Precision for Treatment Success

“It’s simple, convenient and precise.” says Dr. Steffen Lissner, Product Manager at LAP. Users in the field of radiation therapy worldwide benefit from laser systems from LAP within treatment workflows and individual irradiation planning.

The DORADOnova 5 laser system provides highest comfort and optimal time efficiency during patient positioning and marking. Five movable lasers allow a fully flexible shifting of the projected reference points on the patient. Hence the clinical staff can pay their full attention to the patient, transferring the information of the patient’s position to the treatment room. In the next step room lasers from LAP guide the user to the correct position of the patient – reproducible fraction by fraction.

Lasers for patient positioning increase safety and precision during the whole treatment chain. From the first step of planning to the last irradiation of the patient, precise reproducible positioning saves valuable time. Marking the patient’s reference point on the CT makes it needless to mark on the LINAC which leads to more treatment time.
Five movable lasers for sagittal, coronal and transverse body plane make it easy to mark the patient without moving the CT couch. The clinical staff operate the lasers comfortably and seamless via smart laser control CARINAnav. Users can choose between three different laser colors, green, red and blue, to meet all room and staff requirements.

“We get feedback from users all over the world that the lasers are an important and reliable tool in their daily work.” Dr. Steffen Lissner states. Users rely on the functionality and high quality of radiation therapy solutions from LAP. Not least because all products from LAP meet certification standards for medical devices.

Researchers at Mayo Clinic and Arizona State University have developed an app and algorithm to help patients with type 1 diabetes, according to ABC15.
The app collects data from patients and then the algorithm derives a complete timeline of a patient’s blood sugar levels. Patients have access to a comprehensive report of when their blood sugar was low, the reason why and potential recommendations.

Maria Adela Grando, MD, a physician at the Tempe-based university, led of team of students to develop the app, which tracks a patient’s food, exercise, and insulin.

“It’s something meaningful to us and we can actually help patients learn from what they’re doing,” said Bithika Thompson, MD, a physician at the Phoenix-based Mayo Clinic campus.

Artificial intelligence is bringing about major innovations in healthcare in a number of different ways. While so much regarding artificial intelligence involves the future, but within healthcare, it is not just plans or intentions, but AI is already a concrete reality in the field.

It has all been set in motion by advances in machine learning and fueled by the increasing availability of healthcare data. AI aims to simulate human cognitive functions. It can replace human judgment in certain functional areas of healthcare and provide a major assist to physicians with clinical decisions. A large volume of healthcare data can be run through sophisticated mathematical algorithms to identify and utilize insights that assist in clinical practice. Learning and self-correcting abilities within the formulas can also improve accuracy based on feedback. Up-to-date medical information from journals, textbooks, and clinical practices can be easily assimilated and that helps reduce diagnostic and therapeutic errors in human clinical practice.

For example, artificial intelligence allows physicians to understand specific problems before deciding on a solution. In the area of cardiac intervention, using arrhythmia as an example, you can create a map of the heart to pinpoint the exact problem causing an irregular heartbeat. Mapping provides the exact anatomical structure of the arteries. This is a major assist in planning interventions with a catheter. Mapping can determine the exact kind of catheter to be used and the exact behavior of the arteries at the specific point where you have to do the intervention. Mapping sometimes can be used during an operation itself. With images from the fluoroscopy on hand, AI provides analysis of those images in order to get timely and precise information about the location and the structure of the arteries.

Another challenging application for artificial intelligence is spinal surgery, which generally involves putting in screws into the vertebrae so precision is crucial. Precision does not come about due to what the surgeon sees because it’s a percutaneous procedure in many cases. Utilizing pre-op scanning, along with information provided by the x-ray, artificial intelligence assists in the operating room by detailing exactly where the vertebra line up. It happens through algorithms combining those two sources of information which allow the surgeon to accurately navigate to the exact point of insertion.

The use of algorithms during the planning phase provides the same benefits of precision for hip or knee replacement. Mapping also provides very good segmentation of the bones prior to the operation. It helps decisions on a specific implant for a particular patient, avoiding future suffering because generic methods might produce an implant that does not fully fit the knee or hip.

Utilizing multiple CTs and using deep learning, artificial intelligence also helps provide exact segmentation of the pulmonary airways, even the tiny airways found in nether regions of the lungs. It is a prerequisite procedure in planning an intervention surgery, such as a biopsy or, in some cases, an ablation. The mapping of the lungs again allows a surgeon to go and plan precise actions with the catheter (and in some cases with a robotic catheter). Accuracy is very important because you don’t want to miss and take the biopsy from adjacent places instead of the lesion itself and the AI process also reduces the possibility of puncturing blood vessels, the fissure between the lobes, et cetera.

Lastly, in the area of pharmaceutical development, artificial intelligence is used in assessing the influence of new drugs. A lot of effort is invested by collecting CTs that are done for the patient during the use of a new drug. AI algorithms take all of that information to produce an automatic scoring (which is called RECIST) that analyze and measures the impact of the drug (an example being whether a lesion has disappeared or shrunk or whether it stayed the same). Through AI, results of these scans can be determined within a few hours, as opposed to several months as before, providing better and more immediate decision making.

You can imagine many other instances where mapping and the amalgamation of data can assist in healthcare endeavors. But there is still a shortage of trained engineers that can develop new algorithms to solve ever more difficult situations. However, utilizing skilled engineers on an outsourcing basis to accomplish new algorithm cultivation is an important option for healthcare project managers. In the last five years, there has been a big change in the healthcare market where the understanding of the value of AI and computer vision has been made crystal clear and will result in the integration of newer and better AI technology into the healthcare system. Artificial intelligence has been around for 30 years but there is so much more work to be done.

The current examples described above point to artificial intelligence providing extremely fast and almost unlimited image analysis capabilities. Taken together, AI removes a seemingly endless bottleneck of tedious doctor tasks and will continue to provide accurate assistance in surgery (both pre-op and in-op). And through its speedy compilation of patient anatomical data augmented by observations and healthcare correlations that generally aren’t easy to be found, artificial intelligence will also foster more patient-specific healthcare.

Ron founded RSIP Vision with the idea of bringing advanced services to the image processing and computer vision marketplace. Armed with sophisticated algorithms, and deep learning technology for projects across multiple industries, Ron has guided RSIP Vision to the forefront of AI technology, solving today’s complex technology challenges for businesses of all kinds—a vital benefit as AI grows increasingly essential to every industry.

Background: Insights into the biology of chemotherapy resistance may suggest novel strategies to treat Acute Myeloid Leukemia (AML). We examined the role of hyperbaric oxygen (HBO) in AML sensitivity to chemotherapy, oxygen consumption, reactive oxygen species (ROS) generation, glycolytic pathway activation, and gene expression.

Methods: Human AML cell lines HL-60 and MV-411 were treated with cytarabine followed by HBO (100% oxygen at 2.5 atmosphere absolutes for 2 hours in an in vitro HBO chamber) or normobaric culture conditions. At 24 hours, cells were analyzed for proliferation, apoptosis and oxygen consumption. Studies of HBO- treated cells without chemotherapy included CellROX Oxidative Stress assay and real-time PCR with primer sets specific for human hexokinase2 and phosphofructokinase to examine HBO effects on glycolysis. Gene expression profiling by the Human Transcriptome Array 2.0 (Affymetrix) examined differences in gene expression following HBO in HL-60 cells and AML patient samples.

Results: Leukemia cells treated with HBO and cytarabine demonstrated reduced proliferation and increased late apoptosis confirming increased sensitivity to cytarabine. Treatment with HBO plus cytarabine resulted in increased oxygen consumption measured by the seahorse assay at 24 hours post-HBO in MV-411 cells compared to cytarabine alone. Significant increases in ROS levels were observed at 24 hours post-HBO for both cell lines when compared to non-treated cells. Glycolysis pathway components human hexokinase 2 and phosphofructokinase were upregulated in HL60 and MV411 cells treated with HBO compared to controls. Gene expression profiling showed that approximately 200 genes in coding regions were upregulated in HBO-treated HL-60 cells; specific piRNA clusters were downregulated in both AML cell line HL60 and an AML bone marrow sample when treated with HBO.

Conclusions: HBO treatment significantly increases the sensitivity to cytarabine in AML cell lines in vitro, an effect associated with increased late apoptosis and changes in cellular respiration. Increased ROS, upregulation of glycolysis-related enzymes and changes in gene expression profiling provide insight into potential mechanisms of HBO in AML.

For ve years, the 58-year-old woman diagnosed with Alzheimer’s disease had experienced slipping mental abilities, a decline that was beginning to accelerate.

“Think of it like a straitjacket that gets tighter and tighter,” said Molly Fogel, director of educational and social services for the Alzheimer’s Foundation of America.

But for this particular patient, one of 5.7 million Americans who suffer from Alzheimer’s disease, the straitjacket is looser following treatment with hyperbaric oxygen therapy.Dr. Paul Harch, a clinical professor and director of hyperbaric medicine at the LSU Health New Orleans School of Medicine, and Dr. Edward Fogarty, of the University of North Dakota School of Medicine, have outlined her hopeful case in a report published in the peer-reviewed journal Medical Gas Research.

After 66 days of hyperbaric oxygen therapy, the woman regained some of what the disease had stolen from her. Her memory and concentration improved, as did her ability to do crossword puzzles and use the computer. But the case study goes beyond what the patient reported about her symptoms or her performance on tests, like drawing the face of a clock. The study shows visible improvement of her brain itself on PET scans taken before and after the treatment. The result is images that Harch said a third-grader could look at and say: “That patient looks better.

“We demonstrated the largest improvement in brain metabolism of any therapy for Alzheimer’s disease,” said Harch, who described metabolism as the gas that makes an engine go.

The PET scans taken a month after the treatment showed global improvement in brain metabolism of 6.5 percent to 38 percent, according to the study.

“HBOT in this patient may be the first treatment not only to halt but temporarily reverse disease progression in Alzheimer’s disease,” Harch said.

That would be a significant development for a disease that is considered irreversible. Alzheimer’s disease affects 5.5 million Americans over age 65 and 200,000 who are younger, like the patient in Harch’s study. The most common form of dementia, is the sixth leading cause of death in the United States, according to the National Institutes of Health. It’s also on the increase, according to the Alzheimer’s Association, with deaths from the disease increasing 123 percent from 2000 to 2015. By 2050, the association said, the number of cases is expected to reach nearly 14 million. As the Baby Boom generation ages, Harch said, the negative consequences of their excesses in earlier decades, including alcohol and drug abuse, will make cognitive decline faster.

“The load of toxins, food additives, pesticides in chemicals — all take a toll,” he said.

To Harch, Alzheimer’s is an injury to the brain, and hyperbaric oxygen therapy is used to treat wounds anywhere in the body, including the brain. He has treated stroke victims, patients suffering from a post-traumatic stress disorder and those with concussions as well as Alzheimer’s patients. The woman in the case study is the first in a series of 11 Alzheimer’s patients whose improvement has been documented with PET scans.

Harch has also treated near-drowning victims, including a toddler who fell into her family’s backyard pool. In that case, he was able to show the reversal of severe brain damage, an actual regrowth of brain tissue, after hyperbaric treatment. The child, who doctors had said would never walk or talk again, now is doing both.

Hyperbaric oxygen treatment puts patients in a chamber where they breathe 100 percent oxygen under increased atmospheric pressure. The increased pressure and oxygen turn on genes for growth and repair hormones and inhibit those that cause an inflammatory response and cell death, Harch said. Alzheimer’s is primarily a vascular disease, Harch said. The protein plaques and tangles in the brains of Alzheimer’s sufferers could be the end product of injury, he said. Hyperbaric oxygen therapy reduces the burden put on the brain by the protein plaques and tangles. But Harch said it targets all four pathological processes that have been identified in Alzheimer’s patients, including microcirculation and dysfunction of the mitochondria, which provide the chemical energy for cells to live.

Alzheimer’s is a progressive disease that affects memory, thinking, and behavior. It disconnects those who have it from themselves and their environment, Fogel said. People with Alzheimer’s can nd themselves overwhelmed simply by all the items in a bathroom or a closet.

After 21 treatments, the patient in Harch’s study reported an increase in her energy and activity level, as well as an improved mood. She could draw the face of a clock correctly, perform daily activities and work crossword puzzles. After 40 treatments, she had increased memory and concentration, according to the report. She slept better and had a better appetite. She also felt less disorientation and frustration, with more good days than bad. The study notes that she had a recurrence in her symptoms after the treatment stopped, but she has then retreated over the next 20 months and her symptoms stabilized.

“I talked to her and her husband the other day,” Harch said. “She’s hanging in there, doing fairly well.”

The results of the study suggest that Alzheimer’s can be treated in the long term with hyperbaric oxygen therapy along with drugs, Harch said. The challenge now is to inform doctors and overcome what he calls a misunderstanding of the science behind hyperbaric oxygen therapy, which he describes as gene therapy.

“Medicine is so pathetically slow,” Harch said. “Now the science is out, and we need to inform doctors and change the perception.”

EHS was the Gold Sponsor at Arab Health which took place during January 2020. Some of our key partners were part of the EHS booth showcasing their highly sought after solutions.

We hosted some of our key partners and had an excellent networking opportunity.

Highlights of the event can be viewed below:

a group of people posing for the camera

Etqan was part of the 14th Annual Meeting of the Saudi Association of Neurological Surgery (SANS 2020). The Annual Meeting of SANS was conducted in the city of Riyadh from 28 February to 1 March 2020 at Hilton Hotel & Resort Riyadh, Kingdom of Saudi Arabia.

EHS showcased the Neurosurgery Solutions including Brainlab at this event.

Etqan Healthcare Solutions signs an agreement with ZMC in the presence of His Excellency the Governor of Al-Qunfudhah to equip the Radiology department at Dr. Abdu Al Zobydi Hospital in Al-Qunfudhah Governorate with advanced equipment from our partner Philips Healthcare.

EHS participated at the Arab Health event from January 25th to January 28th, 2016. We had taken up 395sqm space and also had some prominent and promising partners like Skytron, Mizuho, Systmz, Follett, Stanley, Vocera, Starkstrom, AT-OS, and Lincor participating with us. It was a phenomenal success! At the 4 day event, EHS was also the official Sponsor for visitor carrier bags and the Silver Sponsor.

EHS participated at the Arab Health event from January 28th January to 2nd Feb 2017. We had taken up 195sqm space and also had some prominent and promising partners like Skytron, Mizuho, Follett, Stanley, Panasonic, Vocera, AT-OS, and Lincor participating with us. It was a phenomenal success! At the 4 day event, EHS was the silver sponsor for the event