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Computer Imaging Improves Non-Invasive Approaches to Medicine

Article Posted On 10/23/2009



Medical imaging is a field which uses machines to non-invasively visualize human anatomy. Clinicians use these images to diagnose disease or injuries, place medical devices, monitor treatment, and plan for procedures. Recently, researchers have begun to apply sophisticated computational techniques to these images to create 3D reconstructions, harvest more valuable data, and as a result, plan procedures that are less invasive and more accurate.

Two groups of PITA-funded researchers at the Institute for Complex Engineered Systems (ICES) have been collaborating with Pittsburgh-area medical schools and facilities to enhance the capabilities of magnetic resonance imaging (MRI) in the diagnosis and surgical planning stages of treatment. In one research project, professors Kerem Pekkan, Levent Burak Kara, and James Antaki are working to improve aortic root reconstruction surgeries by improving the information that can be obtained by a computer and help surgeons plan prior to open-heart surgery. In another project, professors Gustavo Rohde and Jelena Kovacevic are "teaching" MRIs to be more accurate by relating it to histology image data, from which pathologists can obtain more specific tissue information.

Pekkan, Kara, and Antaki are collaborating on their research with professors and physicians from the Center for Thoracic Aortic Disease; the Center for Heart Valve Disease; and the Heart, Lung, and Esophageal Surgery Institute at the University of Pittsburgh Medical Center (UPMC). Aortic root reconstruction and valve surgeries are complex, three-dimensional, open-heart operations requiring advanced surgical mastery and art for the best outcome. Pre-surgical customized planning is essential to reduce the amount of time a patient will be on cardiopulmonary by-pass during the operation. However, because of the complex features of the aortic root and variations of its structure for different patients, current pre-operative image data is often incorrect, requiring surgeons to make improvised and trial-and-error decisions during surgery.

Pekkan, Kara, and Antaki's goal is to provide clinicians with an interactive anatomical design tool which allows patient-specific virtual aortic reconstructive root surgeries to be performed ahead of time by the computer. This process will allow surgeons to plan by providing answers to various "What if?" surgical scenarios for each patient and to assess their relative merit. The tool also provides a computational analysis of a patient's potential blood flow through the repaired aortic pathway. The team recently started to incorporate automated engineering optimization techniques in hemodynamic pre-surgical planning.

PITA funding has provided seed funding for the team to realize the first version of their tool, and they are using this funding toward collaborative National Institutes of Health and NSF grants, involving Carnegie Mellon and UPMC faculty and focusing on broader patient-specific cardiovascular surgical planning research issues.

Professors Gustavo Rohde and Jelena Kovacevic, from biomedical engineering, and electrical and computer engineering, are collaborating with Dr. John Ozokek, assistant professor of pathology at the University of Pittsburgh Medical School to create more accurate imaging procedures with the hope that some invasive medical procedures can be avoided. The typical method of testing tissue for pathology includes removing the tissue after a noninvasive radiological imaging procedure (usually an MRI) has detected an abnormality. Biopsying tissue samples, however, are invasive and can cause hemorrhaging, pain, significant patient and family anxiety, and in rare cases, organ loss. Rohde and Kovacevic's PITA-funded research is to develop methods for relating information from histology images to the information present in MRIs. If certain relationships can be decoded with the aid of computations, it may be possible to better interpret MRIs without need for tissue biopsies.

In both of these instances, PITA-funded researchers are collaborating with University of Pittsburgh medical doctors and researchers to make medical procedures more efficient, accurate, and safer for the patients that must undergo them. On a larger scale, they are collaborating in ways that will help to innovate other areas of medicine and impact the overall field and practice.