2008- prenatal diagnosis
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DiagnosticoDiagnostico perinatalperinatal y y
TELEMEDICINATELEMEDICINA
Prof.Dr.O.Ferrer-RocaProf.Dr.O.Ferrer-Roca
UNESCO Chair UNESCO Chair TelemedicineTelemedicine
Congreso Nacional Congreso Nacional AEDPAEDP
6-7 Nov 20086-7 Nov 2008
Chair of Pathology
Transforming Healthcare through Technology
OFR2008 2
Computer evolutionComputer evolution
Moore’s Law Moore’s Law Bell’s Corollary on Computer Class FormationBell’s Corollary on Computer Class FormationU
MP
C=
Ult
ram
ob
ile P
ers
on
al co
mp
ute
rsS
PO
T=
Sm
art
Pers
on
al ob
ject
tech
nolo
gy
Nanosensor sprays
El viaje fantastico
2004
Glucowatch
Foglet 5μ
CreationLevitationManipulationTeleportation
Hitachi 50μ RFIDTIN
Y c
om
pu
ters
OFR2008 3
Bell´s law Bell´s law toto
CyberspacCyberspacee
New computer classesNew computer classes require new platforms, require new platforms, networks, and cyberization.networks, and cyberization.
New computer platformsNew computer platforms based on chip based on chip density evolution density evolution
New New apps and contentapps and content around each new around each new classclass
Each classEach class becomes a vertically becomes a vertically disintegrateddisintegrated industry based on industry based on hardware and hardware and software standards software standards ,, after it after it FLAILS FLAILS around 5-10 YEARSaround 5-10 YEARS
1999 20062000 veterinaria
OFR2008 4
Imagen medicaImagen medica FonendoFonendo
Ultrasonografo portatil (con TM.)Ultrasonografo portatil (con TM.)
ZONARE Medical Systems- Z one ultra system
Siemens-Acuson P50
OFR2008 5
Siemens-Acuson P10 Siemens-Acuson P10 20082008
HAND HELDHAND HELD
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Phot0Baby Phot0Baby Customizes Ultrasound VideosCustomizes Ultrasound Videos
Nursing Nursing management & management & something else…something else…
OFR2008 7
Royal Philips ElectronicsRoyal Philips Electronics 4-D time-lapse ultrasound 4-D time-lapse ultrasound
imageimage 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
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VIRTUAL SONOGRAPHYVIRTUAL SONOGRAPHY20002000
Ultrasound in Obs & GynecologyUltrasound in Obs & Gynecology 2000 16:102,. Ferrer-Roca et al.16:102,. Ferrer-Roca et al.
Three dimensional ultrasound reconstruction Three 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 Issuehttp://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
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 1.0False Alarm Rate
0.0
0.2
0.4
0.6
0.8
1.0
Hit
Rat
e
Respuesta diagnostica con Ecografia local=66casos 12meses
Receiver Operating Characteristic (ROC) Plot
0.0 0.2 0.4 0.6 0.8 1.0False Alarm Rate
0.0
0.2
0.4
0.6
0.8
1.0
Hit
Rat
e
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);
OFR2008 10
New image modalitiesNew image modalities
CT US MRI OCT CMicro Hybri
d
OFR2008 11
3x
Image modalities-SSVS 2005
Areas identified by pathologist / technician
26Mb 16Mb
40x
250x
TEXCAN-II ® Ferrer-RocaSSVS 2005© Ferrer-Roca
Low power M
O 3x
SUPER-RESOLU
TION
OFR2008 12
New ICT-tools New ICT-tools Health-GRID (2008)Health-GRID (2008)
GRID TECHNOLOGY IN TELEPATHOLOGY AND PERSONALIZED TREATMENTGRID TECHNOLOGY IN TELEPATHOLOGY AND PERSONALIZED TREATMENTFerrer-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
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TeleTele●●US US Solo Solo●●DPDP
WirelessWireless Hand-held portableHand-held portable Virtual sonography Virtual sonography Super-resolution imagesSuper-resolution images New image modalitiesNew image modalities Ultra-resolutionUltra-resolution Personalized medicinePersonalized medicine LBD-Image search LBD-Image search “solo- “solo-
perinatology”perinatology”
INNOVATIONS
OFR2008 14
LUMA cervical imagingLUMA cervical imaging
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Image mergingImage merging
LOGIQ® E9 LOGIQ® E9
new image technology new image technology & real-time capability & real-time capability
to mergeto merge an ongoing an ongoing ultrasound exam with ultrasound exam with previously acquired previously acquired CT, MR or US images. CT, MR or US images.
OFR2008 16
Siemens- ACUSON Siemens- ACUSON P10P10
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 Im
age Correlation)
RF images
HD (high density) transducer technology
OFR2008 17
Photoacoustic Photoacoustic microscopy at super microscopy at super
depthsdepths3D tomographic photoacoustic microscopy (PAM) 3D tomographic photoacoustic microscopy (PAM)
• LightLight & & ultrasoundultrasound hybrid technology hybrid technology HIGH HIGH RESOLUTION IMAGING SUPER-DEPTH image. RESOLUTION IMAGING SUPER-DEPTH image.
•1. 1. Short-pulsed laserShort-pulsed laser light absorbed light absorbed causes an causes an increase in pressure via increase in pressure via thermoelastic expansionthermoelastic expansion. . •2. The increased pressure propagates through the tissue 2. The increased pressure propagates through the tissue as an ultrasonic wave, known as a as an ultrasonic wave, known as a photoacoustic wavephotoacoustic wave, , •3. The wave is detected by an 3. The wave is detected by an ultrasonic transducerultrasonic transducer that that produces electrical signals. produces electrical signals. •4. The signals are then 4. 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.
PAM PAM optical irradiation, ultrasonic optical irradiation, ultrasonic detection, and image formation detection, and image formation
5MHz US & 804 nm light 3cm depth
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OPTICAL COHERENCE OPTICAL 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 OCT OCT echo techniqueecho technique similar similar 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.
OFR2008 19
OCT-ScannersOCT-Scanners
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OCT & MicroscopyOCT & Microscopy
Fiberoptic OCT systemFiberoptic OCT system OCT endoscopyOCT endoscopy
OCT
MO
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OCT-Optical biopsyOCT-Optical biopsy
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OCT-ColposcopeOCT-Colposcope
Resolucion transversa 20 micrasResolucion transversa 20 micras
Zeiss
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High Speed OCT High Speed OCT colposcopecolposcope
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Ultra-High resolution OCTUltra-High resolution OCT
CYTOLOGIST
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Ultra-High & spectroscopic Ultra-High & spectroscopic OCTOCT
1x3 micras1x3 micras100 micras
UH-resolution OCTSpectroscopic OCT- melanocytes Red
OFR2008 26
OCT Microscope - OCT Microscope - EX1301 EX1301
Gloucestershire Royal Hospital and University College London Hospital (UCLH) are to trial 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 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.identification of cancers affecting the cervix, oesophagus, skin, lung and other organs.
http://www.md-ltd.co.uk/
OFR2008 27
OCT & Embrion OCT & 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
OFR2008 28
MEDICINE AT DISTANCEMEDICINE AT DISTANCE
Standardization Standardization & interoperability& interoperability Quality assurance Quality assurance Risk management & consumer/user confidenceRisk management & consumer/user confidence Plug & play Plug & play easy to use / easy to integrate easy to use / easy to integrate Portability & Mobility.Portability & Mobility.
TECHNICALTECHNICAL IMPLEMENTATIONIMPLEMENTATIONee--medicine,medicine, tt--medicine,medicine, pp--medicine.medicine.
LIC
ENC
ING
OFR2008 29
AMI@medicine in AMI@medicine in NeonatologyNeonatology
Alimentación con el roce del tejido
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 gran utilidad.La SONOGRAFIA VIRTUAL es de gran utilidad. Las NUEVAS MODALIDADES imagen la acercan Las NUEVAS MODALIDADES imagen la acercan
a la Anatomía Patológica.a la Anatomía Patológica.
OFR2008 31
THANK YOU FOR YOUR THANK YOU FOR YOUR ATTENTIONATTENTION
Prof.Dr.O.Ferrer-RocaProf.Dr.O.Ferrer-RocaUNESCO Chair TelemedicineUNESCO Chair Telemedicine
““Who's who in the World”,Who's who in the World”, 1996- 1996-actact
““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-act.Who’s who in Science and Engineering”, 2001-act.
catai@teide.netcatai@teide.nethtttp://www.teide.net/cataihtttp://www.teide.net/catai
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