Unexpected twist on Medical Care: Aerospace and Auto Technologies Helping to Provide Better Treatments

If you're a fan of German engineering in your car, chances are you'll love it in your brain scan. Hospitals are trying to cross-pollinate health care with technologies that have roots in the automotive and aerospace industries. The hope is that, with a medical twist, high-tech navigation systems, pattern recognition software and top-of-the-line robots can revolutionize the treatment of everything from irregular heartbeats to lung cancer. St. Luke's Episcopal Hospital says it is the first in the world to treat stroke patients with the help of a robotic arm that has its origins in systems created by Munich-based Siemens AG for precision welding on the assembly lines of BMW and Mercedes-Benz.

From Houston Chronicle

If you’re a fan of German engineering in your car, chances are you’ll love it in your brain scan.

Local hospitals are trying to cross-pollinate health care with technologies that have roots in the automotive and aerospace industries. The hope is that, with a medical twist, high-tech navigation systems, pattern recognition software and top-of-the-line robots can revolutionize the treatment of everything from irregular heartbeats to lung cancer.

St. Luke’s Episcopal Hospital says it is the first in the world to treat stroke patients with the help of a robotic arm that has its origins in systems created by Munich-based Siemens AG for precision welding on the assembly lines of BMW and Mercedes-Benz.

The medical robot, dubbed Artis zeego and manufactured by Siemens Medical Solutions, is coupled with a CT scanner and X-ray. It can tilt, turn and spin at virtually infinite angles, capturing detailed images that track blood flow.

Imaging is usually limited, requiring a lot of time and guesswork to get the right picture so doctors can tell what’s going on inside an artery. But this robot is made with a memory for pinpointing locations, allowing it to snap back almost instantly to an exact spot should the doctor need to take a second look.

Tracing a tiny bubble deep in the brain only a few millimeters long is an arduous business. In some cases mere seconds matter and older equipment becomes a time-drag, says Dr. Michel Mawad, the director of Neurovascular Radiology at St. Luke’s who is testing out the Artis zeego. Mawad is also a member of Siemens’ medical advisory board.

"This takes the human error out. You can reproduce the exact angle every time," he says. "We’re being very careful. We’re going very slow for now, but there’s tremendous potential for speed here."

Helps in difficult cases

St. Luke’s Vice President Mike Reno says the hospital invested $3.5 million in the machine and built a new suite for it because it allows doctors to tackle the most complex cases.

"Even though we’ve already hit the best outcomes for stroke in Texas, we’re not settling for that. This allows us to do the most difficult patients," he says.

At The Methodist Hospital Research Institute, physicist Christof Karmonik is testing aerodynamics software used to build race cars to try to predict blood flows through potentially deadly aneurysms.

Fluids and air flow in similar ways, Karmonik says. So Methodist is using a program created by Pittsburgh-based Ansys to project the velocity and sheer of blood as it moves toward and through a bulging vessel. The goal: find alternate treatment options based on how fast the blood is traveling and how it reacts when encountering a hard surface, such as the wall of an artery.

"We want to understand how high and low pressure might result in different treatments. We want to understand why, even once aneurysms are closed off, they sometimes grow back," Karmonik says.

"People have started applying this to patient-specific images. It’s not an abstract model of the geometry of an aneurysm any more."

Last month, Methodist cardiologist Dr. Miguel Valderrabano began using triangulation similar to that employed by global positioning satellite navigation devices to track heart catheters in his patients suffering from atrial fibrillation, a type of heart arrhythmia that puts people at risk for blood clots.

Instead of using satellites to zero in on the catheter, the Sensei Robotic Catheter uses three magnets to triangulate and locate the catheter, which is fitted with a magnetic tip. The device also measures electrical impedance on three axes.

In the past, physicians had to insert catheters manually and hold them in place while rotating and coercing them up the vessel from the groin to the heart, taking X-rays along the way to track progress.

"It becomes very tricky to know where you are by looking at X-rays," Valderrabano says, adding the near constant radiation is bad for the doctors who do this all day long wearing a heavy lead apron. The new system reduces doctors’ and patients’ exposure to X-rays.

Valderrabano sits across the room from the patient with an irregular heartbeat. At a computer console with 10 monitors displaying the 3-D body-mapping system, he uses a joystick to drive the catheter to the heart.

The catheter is equipped to measure resistance four times per second as it proceeds so it won’t puncture the vessel.

Valderrabano says the technology does not replace judgment or training.

"But this takes the guesswork out of it," he said. "You know what you’re doing all the time and it’s harder to make mistakes."

Reducing waiting time

The system is part of a "see and treat" movement in medicine that often saves patients from multiple procedures or waiting months to undergo a separate surgery after an initial diagnosis is made.

Stephen Wong, an engineer who is not a physician, chairs medical physics efforts at The Methodist Hospital Research Institute. He says see-and-treat procedures for small-scale lung cancer is coming soon thanks to GPS-like technology.

GPS navigation systems use a preloaded street map and show one variable — the car — moving through it. In Wong’s world, a snapshot of the body is the preloaded map and a needle is the car.

Fiber optic wire can be pushed down the needle into the tumor to provide images to the physicians, then a special dye is injected. "If it lights up, it’s cancer," Wong says.

With existing methods the process from initial screening to surgery can take three to four months.

But with the method Wong is interested in, an electrical wire could be inserted through the diagnostic needle to burn away the cancer. Tests on animals have been successful, Wong said, adding human subjects won’t be far behind.

Wong is also directing a team of researchers that is using pattern recognition software to sift through millions of images of millions of cells in the hopes of finding the origins of cancer.

Wong says it may be possible to predict cancer using the same kind of computer algorithms that help track objects in space.

In theory, the same approach could track treatment, with doctors monitoring a patient’s cells to determine if the cancerous ones were dying off or continuing to proliferate.

"This is about early detection and treatment. This is about prevention," Wong says. "We can apply this to a population of millions or take it down to you — just you. You couldn’t think of this even two years ago."