Hypothermic Cooling Measured by Thermal Magnetic Resonance Imaging; Feasibility and Implications for Virtual Imaging in the Urogenital Pelvis.

OBJECTIVE: To study the combination of thermal magnetic resonance imaging (MRI) and novel hypothermic cooling, via an endorectal cooling balloon (ECB), to assess the effective dispersion and temperature drop in pelvic tissue to potentially reduce inflammatory cascade in surgical applications. METHODS: Three male subjects, before undergoing robot-assisted radical prostatectomy, were cooled via an ECB, rendered MRI compatible for patient safety before ECB hypothermia. MRI studies were performed using a 3T scanner and included T2-weighted anatomic scan for the pelvic structures, followed by a temperature mapping scan. The sequence was performed repeatedly during the cooling experiment, whereas the phase data were collected using an integrated MR-high-intensity focused ultrasound workstation in real time. Pelvic cooling was instituted with a cooling console located outside the MRI magnet room. RESULTS: The feasibility of pelvic cooling measured a temperature drop of the ECB of 20-25 degrees in real time was achieved after an initial time delay of 10-15 seconds for the ECB to cool. The thermal MRI anatomic images of the prostate and neurovascular bundle demonstrate cooling at this interface to be 10-15 degrees, and also that cooling extends into the prostate itself ~5 degrees, and disperses into the pelvic region as well. CONCLUSION: An MRI-compatible ECB coupled with thermal MRI is a feasible method to assess effective hypothermic diffusion and saturation to pelvic structures. By inference, hypothermia-induced rectal cooling could potentially reduce inflammation, scarring, and fistula in radical prostatectomy, as well as other urologic tissue procedures of high-intensity focused ultrasound, external beam radiation therapy, radioactive seed implants, transurethral microwave therapy, and transurethral resection of the prostate.

AsTeRICS: a new flexible solution for people with motor disabilities in upper limbs and its implication for rehabilitation procedures.

PURPOSE: To present the AsTeRICS construction set, and examine different combinations of sensors installed in the platform and how users interact with them. METHOD: Nearly 50 participants from Austria, Poland and Spain were included in the study. They had a heterogeneous range of diagnoses, but as a common feature all of them experienced motor limitations in their upper limbs. The study included a 1 h session with each participant where the user interacted with a personalized combination of sensors, based on a previous assessment on their motor capabilities performed by healthcare professionals. The sensors worked as substitutes for a standard QWERTY keyboard and a standard mouse. Semi-structured interviews were conducted to obtain participants' opinions. All collected data were analyzed based on the qualitative methodology. RESULTS: The findings illustrated that AsTeRICS is a flexible platform whose sensors can adapt to different degrees of users' motor capabilities, thus facilitating in most cases the interaction of the participants with a common computer. CONCLUSION: AsTeRICS platform can improve the interaction between people with mobility limitations and computers. It can provide access to new technologies and become a promising tool that can be integrated in physical rehabilitation programs for people with motor disabilities in their upper limbs. IMPLICATIONS FOR REHABILITATION: The AsTeRICS platform offers an interesting tool to interface and support the computerized rehabilitation program of the patients. Due to AsTeRICS platform high usability features, family and rehabilitation professionals can learn how to use the AsTeRICS platform quickly fostering the key role of their involvement on patients' rehabilitation. AsTeRICS is a flexible, extendable, adaptable and affordable technology adapted for using computer, environmental control, mobile phone, rehabilitation programs and mechatronic systems. AsTeRICS makes possible an easy reconfiguration and integration of new functionalities, such as biofeedback rehabilitation, without major changes in the system.