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Knighton NJ, Cottle BK, Tiwari S, Mondal A, Kaza AK, Sachse FB, Hitchcock RW. Toward cardiac tissue characterization using machine learning and light-scattering spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-200330RR. [PMID: 34729970 PMCID: PMC8562351 DOI: 10.1117/1.jbo.26.11.116001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
SIGNIFICANCE The non-destructive characterization of cardiac tissue composition provides essential information for both planning and evaluating the effectiveness of surgical interventions such as ablative procedures. Although several methods of tissue characterization, such as optical coherence tomography and fiber-optic confocal microscopy, show promise, many barriers exist that reduce effectiveness or prevent adoption, such as time delays in analysis, prohibitive costs, and limited scope of application. Developing a rapid, low-cost non-destructive means of characterizing cardiac tissue could improve planning, implementation, and evaluation of cardiac surgical procedures. AIM To determine whether a new light-scattering spectroscopy (LSS) system that analyzes spectra via neural networks is capable of predicting the nuclear densities (NDs) of ventricular tissues. APPROACH We developed an LSS system with a fiber-optics probe and applied it for measurements on cardiac tissues from an ovine model. We quantified the ND in the cardiac tissues using fluorescent labeling, confocal microscopy, and image processing. Spectra acquired from the same cardiac tissues were analyzed with spectral clustering and convolutional neural networks (CNNs) to assess the feasibility of characterizing the ND of tissue via LSS. RESULTS Spectral clustering revealed distinct groups of spectra correlated to ranges of ND. CNNs classified three groups of spectra with low, medium, or high ND with an accuracy of 95.00 ± 11.77 % (mean and standard deviation). Our analyses revealed the sensitivity of the classification accuracy to wavelength range and subsampling of spectra. CONCLUSIONS LSS and machine learning are capable of assessing ND in cardiac tissues. We suggest that the approach is useful for the diagnosis of cardiac diseases associated with changes of ND, such as hypertrophy and fibrosis.
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Affiliation(s)
- Nathan J. Knighton
- University of Utah, Department of Biomedical Engineering, Salt Lake City, United States
- University of Utah, Nora Eccles Harrison Cardiovascular Research and Training Institute, Salt Lake City, United States
| | - Brian K. Cottle
- University of Utah, Department of Biomedical Engineering, Salt Lake City, United States
- University of Utah, Nora Eccles Harrison Cardiovascular Research and Training Institute, Salt Lake City, United States
| | - Sarthak Tiwari
- University of Utah, Department of Biomedical Engineering, Salt Lake City, United States
- University of Utah, Nora Eccles Harrison Cardiovascular Research and Training Institute, Salt Lake City, United States
| | - Abhijit Mondal
- Boston Children’s Hospital, Harvard Medical School, Department of Cardiac Surgery, Boston, United States
| | - Aditya K. Kaza
- Boston Children’s Hospital, Harvard Medical School, Department of Cardiac Surgery, Boston, United States
| | - Frank B. Sachse
- University of Utah, Department of Biomedical Engineering, Salt Lake City, United States
- University of Utah, Nora Eccles Harrison Cardiovascular Research and Training Institute, Salt Lake City, United States
| | - Robert W. Hitchcock
- University of Utah, Department of Biomedical Engineering, Salt Lake City, United States
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Ourak M, Buck SD, Ha XT, Al-Ahmad O, Bamps K, Ector J, Poorten EV. Fusion of Biplane Fluoroscopy With Fiber Bragg Grating for 3D Catheter Shape Reconstruction. IEEE Robot Autom Lett 2021. [DOI: 10.1109/lra.2021.3094238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Gopesh T, Wen JH, Santiago-Dieppa D, Yan B, Scott Pannell J, Khalessi A, Norbash A, Friend J. Soft robotic steerable microcatheter for the endovascular treatment of cerebral disorders. Sci Robot 2021; 6:6/57/eabf0601. [PMID: 34408094 PMCID: PMC9809155 DOI: 10.1126/scirobotics.abf0601] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 07/26/2021] [Indexed: 01/05/2023]
Abstract
Catheters used for endovascular navigation in interventional procedures lack dexterity at the distal tip. Neurointerventionists, in particular, encounter challenges in up to 25% of aneurysm cases largely due to the inability to steer and navigate the tip of the microcatheters through tortuous vasculature to access aneurysms. We overcome this problem with submillimeter diameter, hydraulically actuated hyperelastic polymer devices at the distal tip of microcatheters to enable active steerability. Controlled by hand, the devices offer complete 3D orientation of the tip. Using saline as a working fluid, we demonstrate guidewire-free navigation, access, and coil deployment in vivo, offering safety, ease of use, and design flexibility absent in other approaches to endovascular intervention. We demonstrate the ability of our device to navigate through vessels and to deliver embolization coils to the cerebral vessels in a live porcine model. This indicates the potential for microhydraulic soft robotics to solve difficult access and treatment problems in endovascular intervention.
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Affiliation(s)
- Tilvawala Gopesh
- Department of Mechanical and Aerospace Engineering, University of California San Diego, USA
| | - Jessica H. Wen
- Department of Mechanical and Aerospace Engineering, University of California San Diego, USA
| | | | - Bernard Yan
- Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - J. Scott Pannell
- Department of Neurosurgery, University of California San Diego, USA
| | | | | | - James Friend
- Department of Mechanical and Aerospace Engineering, University of California San Diego, USA,Department of Surgery, University of California San Diego, USA,To whom correspondence should be addressed; , Medically Advanced Devices Laboratory, 9500 Gilman Drive, La Jolla, CA 92093, USA
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Shape Memory Biomaterials and Their Clinical Applications. Biomed Mater 2021. [DOI: 10.1007/978-3-030-49206-9_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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First Expert Evaluation of a New Steerable Catheter in an Isolated Beating Heart. Cardiovasc Eng Technol 2020; 11:769-782. [PMID: 33210258 PMCID: PMC7782459 DOI: 10.1007/s13239-020-00499-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 11/05/2020] [Indexed: 11/21/2022]
Abstract
Purpose In previous studies we developed two mechanical prototypes of steerable catheters: the Sigma, which uses joysticks to actuate two steerable tip segments, and the Epsilon, which has a handle that is an enlarged version of the tip. In this study, we present a first performance evaluation of the prototypes in the cardiac environment. The evaluation was carried out by an expert user, an electrophysiologist with over 20 years of experience, to obtain insight in clinically relevant factors. Methods Two experiments were conducted. In the first experiment, the Sigma was used in a passive beating heart setup connected to pumps with a saline solution and camera visualization, and compared with the expert’s past experience with conventional steerable catheters. In the second experiment, the Sigma was used in an active beating heart setup with blood perfusion through the coronary arteries and echo visualization, and compared with the Epsilon prototype. The prototype was evaluated through questionnaires on task performance, catheter usability, and workload. After each of the experiments, the catheter characteristics were evaluated via a survey and followed by an in-depth interview. Results & Conclusions The expert user found the passive beating heart setup to more successful than the active beating heart setup for the purpose of this experiment, with insightful visualization while the heart was in beating condition. The steerability of the prototypes was experienced as useful and clinically relevant. Based on the questionnaires and interview we were able to identify future design improvements and developments for the steerable catheter prototypes. Electronic supplementary material The online version of this article (10.1007/s13239-020-00499-3) contains supplementary material, which is available to authorized users.
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Ali A, Sakes A, Arkenbout EA, Henselmans P, van Starkenburg R, Szili-Torok T, Breedveld P. Catheter steering in interventional cardiology: Mechanical analysis and novel solution. Proc Inst Mech Eng H 2019; 233:1207-1218. [PMID: 31580205 PMCID: PMC6859597 DOI: 10.1177/0954411919877709] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 08/13/2019] [Indexed: 11/27/2022]
Abstract
In recent years, steerable catheters have been developed to combat the effects of the dynamic cardiac environment. Mechanically actuated steerable catheters appear the most in the clinical setting; however, they are bound to a number of mechanical limitations. The aim of this research is to gain insight in these limitations and use this information to develop a new prototype of a catheter with increased steerability. The main limitations in mechanically steerable catheters are identified and analysed, after which requirements and solutions are defined to design a multi-steerable catheter. Finally, a prototype is built and a proof-of-concept test is carried out to analyse the steering functions. The mechanical analysis results in the identification of five limitations: (1) low torsion, (2) shaft shortening, (3) high unpredictable friction, (4) coupled tip-shaft movements, and (5) complex cardiac environment. Solutions are found to each of the limitations and result in the design of a novel multi-steerable catheter with four degrees of freedom. A prototype is developed which allows the dual-segmented tip to be steered over multiple planes and in multiple directions, allowing a range of complex motions including S-shaped curves and circular movements. A detailed analysis of limitations underlying mechanically steerable catheters has led to a new design for a multi-steerable catheter for complex cardiac interventions. The four integrated degrees of freedom provide a high variability of tip directions, and repetition of the bending angle is relatively simple and reliable. The ability to steer inside the heart with a variety of complex shaped curves may potentially change conventional approaches in interventional cardiology towards more patient-specific and lower complexity procedures. Future directions are headed towards further design optimizations and the experimental validation of the prototype.
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Affiliation(s)
- Awaz Ali
- BioMechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | - Aimee Sakes
- BioMechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | - Ewout A Arkenbout
- BioMechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | - Paul Henselmans
- BioMechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
| | | | - Tamas Szili-Torok
- Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Paul Breedveld
- BioMechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands
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Nanda S, Mahapatra S, Lindeen SA, Bernau JL, Cutshall SM, Schierwater B, Chon TY, Wahner-Roedler DL, Bauer BA. Evaluation of a Novel Wellness Assessment Device (Preventiometer): A Feasibility Pilot Study. Glob Adv Health Med 2019; 8:2164956119881096. [PMID: 31637111 PMCID: PMC6785912 DOI: 10.1177/2164956119881096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/14/2019] [Accepted: 09/05/2019] [Indexed: 12/20/2022] Open
Abstract
Background Periodic wellness assessments can provide an estimate of a person’s relative risks for major diseases, but wellness visits are underused. Our suggestion is to use a comprehensive device during a single visit. Objective The goal of this pilot study was to evaluate the feasibility of a novel one-stop wellness device (Preventiometer; iPEx5 GmbH, Greifswald, Germany) for performing multiple tests and providing a comprehensive wellness assessment in a short period. Methods A Preventiometer was used to provide wellness assessments for 10 healthy volunteers who then answered a 25-question survey to rate their satisfaction with the testing and their overall impression. Results All volunteers agreed or strongly agreed with the following: The assessment reports were easy to understand, the Preventiometer met their satisfaction, the participants were comfortable during the assessment, and all measurements and testing were well coordinated. Participants liked the instant test result feature. Most (90%) agreed that the machine was useful for a quick health assessment for busy people, and 70% felt that it was time efficient. Conclusion In this feasibility pilot study, the Preventiometer performed multiple tasks and provided a comprehensive wellness assessment in a short period. Participants reported remarkably high satisfaction with the tests. A larger study is needed to prove that this is a pragmatic approach to help individuals improve their health.
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Affiliation(s)
- Sanjeev Nanda
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Saswati Mahapatra
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | | | - Susanne M Cutshall
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota.,Center For Innovation, Mayo Clinic, Rochester, Minnesota
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Impact of balloon aortic valvuloplasty on transcatheter aortic valve implantation with self-expandable valve. J Cardiol 2017; 69:245-252. [DOI: 10.1016/j.jjcc.2016.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/26/2016] [Accepted: 03/24/2016] [Indexed: 11/24/2022]
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Ali A, Plettenburg D, Breedveld P. Steerable Catheters in Cardiology: Classifying Steerability and Assessing Future Challenges. IEEE Trans Biomed Eng 2016; 63:679-93. [DOI: 10.1109/tbme.2016.2525785] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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