Wearable Fetal Monitoring Solution for Improved Mobility During Labor & Delivery.

Electronic fetal monitoring (EFM) is used widely during labor & delivery, but existing solutions limit patient mobility, are uncomfortable, and do not consistently capture fetal heart rate (FHR) and uterine activity (UA) signals. A wireless EFM system was developed that features wearable US and tocodynamometer devices that conform to the body and do not require cables or belts. Benchtop testing demonstrated that the devices can accurately and consistently measure simulated FHRs and UAs over clinically meaningful ranges and body curvatures. The wearable EFM devices are expected to provide more reliable signal capture independent of maternal movement and repositioning, while also significantly improving patient comfort and mobility.

Wearable Ultrasound Array for Point-of-Care Imaging and Patient Monitoring.

A versatile, flexible piezoceramic array has been developed for a variety of ultrasound applications. The transducer can be configured as a linear or curvilinear transducer array, or mounted directly onto the body as a patch or wearable device. Results using a prototype 16-element array demonstrated equivalence to commercial linear array probes in accuracy of vessel diameter measurements in vascular phantoms. The ability to view needle insertion for peripherally inserted central catheter (PICC) procedures was also demonstrated. Opportunities for wearable ultrasound devices include point-of-care imaging, combat casualty care, ultrasound therapy, patient monitoring, and personal health.

Integrated Self-Management System for Improved Treatment of Asthma.

A mobile, affordable product that provides clinicians and patients with comprehensive asthma assessment is needed to improve asthma control. Our solution is an integrated system consisting of a portable, inexpensive, easy-to-use spirometer and a mobile application that communicates wirelessly with the spirometer. Results demonstrated that the wireless asthma management solution meets recommended American Thoracic Society (ATS) and European Respiratory Society (ERS) standards. The device is expected to empower patients to accurately self-assess their asthma for better self-management at home, work, or leisure.

Ultrasound imagery for dental implant diagnosis and treatment planning in a porcine model.

STATEMENT OF PROBLEM: Currently, there is no commercially available method to provide non-invasive, non-ionizing, real-time imaging of the gingival form and bony architecture of implant sites, before, during, and after implant placement. PURPOSE: The purpose of this study was to demonstrate the feasibility of 2-dimensional (2-D) ultrasound imaging of soft and hard tissues for implant diagnosis and treatment planning. MATERIAL AND METHODS: A sector scanning ultrasound system was applied. Five representative clinical features (implant in an edentulous ridge, single implant tooth replacement, implant dehiscence, tooth dehiscence, and mental foramina) were created or identified in each of the 5 porcine jaws, which were then covered with soft tissue and imaged in an acoustic water tank. RESULTS: All of the 5 model features, in all 5 jaws, were clearly visible with the ultrasound. Most objects were visible over a large range of positions and angles. Each of the features, as well as the soft tissue and bone surfaces, were recognized by specific acoustic signatures, with the same signature recurring for each object type among all 5 of the jaw specimens. All implants were highly reflective and clearly visualized. CONCLUSIONS: A 2-D sector scanning ultrasound system was demonstrated to be capable of imaging representative features for implant treatment planning in a porcine model; these included implants placed in edentulous ridges; implants placed for single tooth replacement; implants with simulated dehiscences; teeth with simulated dehiscences; and mental foramina. Specific acoustic signatures for these features were defined. Qualitative differences between ultrasound and other dental imaging techniques were described.

In vivo terahertz imaging of rat skin burns.

A reflective, pulsed terahertz (THz) imaging system was used to acquire high-resolution (d(10-90)/λ~1.925) images of deep, partial thickness burns in a live rat. The rat's abdomen was burned with a brass brand heated to ~220°C and pressed against the skin with contact pressure for ~10 sec. The burn injury was imaged beneath a Mylar window every 15 to 30 min for up to 7 h. Initial images display an increase in local water concentration of the burned skin as evidenced by a marked increase in THz reflectivity, and this likely correlates to the post-injury inflammatory response. After ~1 h the area of increased reflectivity consolidated to the region of skin that had direct contact with the brand. Additionally, a low reflecting ring of tissue could be observed surrounding the highly reflective burned tissue. We hypothesize that these regions of increased and decreased reflectivity correlate to the zones of coagulation and stasis that are the classic foundation of burn wound histopathology. While further investigations are necessary to confirm this hypothesis, if true, it likely represents the first in vivo THz images of these pathologic zones and may represent a significant step forward in clinical application of THz technology.

A prototype stimulator system for noninvasive Low Intensity Focused Ultrasound delivery.

A prototype Low Intensity Focused Ultrasound (LIFU) stimulator system was developed to evaluate non-invasive neuromodulation in a large animal model. We conducted a feasibility study on a Göttingen minipig, demonstrating reversible, targeted transcranial neuromodulation. The hypothalamus of the minipig was repeatedly stimulated with LIFU which evoked temporally correlated increases in both heart rate and blood pressure.

Ultrasound imaging of dental implants.

Accurate measurement of soft tissue thickness is needed prior to dental implant placement and prior to surgical uncovering of the implant. Ultrasonography has many potential advantages for use in dental implant surgery, but has not yet been made suitable for clinical use. A 2D ultrasound imaging system and a mechanical positioning system were used to scan dental implants embedded in a porcine jaw, covered by soft tissue, submerged in a water tank. Results indicated that ultrasound can be used to accurately detect, locate, and measure dental implant fixtures and measure the thickness of the overlying soft tissue in an ex vivo environment.

Terahertz sensing in corneal tissues.

This work introduces the potential application of terahertz (THz) sensing to the field of ophthalmology, where it is uniquely suited due to its nonionizing photon energy and high sensitivity to water content. Reflective THz imaging and spectrometry data are reported on ex-vivo porcine corneas prepared with uniform water concentrations using polyethylene glycol (PEG) solutions. At 79% water concentration by mass, the measured reflectivity of the cornea was 20.4%, 14.7%, 11.7%, 9.6%, and 7.4% at 0.2, 0.4, 0.6, 0.8, and 1 THz, respectively. Comparison of nine corneas hydrated from 79.1% to 91.5% concentration by mass demonstrated an approximately linear relationship between THz reflectivity and water concentration, with a monotonically decreasing slope as the frequency increases. The THz-corneal tissue interaction is simulated with a Bruggeman model with excellent agreement. THz applications to corneal dystrophy, graft rejection, and refractive surgery are examined from the context of these measurements.

Terahertz imaging of biological tissues.

A reflective THz imaging system sensitive to small variations in water concentrations has been developed. Biological tissues such as skin, eyes and teeth were imaged to ascertain the systems response to tissue hydration. Difference in water concentrations translated to contrast in the THz images. Contrast was also seen in THz images of skin cancer and burns suggesting the potential diagnostic capability of THz imaging system in clinical settings. All specimens analyzed were freshly excised ex-vivo tissues. These encouraging preliminary results have motivated us to explore the in vivo potential of our imaging system.

THz Medical Imaging: in vivo Hydration Sensing.

The application of THz to medical imaging is experiencing a surge in both interest and federal funding. A brief overview of the field is provided along with promising and emerging applications and ongoing research. THz imaging phenomenology is discussed and tradeoffs are identified. A THz medical imaging system, operating at ~525 GHz center frequency with ~125 GHz of response normalized bandwidth is introduced and details regarding principles of operation are provided. Two promising medical applications of THz imaging are presented: skin burns and cornea. For burns, images of second degree, partial thickness burns were obtained in rat models in vivo over an 8 hour period. These images clearly show the formation and progression of edema in and around the burn wound area. For cornea, experimental data measuring the hydration of ex vivo porcine cornea under drying is presented demonstrating utility in ophthalmologic applications.

Terahertz sensing of corneal hydration.

An indicator of ocular health is the hydrodyanmics of the cornea. Many corneal disorders deteriorate sight as they upset the normal hydrodynamics of the cornea. The mechanisms include the loss of endothelial pump function of corneal dystophies, swelling and immune response of corneal graft rejection, and inflammation and edema, which accompany trauma, burn, and irritation events. Due to high sensitivity to changes of water content in materials, a reflective terahertz (300 GHz and 3 THz) imaging system could be an ideal tool to measure the hydration level of the cornea. This paper presents the application of THz technology to visualize the hydration content across ex vivo porcine corneas. The corneas, with a thickness variation from 470 - 940 µm, were successfully imaged using a reflective pulsed THz imaging system, with a maximum SNR of 50 dB. To our knowledge, no prior studies have reported on the use of THz in measuring hydration in corneal tissues or other ocular tissues. These preliminary findings indicate that THz can be used to accurately sense hydration levels in the cornea using a pulsed, reflective THz imaging system.

A review of tissue substitutes for ultrasound imaging.

The characterization and calibration of ultrasound imaging systems requires tissue-mimicking phantoms with known acoustic properties, dimensions and internal features. Tissue phantoms are available commercially for a range of medical applications. However, commercial phantoms may not be suitable in ultrasound system design or for evaluation of novel imaging techniques. It is often desirable to have the ability to tailor acoustic properties and phantom configurations for specific applications. A multitude of tissue-mimicking materials and phantoms are described in the literature that have been created using a variety of materials and preparation techniques and that have modeled a range of biological systems. This paper reviews ultrasound tissue-mimicking materials and phantom fabrication techniques that have been developed over the past four decades, and describes the benefits and disadvantages of the processes. Both soft tissue and hard tissue substitutes are explored.

Towards medical terahertz sensing of skin hydration.

Terahertz imaging has shown promise as a tool for noninvasive in-vivo detection of skin abnormalities, including skin cancer, burns, scars, and wounds due to its low non-ionizing photon energy and ability to penetrate clothing and gauze. This study examines whether low-level bulk differences in the water content between hyperhydrated and dehydrated skin can be detected using a scanning, reflective THz imaging system. Our results show an 8.7 x difference in the THz reflectivity between hyperhydrated and dehydrated specimens of chicken skin. The results provide further evidence that water concentration is the primary contrast mechanism in reflective THz biomedical imaging.

Tissue mimicking materials for dental ultrasound.

While acoustic tissue mimicking materials have been explored for a variety of soft and hard biological tissues, no dental hard tissue mimicking materials have been characterized. Tooth phantoms are necessary to better understand acoustic phenomenology within the tooth environment and to accelerate the advancement of dental ultrasound imaging systems. In this study, soda lime glass and dental composite were explored as surrogates for human enamel and dentin, respectively, in terms of compressional velocity, attenuation, and acoustic impedance. The results suggest that a tooth phantom consisting of glass and composite can effectively mimic the acoustic behavior of a natural human tooth.

A flexible, conformal ultrasound array for medical imaging.

An ultrasound imaging system is under development that features a flexible transducer that can be wrapped conformally around curved surfaces of the body. The device is intended to deliver high image quality without the need for mechanical scanning, and will benefit medical personnel with limited ultrasound training. A 2 x 8 element piezoelectric transducer prototype and 15.5 MHz imaging system have been built, and the system concept has been demonstrated by imaging a soft tissue phantom. The transducer design, imaging procedure, and preliminary image processing techniques are presented.

Towards THz medical imaging; reflective imaging of animal tissues.

A reflective THz imaging system has been developed, and features a photoconductive switch and zero-bias Schottky diode detector. The system was used to image deli meats and can distinguish between muscle and adipose tissue based on water content. This capability is a step towards the development of THz medical imaging systems.

Ultrasound detection of submerged dental implants through soft tissue in a porcine model.

STATEMENT OF PROBLEM: Current methods of measuring soft tissue thickness over potential dental implant sites and locating submerged implants may be imprecise or invasive. PURPOSE: The purpose of this study was to develop and demonstrate proof of the concept of a customized ultrasound imaging system in locating and measuring the depth of implants submerged beneath soft tissue. MATERIAL AND METHODS: A complete ultrasound system, including a customized soft tissue-matched transducer, transceiver, and digital signal processing algorithms, was created for the specific application of detecting dental implants anchored in bone beneath soft tissue. The system was used to locate implants placed in cancellous bone and measure overlying soft tissue depth in a porcine model. Ten measurements were made on each porcine model by manually moving the transducer laterally over the soft tissue surface. Data were analyzed with descriptive statistics. RESULTS: The mean signal-to-noise ratio, SNR (standard deviation), from the bone surfaces, was 19.1 (4.6) dB, and the mean SNR from the implant surfaces was 36.6 (2.2) dB, resulting in a mean difference of 17.5 dB, or x56.2, in average signal power between the bone and implant surfaces. Consequently, implants were easily and accurately (+/-0.2 mm) located beneath at least 5 mm of soft tissue. Likewise, soft tissue depths over bone and implants were accurately measured and were within the corresponding caliper tissue measurement error (+/-0.5 mm). CONCLUSIONS: The specialized ultrasound imaging system located and measured the depth of implants placed in bone submerged beneath soft tissue in a porcine model.

Penetration of radiopaque dental restorative materials using a novel ultrasound imaging system.

PURPOSE: To determine whether a novel ultrasound imaging system could detect 25 microm thick cracks beneath gold, silver amalgam, and porcelain restorations on tooth phantoms. METHODS: Tooth phantoms were constructed using acoustically-matched composite to simulate dentin, with 25 microm thick water-filled cracks located approximately 1 mm inside the simulated dentin. Porcelain and gold restorations were bonded using resinous cement, and an amalgam restoration was attached using mechanical retention. A portion of the gold restoration was left unattached to simulate cement washout. A novel monostatic pulse-echo ultrasound system with a 19 MHz single-element PLZT transducer, custom transmit/receive electronics and signal processing with a Ga-In alloy couplant was used to measure the relative return echo amplitude from restoration surfaces, simulated dentin/restoration interfaces, and cracks. Extracted teeth were also used to demonstrate that the system was capable of detecting cracks in real teeth. RESULTS: Cracks were detected beneath porcelain and amalgam, and within a human molar. Cracks were not detected in simulated dentin beneath gold; however, simulated cement washout directly beneath gold was identified. The ability to detect defects in the phantom was dependent on the acoustic reflection coefficient between interfaces, the attenuation of each material, acoustic clutter within the phantom, and geometry. Gold restorations transmitted minimal acoustic energy due to their large acoustic impedance; however, the ability to distinguish the gold/cement interface from the gold/washout interface indicated that ultrasound can detect density changes immediately below restorations, such as caries, fractures, or debonding. The ability to penetrate resin-composite was also demonstrated.