization.networks, and cyberization.
New computer platformsNew computer platforms based on chipbased on chip
density evolutiondensity evolution
NewNew apps and contentapps and content around each new classaround each new class
Each classEach class becomes a verticallybecomes a vertically disintegrateddisintegrated
industry based onindustry based on hardware andhardware and
software standardssoftware standards ,, after itafter it FLAILSFLAILS
around 5-10 YEARSaround 5-10 YEARS
1999 2006
2000
veterinaria
4. OFR2008 4
Imagen medicaImagen medica
FonendoFonendo
Ultrasonografo portatil (con TM.)Ultrasonografo portatil (con TM.)
ZONARE Medical Systems- Z one ultra system
Siemens-Acuson P50
7. OFR2008 7
Royal Philips ElectronicsRoyal Philips Electronics
4-D time-lapse ultrasound image4-D time-lapse ultrasound image
time-lapsed imagestime-lapsed images
space is intended to emulate that of a spa.space is intended to emulate that of a spa.
view images of your baby on a bubble-like screenview images of your baby on a bubble-like screen
8. OFR2008 8
VIRTUAL SONOGRAPHYVIRTUAL SONOGRAPHY
20002000
Ultrasound in Obs & GynecologyUltrasound in Obs & Gynecology 2000 16:102,.16:102,.
Ferrer-Roca et al.Ferrer-Roca et al.
Three dimensional ultrasound reconstructionThree dimensional ultrasound reconstruction
and telemedicine. Image analysis.and telemedicine. Image analysis.
J Med Internet ResJ Med Internet Res 20012001, June 22; 3 (2): e21., June 22; 3 (2): e21.
Ferrer-Roca et al.Ferrer-Roca et al.
Virtual Sonography through the Internet:Virtual Sonography through the Internet:
Volume Compression IssueVolume Compression Issue
http://http://www.pubmedcentral.nih.gov/articlerender.fcgi?artidwww.pubmedcentral.nih.gov/articlerender.fcgi?artid
=1761897=1761897
J Perinat MedJ Perinat Med ((20062006) vol 34 :123-129 .) vol 34 :123-129 .
Ferrer-Roca et al.Ferrer-Roca et al.
Tele-Virtual Sonography.Tele-Virtual Sonography.
www.atypon-link.com/WDG/doi/pdf/10.1515/JPM.2006.022
9. OFR2008 9
Tele-Virtual Sonography
J Perinat MedJ Perinat Med 34 (34 (20062006) 123-129 . Ferrer-Roca et al.) 123-129 . Ferrer-Roca et al.
Receiver Operating Characteristic (ROC) Plot
0.0 0.2 0.4 0.6 0.8 1.0
False Alarm Rate
0.0
0.2
0.4
0.6
0.8
1.0
HitRate
Respuesta diagnostica con Ecografia local=66casos 12meses
Receiver Operating Characteristic (ROC) Plot
0.0 0.2 0.4 0.6 0.8 1.0
False Alarm Rate
0.0
0.2
0.4
0.6
0.8
1.0
HitRate
Respuesta a distancia con TeleInvivo 66 casos-12meses
Diagnostic interobserver variability, local versus
distant, was low since the kappa statistics is high
(k=0.7);
10. OFR2008 10
New image modalitiesNew image modalities
CT
US
MRI
OCT
CMicro
Hybrid
12. OFR2008 12
New ICT-toolsNew ICT-tools
Health-GRID (2008)Health-GRID (2008)
GRID TECHNOLOGY IN TELEPATHOLOGY AND PERSONALIZEDGRID TECHNOLOGY IN TELEPATHOLOGY AND PERSONALIZED
TREATMENTTREATMENT
Ferrer-Roca OFerrer-Roca O . et al (2008). et al (2008)
In: Grid Technologies for eHealth: Applications for Telemedicine Services & Delivery
Editor: Dr. Ekaterina Kldiashvili. Georgian Telemedicine Union, Georgia
IGI Global Publ. Philadelphia. USA
Text Mining
Literature Based Discovery (LBD) technique that use annotations and
data in existing biomedical sources to discover associations.
Image Mining
ISO 19115/19139 standard on image metadata ontologies,
MPEG-7 (MPEG Query Format-MPQF ISO/IEC 15938-12 ),
MPEG-21 or ISO 21000-14,
ISO 24800-3 for JPEG query search
ISO/IEC 15444-2 for JPX metadata set
DICOM (Q/R SCP query-retrieve service class )
KNOWLEDGE DISCOVERY
15. OFR2008 15
Image mergingImage merging
LOGIQ® E9LOGIQ® E9
new image technology &new image technology &
real-time capabilityreal-time capability
to mergeto merge an ongoingan ongoing
ultrasound exam withultrasound exam with
previously acquired CT,previously acquired CT,
MR or US images.MR or US images.
16. OFR2008 16
Siemens- ACUSON P10Siemens- ACUSON P10
Forthcomming Innov.
ARFI (Acoustic Radiation
Forced Impulse) imaging &
new silicon US-technology
Precise semiconductor production that realizes
isotropic 3D and 4D ultrasound imaging.
Dynamic TCE technology
Amnioscopic Rendering
Fetal Heart STIC (Spatio-Temporal Image Correlation)
RF images
HD (high density) transducer technology
17. OFR2008 17
Photoacoustic microscopyPhotoacoustic microscopy
at super depthsat super depths
3D tomographic photoacoustic microscopy (PAM)3D tomographic photoacoustic microscopy (PAM)
• LightLight && ultrasoundultrasound hybrid technologyhybrid technology HIGHHIGH
RESOLUTION IMAGING SUPER-DEPTH image.RESOLUTION IMAGING SUPER-DEPTH image.
•1.1. Short-pulsed laserShort-pulsed laser light absorbedlight absorbed causes ancauses an
increase in pressure viaincrease in pressure via thermoelastic expansionthermoelastic expansion..
•2. The increased pressure propagates through the tissue2. The increased pressure propagates through the tissue
as an ultrasonic wave, known as aas an ultrasonic wave, known as a photoacoustic wavephotoacoustic wave,,
•3. The wave is detected by an3. The wave is detected by an ultrasonic transducerultrasonic transducer thatthat
produces electrical signals.produces electrical signals.
•4. The signals are then4. The signals are then amplified, digitizedamplified, digitized, and, and
transferred to a computer, where an image is formed.transferred to a computer, where an image is formed.
PAMPAM optical irradiation, ultrasonicoptical irradiation, ultrasonic
detection, and image formationdetection, and image formation
5MHz US & 804 nm light 3cm depth
18. OFR2008 18
OPTICAL COHERENCEOPTICAL COHERENCE
TOMOGRAPHYTOMOGRAPHY
LLimited to imaging 1 to 2 mm below the surface in biological tissueimited to imaging 1 to 2 mm below the surface in biological tissue
OCTOCT echo techniqueecho technique similarsimilar to UltraSound image
Depending on high-brightness and wide-spectrum light sources such as
superluminescent diodes or ultrashort pulse lasers, OCT has achieved sub-
micrometre resolution (with very wide-spectrum sources emitting over a
~100 nm wavelength range).
Resolution : EQUIVALENT TO LOW POWER MICROSCOPE.
OCT high resolution based on light
Optical Ultrasound:
imaging reflections from tissue to provide cross-sectional images.
25. OFR2008 25
Ultra-High & spectroscopicUltra-High & spectroscopic
OCTOCT
1x3 micras1x3 micras100 micras
UH-resolution OCT
Spectroscopic OCT- melanocytes Red
26. OFR2008 26
OCT Microscope - EX1301OCT Microscope - EX1301
Gloucestershire Royal Hospital and University College London Hospital (UCLH) are to trial MDL’sGloucestershire Royal Hospital and University College London Hospital (UCLH) are to trial MDL’s
Optical Coherence Tomography (OCT) scanner for research into rapid in-vivo identification ofOptical Coherence Tomography (OCT) scanner for research into rapid in-vivo identification of
cancers affecting the cervix, oesophagus, skin, lung and other organs.cancers affecting the cervix, oesophagus, skin, lung and other organs.
http://www.md-ltd.co.uk/
27. OFR2008 27
OCT & EmbrionOCT & Embrion
developmentdevelopment
Animal development in vivoAnimal development in vivo
No hay razón, mas que los plazos éticos y de autorización
para no hacerlo en humanos
28. OFR2008 28
MEDICINE AT DISTANCEMEDICINE AT DISTANCE
StandardizationStandardization & interoperability& interoperability
Quality assuranceQuality assurance
Risk management & consumer/user confidenceRisk management & consumer/user confidence
Plug & playPlug & play easy to use / easy to integrateeasy to use / easy to integrate
Portability & Mobility.Portability & Mobility.
TECHNICALTECHNICAL IMPLEMENTATIONIMPLEMENTATION
ee--medicine,medicine, tt--medicine,medicine, pp--medicine.medicine.
LICENCING
30. OFR2008 30
SUMMARYSUMMARY
La TM debe realizarse con criterio de calidad.La TM debe realizarse con criterio de calidad.
La TM debe implantarse en PERINATOLOGIA.La TM debe implantarse en PERINATOLOGIA.
La SONOGRAFIA VIRTUAL es de granLa SONOGRAFIA VIRTUAL es de gran
utilidad.utilidad.
Las NUEVAS MODALIDADES imagen laLas NUEVAS MODALIDADES imagen la
acercan a la Anatomía Patológica.acercan a la Anatomía Patológica.
31. OFR2008 31
THANK YOU FOR YOURTHANK YOU FOR YOUR
ATTENTIONATTENTION
Prof.Dr.O.Ferrer-RocaProf.Dr.O.Ferrer-Roca
UNESCO Chair TelemedicineUNESCO Chair Telemedicine
““Who's who in the World”,Who's who in the World”, 1996-act1996-act
““Who's who in Medicine and Healthcare”, 1999-act.Who's who in Medicine and Healthcare”, 1999-act.
““Who's who in Technology”,Who's who in Technology”, 1999-act.1999-act.
““Who’s who of Professionals”,Who’s who of Professionals”, 2000-act.2000-act.
““Who’s who in Science and Engineering”, 2001-Who’s who in Science and Engineering”, 2001-
act.act.
catai@teide.netcatai@teide.net
htttp://www.teide.net/cataihtttp://www.teide.net/catai
Hinweis der Redaktion
Los avances tecnológicos acercan la Anatomía Patológica a la US y a la Telemedicina.
España debe estar presentes en esta innovación.
http://www.nanotech-now.com/utility-fog.htm
Nanotechnology is based on the concept of tiny, self-replicating robots.
The Utility Fog is a very simple extension of the idea: Suppose, instead of building the object you want atom by atom , the tiny robots linked their arms together to form a solid mass in the shape of the object you wanted? Then, when you got tired of that avant-garde coffeetable, the robots could simply shift around a little and you'd have an elegant Queen Anne piece instead.
Here's a short list of the powers you'd have or appear to have if embedded in fog:
Creation--causing objects to appear and disappear on command.
Levitation--causing objects to hover and fly around.
Manipulation--causing forces (squeezing, hitting, pulling) on objects (real ones) at a distance.
Teleportation--nearly any combination of telepresence and virtual reality between fog-filled locations
Utility Fog: The Stuff that Dreams Are Made Of By J. Storrs Hall. He discusses the technical details and feasibility of how a swarm of nanobots ("Foglets") that can take the shape of virtually anything. Also covered are some of the possibilities. "Imagine a microscopic robot. It has a body about the size of a human cell and 12 arms sticking out in all directions. A bucketfull of such robots might form a 'robot crystal' by linking their arms up into a lattice structure. Now take a room, with people, furniture, and other objects in it -- it's still mostly empty air. Fill the air completely full of robots. The robots are called Foglets and the substance they form is Utility Fog, which may have many useful medical applications. And when a number of utility foglets hold hands with their neighbors, they form a reconfigurable array of 'smart matter.'" Dr. J. Storrs Hall Research Fellow of the Institute for Molecular Manufacturing.
http://www.ultrasonacolumbus.com/fetaldev.htm
http://www.medgadget.com/archives/obgyn/
Royal Philips Electronics is not only providing time-lapsed images of the baby in the mother's womb, but is developing an environment in which you can enjoy this experience. The space is intended to emulate that of a spa and will allow you to view images of your baby on a bubble-like screen.
A 4-D time-lapse ultrasound image like this may elicit warm emotions as parents distinguish their unborn baby's facial features and fingers for the first time, but the same cannot usually be said about the clinical environment in which such images are created.
The LUMA™ Cervical Imaging System shines a light on the cervix and analyzes how different areas of the cervix respond to this light. The LUMA System assigns a score to tiny areas of the cervix and produces a color map that helps the doctor decide where to biopsy. The colors and patterns on the map help the doctor distinguish between healthy tissue, potentially diseased tissue, and areas that cannot be interpreted (e.g. tissue at the edge of the screen).
http://www.medgadget.com/archives/obgyn/
http://spie.org/x27634.xml
We have demonstrated the multiscale imaging capability of PAM in vivo with optical absorption contrast (see Figure 1). Our initial 50MHz photoacoustic microscope probes to a depth of 3mm—filling the penetration void of ballistic imaging—at 15μm in axial resolution and 45μm in lateral resolution: see Figure 1(b).
We have also been able to scale the spatial resolution down to 5μm by focusing a light beam to less than the depth of one optical transport mean free path. This resolution allows in vivo imaging of capillaries, which are the smallest blood vessels: see Figure 1(a).2 The ultimate lateral resolution is optically diffraction limited, potentially yielding submicron resolution.
We have also scaled the penetration limit up to centimeters, extending photoacoustic microscopy to macroscopy. For example, by employing a 5MHz ultrasonic transducer and an 804nm light source, we were able to increase the penetration to 3cm: see Figure 1(c).4
K. Maslov, H. F. Zhang, S. Hu, L. V. Wang, Optical-resolution photoacoustic microscopy for in vivo imaging of single capillaries, Opt. Lett. 33, pp. 929-931, 2008.doi:10.1364/OL.33.000929
3. H. F. Zhang, K. Maslov, G. Stoica, L. V. Wang, Functional photoacoustic microscopy for high-resolution and noninvasive in vivo imaging, Nat. Biotechnol. 24, pp. 848-851, 2006.doi:10.1038/nbt1220
4. K. Song, L. V. Wang, Deep reflection-mode photoacoustic imaging of biological tissue, J. Biomed. Opt. 12, pp. 060503, 2007.doi:10.1117/1.2818045
OCT delivers high resolution because it is based on light, rather than sound or radio frequency
OCT, an interferometric technique, is able to penetrate significantly deeper into the scattering medium, for example ~3× deeper than its nearest competitor, Confocal microscopy.
OCT is based on low-coherence interferometry.[8][9][10] In conventional interferometry with long coherence length (laser interferometry), interference of light occurs over a distance of meters. In OCT, this interference is shortened to a distance of micrometres, thanks to the use of broadband light sources (sources that can emit light over a broad range of frequencies). Light with broad bandwidths can be generated by using superluminescent diodes (superbright LEDs) or lasers with extremely short pulses (femtosecond lasers). White light is also a broadband source with lower powers.
Depending on the use of high-brightness and wide-spectrum light sources such as superluminescent diodes or ultrashort pulse lasers, OCT has achieved sub-micrometre resolution (with very wide-spectrum sources emitting over a ~100 nm wavelength range).
OCT delivers high resolution because it is based on light, rather than sound or radio frequency. An optical beam is directed at the tissue, and a small portion of this light that reflects from sub-surface features is collected. Note that most light is not reflected but, rather, scatters. The scattered light has lost its original direction and does not contribute to forming an image but rather contributes to glare. The glare of scattered light causes optically scattering materials (e.g., biological tissue, candle wax, or certain plastics) to appear opaque or translucent even while they do not strongly absorb light (as can be ascertained through a simple experiment — e.g., shining a red laser pointer through one's finger). Using the OCT technique, scattered light can be filtered out, completely removing the glare. Even the very tiny proportion of reflected light that is not scattered can then be detected and used to form the image in, e.g., a scanning OCT system employing a microscope.
The physics principle allowing the filtering of scattered light is optical coherence. Only the reflected (non-scattered) light is coherent (i.e., retains the optical phase that causes light rays to propagate in one or another direction). In the OCT instrument, an optical interferometer is used in such a manner as to detect only coherent light.
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Her ses det mobile system i klinikken på Onkologisk Afdeling i Lund.
Og det her er den håndholdte probe.
Gloucestershire Royal Hospital and University College London Hospital (UCLH) are to trial MDL’s Optical Coherence Tomography (OCT) scanner for research into rapid in-vivo identification of cancers affecting the cervix, oesophagus, skin, lung and other organs.
‘Optical Coherence Tomography’ (OCT) to detect non-scattered light from a scanned Near-IR laser, from up to 2 mm deep into translucent or semi-opaque material. Subsequent image processing of the OCT signal enables real-time display of the sub-surface image to the user.
Images 6 mm wide x 2 mm deep are provided at an optical resolution < 10 μm.
http://www.md-ltd.co.uk/