Oncology Archive

Tuesday, November 17, 2009

Ultrafast Lab-on-a-Chip for Detection of Disease Biomarkers

Researchers from IBM Research in Zurich and the University Hospital of Basel in Switzerland developed a microfluidic device that uses capillary action to detect the presence of protein biomarkers for various disease types. The five square centimeter silicon-based lab-on-a-chip takes only fifteen seconds to perform its analysis.

Here are the five functional stages of the device:

Stage 1: A one microliter sample, 50 times smaller than a tear drop, is pipetted onto the chip, where the capillary forces begin to take effect.

Stage 2: These forces push the sample through an intricate series of mesh structures, which prevent clogging and air bubbles from forming.

Stage 3: The sample then passes into a region where microscopically small amounts of the detection antibody have been deposited. These antibodies have a fluorescent tag and similar to the antibodies within our body, they recognize the disease marker and attach to it within the sample. Only seventy picoliters (a volume one million times smaller than a tear) of these antibodies are used, making their dissolution in the passing sample extremely fast and efficient.

Stage 4: The most critical stage is called the "reaction chamber" and it measures 30 micrometers in width and 20 micrometers in depth, roughly the diameter of a strand of human hair. Similar to a common pregnancy test, in this stage the disease marker that was previously tagged is captured on the surface of the chamber. By shining a focused beam of red light, the tagged disease markers can be viewed using a portable sensor device that contains a chip similar to those used by digital cameras, albeit this one being much more sensitive. Based on the amount of light detected, medical professionals can visually confirm the strength of the disease marker in the sample to determine the next course of treatment.

Stage 5: Less a stage and more a part of the entire process is the capillary pump. The capillary pump, which has a depth of 180 micrometers, contains an intricate set of microstructures, the job of which is to pump the sample through the device for as long as needed and at a regular flow rate, just like the human heart. This pump makes the test accurate, portable and simple to use. IBM scientists have developed a library of capillary pumps so that tests needing a variety of sample

More from IBM Research: IBM Scientists Reinvent Medical Diagnostic Testing ...

Abstract in Lab on a Chip: Toward one-step point-of-care immunodiagnostics using capillary-driven microfluidics and PDMS substrates

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Monday, November 16, 2009

Viral Powered Cancer Therapy from Biovex Advancing Through Clinical Trials

Biovex out of Woburn, Massachusetts recently completed Phase II clinical trials of the firm's virus based technology aimed at attacking tumor cells. In this study, the OncoVEX^GM-CSF oncolytic herpes virus was tested on patients with advanced melanoma. The results were promising enough to raise $70 million in funds to move the technology further through the trials.

The Company's lead cancer treatment, OncoVEX^GM-CSF is a first-in-class oncolytic, or cancer destroying virus, that works by replicating and spreading within solid tumors (leaving healthy cells unaffected), thereby causing cancer cell death and stimulating the immune system to destroy un-injected metastatic deposits. Both modes of action have been clearly validated in the clinic, where multiple patients with metastatic disease progressing at enrollment have been declared disease free. BioVex believes OncoVEX^GM-CSF has the potential to become a leading standard of care in the treatment of many solid tumors based on the strength of clinical data so far generated coupled with the relatively benign side effect profile noted to date. Previous clinical trials have enrolled patients with breast cancer, melanoma, head and neck cancer and pancreatic cancer, with indications of clinical activity being observed in each.

Press releases: BIOVEX ANNOUNCES PUBLICATION OF PHASE 2 MELANOMA RESULTS WITH ONCOVEXGM-CSF IN THE JOURNAL OF CLINICAL ONCOLOGY...; BIOVEX COMPLETES $70 MILLION FINANCING TO CONCLUDE PIVOTAL STUDY WITH ITS PIONEERING CANCER TREATMENT, ONCOVEXGM-CSF...

Abstract in Journal of Clinical Oncology: Phase II Clinical Trial of a Granulocyte-Macrophage Colony-Stimulating Factor-Encoding, Second-Generation Oncolytic Herpesvirus in Patients With Unresectable Metastatic Melanoma

Image: Transmission electron micrograph of 4 views of Herpes simplex virus, computer-coloured mauve. Wellcome Images.

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Friday, November 6, 2009

iChemoTracker Keeps Tabs on Your Chemo Regimen

Merck has released the iChemoDiary for the iPhone platform, an app designed to help patients monitor their time on chemotherapy. The software allows patient to compile chemo treatments, side effects, and general well being, through a set of criteria, that can be later presented to a healthcare provider.

Track your chemotherapy schedule, medication, and treatment plan

Record some of the possible side effects from chemotherapy treatments, such as nausea, vomiting, pain, fatigue, change in temperature, lack of appetite, tingling in feet or toes, diarrhea, constipation, and rash

Create reports that include chemotherapy, medications, and some of the possible side effects on a daily or weekly basis

Share your results and discuss your symptoms with your doctor or nurse so you can have a more accurate and informed discussion

Product page: iChemoDiary ...

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Tuesday, October 27, 2009

Mini-Lab Device Helps Identify Ideal Chemo Regiment

To evaluate how tumor cells from an individual cancer patient might react to chemotherapy drugs, researchers from Technische Universität München (TUM) developed a tiny microfluidic device that can automate the testing process.

The microsensors on the chip record, among other things, changes in the acid content of the medium and the cells’ oxygen consumption; photographs of the process are also taken by a microscope fitted underneath the microtitre plate. All of the data merge in a computer that is connected to the system, and which provides an overview of the metabolic activity of the tumor cells and their vitality.
The robots and microtitre plates are kept in a climatic chamber, which, through precisely regulated temperature and humidity, provides an environment similar to that of the human body, and also protects the tumor cells against external influences that can falsify the test results.

After the tumor cells have been able to divide undisturbed for a few hours, the robot applies an anti-cancer substance. If their metabolic activity declines over the next day or two, the active substance was able to kill the tumor cells and the drug is effective. Using the microchips, twenty-four active substances or combinations of active substances can be tested simultaneously in this way.

The gain in time for the patient is not the only positive factor here. Dr. Helmut Grothe, a scientist from the Heinz Nixdorf Chair at the TUM, explains: “Treatment with an ineffective cancer drug sometimes leads to the development of resistance to other drugs in the patient.” Such resistance on the part of the tumor cells can also be identified at an early stage with the help of the sensor chip.

Another advantage of the system is its automation. The robot works faster and more accurately than any human could. Hence, the test results can be obtained quickly, which, in turn, saves on costs. Furthermore, the possibility of testing tumor cells with several active substances simultaneously facilitates the search for effective substances for individually-tailored cancer treatment. Pharmaceutical companies may also be able to use the sensor chip in the development of new drugs in future.

As part of another research project, the scientists at the Heinz Nixdorf Chair are also developing a sensor chip that is intended to control tumor growth. The chip, which would be implanted once in the vicinity of the tumor, could release cancer drugs or pain medication only when the tumor grows. The release of the active substances would be controlled by electric impulses. This sensor system could be used in the treatment of inoperable tumors, for example pancreatic tumors.

Full story from Technische Universität München: Mini-Lab for Cancer Diagnosis....

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Tuesday, October 13, 2009

Microcapsules Deliver Chemo Direct to Lung Tumor

Cisplatin is a chemotherapy drug commonly prescribed to lung cancer patients. Because it is administered systemically, the entire body gets a hefty dose of the toxic substance with side effects that are often quite debilitating. To better target the drug toward lung CA, researchers at the University of Strachlyde, Glasgow and TRANSAVE (Monmouth Junction, NJ) have independently developed inhalation microcapsules that can contain cisplatin.

From The Engineer Online:

While the concept behind their techniques is relatively the same, the materials used to make the bubbles differ. The Transave bubble is based on a lipid and the Strathclyde University team has developed a bubble made of a surfactant, cholesterol and dicetylphosphate.
Katharine Carter, a member of the Strathclyde University research team, said the reagents that make up their bubble are more robust, and the manufacturing method has the potential to be much simpler.

Neither technique is commercially available; however, Transave has already taken its drug-delivery system to stage two clinical trials, while Strathclyde is still performing animal testing.

The technique would work by placing drug-containing bubbles in the solution container of a nebuliser. Carter said their animal trials indicate a patient would only have to breathe in the bubbles for 6.5 minutes.

When the bubbles reach the lung, she added, they will be met by a vast amount of macrophages, which are white blood cells that break down pathogens with special enzymes.

Carter explained that these macrophages would recognise the bubbles as a pathogen and bust them open. 'The drug will then be released locally at the cells and into the environment nearby,' she said.

Tuesday, September 29, 2009

Cancer Diagnosis Via Semiconductor

Researchers at the University of Toronto, led by Dr. Shana Kelly and Dr. Ted Sargent, are reporting in Nature that they have used a combination of nanoparticles and a microchip to determine the type and severity of a patient's cancer based on the signature of biomarkers that indicate the presence of cancer at the cellular level.

>Dr. Kelly's work demonstrates that the cells can be differentiated with these biomarkers because of the cellular genes that indicate aggressive or benign forms. The scanning electron micrograph illustrates the eight variable structures that the system can repeatably track with less than 5% variation. Analysis time is reported to be 30 minutes as compared with contemporary diagnostics tests which can take days.

The researchers' new device can easily sense the signature biomarkers that indicate the presence of cancer at the cellular level, even though these biomolecules - genes that indicate aggressive or benign forms of the disease and differentiate subtypes of the cancer - are generally present only at low levels in biological samples. Analysis can be completed in 30 minutes, a vast improvement over the existing diagnostic procedures that generally take days.
"Today, it takes a room filled with computers to evaluate a clinically relevant sample of cancer biomarkers and the results aren't quickly available," said Shana Kelley, a professor in the Leslie Dan Faculty of Pharmacy and the Faculty of Medicine, who was a lead investigator on the project and a co-author on the publication.

"Our team was able to measure biomolecules on an electronic chip the size of your fingertip and analyse the sample within half an hour. The instrumentation required for this analysis can be contained within a unit the size of a BlackBerry."

Press release: U of T researchers create microchip that can detect type and severity of cancer...

Nature: Programming nucleic acids detection sensitivity using controlled nanostructuring

University of Toronto: Shana Kelly Lab

(hat tip: Next Big Future)

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Tuesday, August 25, 2009

Tactile Sensing Robot Does Hands-On Detection of Tumors

Even though solid tumors often look like the healthy tissue they're invading, they almost always present as fibrous densities, hence surgeons use their fingers to feel for a difference in stiffness during extraction. Canadian researchers from the University of Western Ontario and Canadian Surgical Technologies and Advanced Robotics at the London Health Sciences Center have adapted a robot to identify the change in stiffness as it traverses a surface, hoping to develop this technology for cancer detection or diagnosis. So far, in lab experiments, the instrument has displayed considerably greater precision than humans at detecting the stiffness gradient.

With cows' livers standing in for human tissue and 10mm and 5mm blobs of glue wrapped in wire representing tumours, the researchers compared palpation by surgeons, non-surgeons and the robot in the blinded trials. The researchers used a torque sensor to measure the force of the palpations.

Using tactile MIS sensing instruments under robotic control reduces the maximum force applied to the tissue by over 35% compared to a human controlling the same instrument. Accuracy in detecting the tumours was also far greater with the robot - between 59 and 90% depending on the robot control method used for palpation.

Unlike humans, the robot applies consistent force in each step, and moves over the tissue systematically. This produces a complete map, equivalent to one large pad applying ideal levels of force to the whole sample. (Similar to tactile sensors that have been developed to detect breast tumours.)

Humans do not know from one palpation to the next exactly how much force they are applying. This means some features are only highlighted because the surgeon is applying more force, or because the human user has changed the angle slightly between the instrument and the tissue. It is also easier to miss a tumour due to applying slightly lower force.

In fact both surgeons and non-surgeons were more likely to cause tissue damage than the robot. When a subject observed increased pressure on the visual display, they tended to focus on the area and apply even more force to see if what they had observed was a tumour. In the case of MIS, only a very small area can be palpated, which makes it challenging to compare adjacent areas and search for a tumour manually.

Press release: Robot's gentle touch aids delicate cancer surgery ...

Article in The International Journal of Robotics Research: Robot-assisted Tactile Sensing for Minimally Invasive Tumor Localization

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IsoFlow Catheter Helps Target Tumor During Chemo Infusion

Current methods of delivering chemotherapy and chemoembolization agents have trouble limiting the affected parts of the organ to just the area around the tumor. Dana Blankenhorn, who now blogs at SmartPlanet.com, is reporting that Vascular Designs Inc. out of San Jose, CA has received FDA clearance for its IsoFlow infusion catheter that can occlude a section of vasculature, while allowing blood to continue to perfuse through the catheter itself. Once occluded, the chemo agents can be delivered peripherally to the isolated section, while blood is shunted past uninterrupted.

More details from the product page:

The IsoFlow catheter enables sideways perfusion, which gives you the ability to push specified fluids both into side branch and angiogenicly formed vessels, letting medications reach an isolated area in a highly targeted and concentrated fashion. With IsoFlow's unique design, fluids can reach areas that could not previously be treated directly.
IsoFlow is inserted with a guide wire and catheter for precise positioning within a patient's body. Once in place, both of IsoFlow's balloons are simultaneously inflated using radiopaque fluid via a single inflation lumen. Physician-specified fluid is introduced through the infusion lumen or the guide wire lumen via the one-way stopcock connection. The mixture of infusion and radiopaque agents is then delivered to the target region between the two balloons. For sideways infusion, the guide wire is retracted to allow blood to bypass the isolated target region via holes in the catheter exterior. Complete removal of the guide wire allows fluid delivery from the distal tip.

Watch the video for how the IsoFlow is operated:

Product page: IsoFlow ...

Wednesday, July 22, 2009

CellScope, a "Mobile Phone Based Clinical Microscopy for Global Health Applications"

Investigators from UCSF and UC Berkeley have just published an article at PloS ONE that discusses applicability data and design of a newly developed microscope-enabled mobile phone system, dubbed CellScope. We have covered CellScope on our pages before. The goal of this research is to equip clinicians with a small and cheap technology to image microorganisms and pathology specimens in remote places, for an instant diagnosis or for transmission of images to a central location, such as a regional medical center.

The engineers attached compact microscope lenses to a holder fitted to a cell phone. Using samples of infected blood and sputum, the researchers were able to use the camera phone to capture bright field images of Plasmodium falciparum, the parasite that causes malaria in humans, and sickle-shaped red blood cells. They were also able to take fluorescent images of Mycobacterium tuberculosis, the bacterial culprit that causes TB in humans. Moreover, the researchers showed that the TB bacteria could be automatically counted using image analysis software.

The engineers had previously shown that a portable microscope mounted on a mobile phone could be used for bright field microscopy, which uses simple white light — such as from a bulb or sunlight — to illuminate samples. The latest development adds to the repertoire fluorescent microscopy, in which a special dye emits a specific fluorescent wavelength to tag a target - such as a parasite, bacteria or cell - in the sample.

The researchers used filters to block out background light and to restrict the light source, a simple light-emitting diode (LED), to the 460 nanometer wavelength necessary to excite the green fluorescent dye in the TB-infected blood. Using an off-the-shelf phone with a 3.2 megapixel camera, they were able to achieve a spatial resolution of 1.2 micrometers. In comparison, a human red blood cell is about 7 micrometers in diameter.

The researchers pointed out that while fluorescent microscopes include additional parts, less training is needed to interpret fluorescent images. Instead of sorting out pathogens from normal cells in the images from standard light microscopes, health workers simply need to look for something the right size and shape to light up on the screen.

Article in PLoS ONE: Mobile Phone Based Clinical Microscopy for Global Health Applications...

Press release with video of the microscope in action: UC Berkeley researchers bring fluorescent imaging to mobile phones for low-cost screening in the field...

Side image: Fluorescent image of TB bacteria taken by the CellScope.

Flashback: CellScope for Rural Microscopy On The Go

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Friday, July 17, 2009

MarrowMiner Digs Out More Marrow Using Fewer Holes

Daniel Kraft from the Stanford Institute for Stem Cell Biology and Regenerative Medicine invented a device to make bone marrow harvesting in donors a less invasive and less stressful process on the body. The idea is to drill one hole into the pelvis and then to approach the bone marrow from different angles, thus widening the harvesting region.

Here's a TED talk of Kraft presenting the MarrowMiner device:

Product page: MarrowMiner...

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Thursday, July 16, 2009

Earn Continuing Medical Education (CME) Credits via iPhone

The Center for Biomedical Continuing Education (CBCE) recently launched a continuing medical education (CME) oncology application for the iPhone that lets a physician quickly access clinical news, treatment updates, and conference highlights. The free application pulls in accredited content from the CBCE and allows a medical provider to take quizzes and earn CME credits on the go. Unlike ReachMD, which has a similar application, the CBBE app supports more than just audio - it can handle text, slides, and video as well.

From the CBCE press release:

Through the leveraging of Apple mobile technology, the CBCE CME app allows for fully accredited treatment updates, conference highlights, and CME tests to be used by healthcare professionals in a convenient format. Content includes coverage of both solid tumors and hematologic malignancies.
This continually updated application draws from select CME content found on www.thecbce.com. CME programs will be available in a variety of media formats, including podcasts, Webcasts, slides, and text. This application takes advantage of the best functionality these devices have to offer and contains the following features:

Free content and application

Fully accredited CME programs and posttests

Available on demand, 24/7, wherever Wi-Fi or 3G networks are accessible

Easy-to-use, multimedia CME

Automatic program updates

Bookmarks to quickly return to designated programs

Keyword search for relevant, easy-to-find CME programs

Press release: CBCE Launches Oncology-Focused CME App for the iPhone and iPod Touch...

Product page: The Center for Biomedical Continuing Education...

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Tuesday, July 14, 2009

Watching Circulating Tumor Cell Count Helps Predict Breast Cancer Development

A new study just published in the Journal of Clinical Oncology has shown that monitoring the count of circulating tumor cells (CTC) using the CellSearch system from Veridex, a Johnson & Johnson company, can predict the prognosis of patients with metastatic breast cancer. The CellSearch system uses ferrofluid iron microparticles attached to antibodies that like to grab on to CTC cells. Using a magnet, the device can remove the particles out of a blood sample for precise identification and number count.

More about CellSearch and some details about the study from the J&J press release:

CellSearch® test results should be used in conjunction with all clinical information derived from diagnostic tests (e.g., imaging, laboratory tests), physical examination and complete medical history in accordance with appropriate patient management procedures.
Study Design

A retrospective study was performed on 115 patients with MBC who had the CellSearch test performed as part of their initial staging process at M.D. Anderson over a three-year period. CTC count and FDG-PET/CT imaging were performed at baseline in 102 evaluable patients before starting a new therapy and then again at the midpoint of their therapies (9 - 12 weeks). Patients outcomes were categorized according to midtherapy CTC counts as favorable (< five CTCs/7.5 mL blood) or unfavorable (≥ five CTCs/7.5 mL blood). Based on FDG-PET/CT, patients were considered responders if metabolic activity of target lesions decreased more than 25% compared to baseline, and if there was no change or a decrease in size. Patients were considered nonresponders if the FDG uptake was similar or higher and/or if target lesions had increased in size. CTC counts and FDG-PET/CT response at midtherapy were compared, and univariate and multivariate analyses were performed to identify factors associated with survival.

Study Findings

A total of 115 patients with metastatic breast cancer were considered for the study and 102 were evaluable for efficacy. The median overall survival time was 14 months (range, 1 to > 41 months). In univariate analysis, both midtherapy CTC counts and FDG-PET/CT response predicated overall patient survival (p<.001 and p=.001, respectively). The overall concordance between the CTC counts at midtherapy and FDG-PET/CT was 67% for response/nonresponse and 74% for progression/nonprogression. In the discordant category, detection of five or more CTCs during therapeutic monitoring accurately predicted prognosis in MBC beyond metabolic response. FDG-PET/CT was able to predict outcome in discordant instances of patients with less than five CTCs at midtherapy. Midtherapy CTC levels remained significant in a multivariate analysis (p=.004). These results suggest a higher and independent predictive value of CTCs compared with FDG-PET/CT among patients with a CTC count of five or more. In addition, there was a strong correlation between complete response and the absence of significant levels of CTCs (median CTC level zero).

Press release: Monitoring Circulating Tumor Cells with the Cellsearch® System Can Predict Prognosis in Metastatic Breast Cancer...

Abstract in Journal of Clinical Oncology: Circulating Tumor Cells and [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Outcome Prediction in Metastatic Breast Cancer

Product page: CellSearch Circulating Tumor Cell (CTC) Kit...

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Wednesday, May 13, 2009

Taking Monitoring Straight to The Tumor

Biopsies are good at helping diagnose cancer and its local spread. But once the biopsy and local excision is performed, there is no modality to monitor the state of cancer at the site. Now MIT researchers have developed an implantable probe that can continuously monitor the presence of a particular hormone produced by human tumor cells, and they hope their technology can be implemented for other cancer specific markers.

From an MIT press release:

In the Biosensors & Bioelectronics study, human tumors were transplanted into the mice, and the researchers then used the implants to track levels of human chorionic gonadotropin, a hormone produced by human tumor cells.
The cylindrical, 5-millimeter implant contains magnetic nanoparticles coated with antibodies specific to the target molecules. Target molecules enter the implant through a semipermeable membrane, bind to the particles and cause them to clump together. That clumping can be detected by MRI (magnetic resonance imaging).

The device is made of a polymer called polyethylene, which is commonly used in orthopedic implants. The semipermeable membrane, which allows target molecules to enter but keeps the magnetic nanoparticles trapped inside, is made of polycarbonate, a compound used in many plastics.

Cima [Michael Cima, MIT professor of materials science and engineering] said he believes an implant to test for pH levels could be commercially available in a few years, followed by devices to test for complex chemicals such as hormones and drugs.

Press release: Implantable device offers continuous cancer monitoring

Abstract in Biosensors and Bioelectronics: Implantable diagnostic device for cancer monitoring

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Wednesday, April 29, 2009

New Brachytherapy Set for Better Dose Deliverance to Patients

Varian Medical Systems has introduced a new bronchoscopic brachytherapy applicator set, the Centering Intraluminal Applicator™, that the company says will increase treatment precision and aid comfort for patients suffering from bronchial cancer.

According to the press release, the new system features a novel catheter that enables a centered position of the source in the lumen of the trachea or the bronchus, all the while maintaining an open airway for better ventilation. This 3-centering catheter is designed such that it can be partially or fully extended, thus allowing for a variety of conformations to adapt to each patients unique anatomy.

"This new applicator set helps clinicians to optimize the dose distribution thanks to its ability to center the source at the middle of the bronchial lumen," says Claudia Andres-Zindler, brachytherapy applicator product manager. "Crucially, it also allows the patient to breathe unaided during treatment."

Features of the Centering Intralumninal Applicator™ include:

X-ray contrast strip to display the longitudinal axis and the spreading of the baskets.

Seldinger guide wire to insert and guide the centering catheter with the baskets into the desired position.

4.7 French catheter with a diameter of 1.59 mm for the source transfer.

Press release : Varian Introduces Brachytherapy Applicator Set to Optimize Precision and Comfort of Bronchial Cancer Treatments...

Varian Medical Systems - Brachytherapy...

Flashback : TargetScan Aims for Precise Brachytherapy

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Friday, February 27, 2009

Electrical Nerve Stimulator for Drug Resistant Pain Gets Green Light in U.S.

The FDA has given 510(k) approval to Competitive Technologies, Inc. (Fairfield, CT) to market a pain management device for cases that are not sufficiently responding to drugs and other therapies. The company says its electromedical system sends electronic scrambling messages to the central nervous system, and effectively tricks the body to believe that all is well.

From the product, described as a "transcutaneous electrical modulation pain reprocessor":

Description:
The pain management therapy technology is a non-invasive method for rapid treatment of high-intensity oncologic, neuropathic, and drug-resistant pain through a biophysical rather than a biochemical manner. The method incorporates electromedical equipment for electronic nerve stimulation, and uses the nerve fiber as a passive means to convey a message of normality to the central nervous system (CNS) by a procedure defined as scrambling or tricking of information, which then enables the CNS to modify the reflex adaptive responses — referred to as TEMPR — Transcutaneous Electrical Modulation Pain Reprocessor. It has been successfully used to treat over 2,300 patients in hospitals in Italy.

Advantages:

The non-invasive MC-5A device, using Scrambler technology, is a multiprocessor apparatus able to simultaneously treat multiple pain areas in the individual. The patient experiences longer "no pain" periods after each successive treatment.

Applications:

The global pain management market is estimated to reach $40 billion by 2010. Potential market opportunities include hospitals, nursing homes and hospices, cancer treatment centers, and pain management centers.

Product page: Pain Management Therapy...

Press release: Competitive Technologies Receives FDA Authorization for Sales of Pain Therapy Medical Device ...

Link to interview with Competitive Technologies CEO about the approval...

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Monday, February 23, 2009

Growth of Blood Vessels Within Tumors to be Studied Using New Tool

Researchers at Uppsala University in Sweden have developed a special culture chamber, a micro lab designed to study angiogenesis. Using tiny electrodes, researchers say they can send signals to the vessels that seem to regulate their growth. The technology might shed light on growth of blood vessels in cancers, inflammatory conditions, and post-ischemic tissue regeneration.

From the study abstract published in Lab on a Chip:

Many signals that induce angiogenesis have been identified; however, it is still not clear how these signals interact to shape the vascular system. We have developed a fluidic device for generation of molecular gradients in 3-dimensional cultures of complex tissues and organs in order to create an assay for precise induction and guidance of growing blood vessels. The device features a centrally placed culture chamber, flanked by channels attached to a perfusion system used to generate gradients. A separate network of vacuum channels permits reversible attachment of the device to a flat surface. We show that the fluidic device can be used to create growth factor gradients that induce directional angiogenesis in embryonic mouse kidneys and in clusters of differentiating stem cells. These results demonstrate that the device can be used to accurately manipulate complex morphogenetic processes with a high degree of experimental control.

Press release: Tiny tool to control growing blood vessels opens new potential in tumor research ...

Abstract in Lab on a Chip...

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Siemens Rolls Out 1.5 Tesla MRI for Breast Visualization

Siemens is introducing an MRI machine, called Magnetom Espree-Pink, specifically designed for breast imaging. The 1.5 Tesla device features an innovative Sentinelle Vanguard Siemens' coil, and a 70cm bore size for those who are on the front lines of the obesity epidemic.

From Siemens:

The flexible "Sentinelle Vanguard for Siemens" coil solution makes both imaging and biopsies possible using only a single coil. Depending on requirements, only the lateral inserts of the coil are replaced. The frame itself remains on the table and does not have to be repositioned. In addition, due to its variable coil geometry (VCG), the coil can be optimally adapted to the different breast sizes of various patients. Excellent image quality is attained through an improved signal-to-noise ratio and with the help of eight RF channels.

The new system additionally offers a comprehensive range of standard and advanced applications for breast imaging. These include, among others, the Breast Suite with Syngo Views for routine examination requirements, which can be used to obtain a three-dimensional representation of the breast with a high spatial and high temporal resolution in the sub-millimeter range, for instance. Syngo Grace is an application package for quantitative MR breast spectroscopy. This software can display the biomarker choline, thus providing valuable information on the biochemical composition of breast lesions. Syngo Blade is an application that ensures motion-free images, even when the patient moves during the examination.

The workstation of the Magnetom Espree-Pink is equipped with the new syngo BreVis and syngo BreVis Biopsy software applications for planning and running the individual work steps during the image acquisition and biopsy processes. For example, syngo BreVis enables clinicians to prepare reports, calculate the size of a lesion, or compare MRI results with ultrasound or X-ray mammography images. The syngo BreVis Biopsy software application supports the physician in performing biopsies accurately and quickly using automatic calculations and pre-settings.

The system is equipped with 18 channels, which ensures its investment security. The breast scanner can be upgraded to a Magnetom Espree with all imaging possibilities for any anatomical region, if required.

Press release: Innovation for Women's Health - the new MRI breast scanner from Siemens (PDF)

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Friday, February 13, 2009

LightTouch Device May Eliminate Pap, Biopsy for Cervical CA Testing

A new light based test that detects early signs of cervical cancer may be a better diagnostic tool than a pap smear, according to preliminary findings from a multi-site Food and Drug Administration (FDA) pivotal clinical trial. The study of more than 1,900 women looked at Guided Therapeutics' LightTouch system, a device that uses optical probe to shine light at different wavelengths and to detect alterations in fluorescence spectra coming back from the dysplastic /cancerous growth.

From the press release:

Since the pivotal trial began, more than 1,900 women were tested to demonstrate the technology’s safety and efficacy in detecting cervical disease, including an arm of the study that assessed effectiveness of an investigational commercial version of the device and single-use disposable.
The study protocol indicated that all subjects were referred after undergoing a Pap test, or had some other risk factor that fulfilled the referral criteria of the study. Each subject was tested with the LightTouch investigational device and underwent an additional Pap test, colposcopic exam and biopsy. Two generations of the investigational LightTouch were used in the trial.

Preliminary results from the study showed that the LightTouch performed better than the Pap test. The investigational commercial version of the LightTouch detected approximately 46 percent more cervical disease than the Pap test – a statistically significant improvement.

Here's more about the technology from the manufacturer:

The device system (Guided Therapeutics, Inc. Norcross, GA, USA) used in the study is a nonsignificant risk device by FDA standards that noninvasively and automatically scans the ectocervix and distal endocervix for disease related changes in fluorescence and reflectance spectra.
Alterations in fluorescence spectra are indicative of metabolic changes associated with neoplasia, while alterations in reflectance and scattering are indicative of structural changes associated with neoplasia, such as epithelial thickening, nuclear size, nuclear content and angiogenesis.

A plurality of equally spaced points over a one-inch diameter area of the cervix was automatically scanned during a four-minute period using a filtered xenon arc lamp as an illumination source.

For cervical tissue reflectance measurements, broadband spectral output ranging from about 350 to 900nm was automatically applied under software control to the cervix using the same xenon arc lamp. The resultant reflectance spectral output from the cervical tissue was imaged onto the CCD camera and stored for processing
and analysis.

For cervical tissue fluorescence measurements, light from the arc lamp was band pass filtered to limit exposure
of the cervix to bands within the 300 to 500 nm range. These spectral bands are known to excite fluorophores associated with neoplastic processes as described above. Each of the fluorescence wavelengths were applied automatically under software control in a predetermined order and scan pattern. The resultant fluorescent spectral output of the cervical tissue was imaged onto a charge coupled device (CCD) camera and stored for processing and analysis.

The system consists of two main physical components, the hand-held unit and the base unit. The handheld unit is
connected to the base unit via fiberoptic cables for transmission of light to and from the base unit, which contains the xenon arc lamp, optical processing elements (e.g., filters and lenses) and the CCD camera on a rolling cart (CNDS Device).

The other major component of the CNDS is a computer for control and data processing. This includes the capability for a diagnostic algorithm based on spectroscopic information measured from the cervix, calibration data and other patient data, such as Pap results or patient demographic data.

Press release: Guided Therapeutics, Inc. Reports Preliminary Findings from FDA Pivotal Clinical Trial (PDF)

Device page: LightTouch...

Poster about the system (.pdf) from Georgia Life Sciences Summit 2006...

Bottom image: Cervical maps with biopsy sites marked X.

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Breast Specific Gamma Imaging (BSGI), a New Imaging Modality, Proving Itself in Detecting Breast Cancer

A multicenter clinical trial comparing the sensitivity of traditional breast CA detection technologies (MRI, sonography, and mammography) versus the new one, called the Breast Specific Gamma Imaging (BSGI), has yielded exciting findings. As we have reported before, the technology, being commercialized by Dilon Technologies (Newport News, VA), relies on a pharmaceutical tracing agent that emits gamma radiation after it is injected and taken up by all cells of the body. BCGI is thought to work by detecting the increased metabolic activity of cancerous cells as compared to surrounding tissues. The company says that its diagnostic modality is independent of tissue density and can discover very early stage cancers, hence the firm is hoping that one day BCGI will become a standard adjunctive molecular breast imaging technique to mammography. The result of the latest trial show that company's Dilon 6800 Gamma Camera and the diagnostic system seem to be as good as the other modalities for detecting small tumors within breasts.

Here are the results and conclusions, taken from the study abstract:

RESULTS. Twenty-six women ranging in age from 46 to 82 years (mean age, 62.8 years) with a total of 28 biopsy-proven invasive lobular carcinomas were included in the study group. Mammograms were negative in six of 28 (21%), yielding a sensitivity of 79%. In the 25 patients who underwent sonography, 17 had focal hypoechoic areas, yielding a sensitivity of 68%. In the 12 patients who underwent MRI, the sensitivity was 83%. BSGI had a sensitivity of 93%. There was no statistically significant difference in the sensitivity of BSGI, MRI, sonography, or mammography, although there was a nonsignificant trend toward improved detection with BSGI.

CONCLUSION. BSGI has the highest sensitivity for the detection of invasive lobular carcinoma with a sensitivity of 93%, whereas mammography, sonography, and MRI showed sensitivities of 79%, 68%, and 83%, respectively. BSGI is an effective technique that should be used to evaluate patients with suspected cancer and has a promising role in the diagnosis of invasive lobular carcinoma.

Considering how sales of Dilon's equipment are already going (see press release below), the future for BSGI looks pretty bright.

Abstract: Invasive Lobular Carcinoma: Detection with Mammography, Sonography, MRI, and Breast-Specific Gamma Imaging

Press release: Dilon Technologies Leads Molecular Breast Imaging Expansion

Flashback: Breast Specific Gamma Imaging (BSGI) Goes to RSNA

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