Medical Technology

Medical technology consists of the creation of tools with the broad goal of improving the quality of life of patients. As diagnostic and therapeutic equipment are undergoing constant innovation, hopes are high for what new tools we can develop and what can be achieved through them. For example, in 2016, the Chan Zuckerberg Initiative set the goal of “curing, preventing, and managing all diseases by the end of the century” [1]. The Bill and Melinda Gates Foundation is set to end malaria by the next generation [2]. This suggests a trend of high-tech breakthroughs leading the way in medicine.

Interestingly, a lot of effort is being focused on preventive medicine or catching symptoms or risk factors for disease before it becomes detrimental. This is especially true in the field of Alzheimer’s disease. Alzheimer’s is a neurological disease that causes cell death in the brain, leading to degeneration of memory, cognition, and ultimately motor behavior. Alzheimer’s is very prevalent, it is estimated that 5.3 million people in the United States suffer from this condition [3].

A special report published by the Alzheimer’s Association stated that the development and validation of Alzheimer’s disease biomarkers are a top research priority [3]. Moreover, the report mentions the need to improve earlier detection and treatment of Alzheimer’s, as well as better assess the impact of Alzheimer’s on the population level. Hence, this area of research is highlighted in our issue on medical technology. Leuzy et al. reviews advances in biological markers that can be identified through artificial intelligence as a diagnostic tool for Alzheimer’s disease. In the same vein, Daggett’s perspectives piece discusses the possibility of using alpha sheet peptides to bind toxic oligomers classically found in amyloid diseases like Alzheimer’s, as a way to detect their concentration and to stop them from aggregating together in the brain.

While biomarkers are important in diagnosis, improvement of tools used for detection is significant as well. In this issue, Sonderer and Chen discuss their novel method to improve magnetic resonance imaging of the brain. This common diagnostic tool can characterize tissue properties using advanced methods like Parametric T2 mapping. Their research provides a new form of analysis that improves the accuracy of this mapping method and enhances the overall quality of magnetic resonance imaging.

Innovation in biomedical imaging for diagnosis and treatment has garnered attention in the field of oncology as well. Cancer is one of the leading causes of death worldwide; its prevention and treatment is a priority in biomedical research nationally. This year, according to the Cancer Action Network, the U.S. House of Representatives approved an increase in federal funding of $10 million in cancer prevention programs at the Centers for Disease Control and Prevention and a $275 million increase for the National Cancer Institute. In our issue, we highlight the importance of biomedical imaging to study cancerous cells and detect tumorigenesis in patients. Additionally, we highlight the need of surgical innovation to prevent cancer formation and spread. Pellionisz et al. discuss the development of a novel tool using vibroacoustographics that aims at improving the detection of tumors related to oral and head and neck squamous cell carcinoma. With improved detection of tumors in the tissue, surgery can become more accurate and more effective at preventing recurrence in cancer formation.

However, the patient safety of surgical advances is highlighted in Duy and Anderson’s report. Here, they discuss the shortcomings and benefits of spinal cord stimulator implants for back pain in patients. While reports claim that this tool is beneficial for the alleviation of pain, they warn in detail about the need for better trials to test this device, and the negative implications to unnecessary surgeries. Moreover, they discuss the unfortunate reality of the creation of ineffective medical devices for exploitative purposes on behalf of the manufacturer.

The use of advanced diagnostic tools was critical in identifying the etiology of an atypical presentation of anemia. In this case study by Chaunzwa et al., endoscopic biopsy and radio-isotope based imaging were ultimately used to diagnose a patient with autoimmune gastritis and a gastric carcinoid tumor. Their work also highlights the importance of screening for vitamin deficiencies as a form of preventative action. Another case study, examined by Salazar et al., discusses the drawbacks to certain diagnostic tools in identifying an extremely rare congenital disease: gallbladder agenesis. Diagnostic studies like hepatobiliary iminodiacetic acid and endoscopic retrograde cholangiopancreatography may overlook this life-threatening condition. Therefore, we must approach these disease presentations with an open mind and consider other diagnostic tests, like magnetic resonance cholangiopancreatography, that can more accurately make this diagnosis.

By outlining patient symptoms and diagnostic approaches, these case studies not only highlight crucial medical advances, but also the importance for continued improvement of diagnostic tools’ accuracy and capacity for early detection.

While imaging and diagnostic tools at organ or tissue level is discussed, our issue also highlights important advances in biomedical imaging at the cellular level. The microscope is one of the first diagnostic tools ever invented, dating back to the mid-1600s. It gave us the capacity to observe organisms and cells that are invisible to the naked eye, and current innovations in microscopy allow us to observe even smaller organisms in real time, with amazing resolution. In our issue, Kim et al. reviews the role of three-dimensional quantitative phase imaging and fluorescence microscopy in the study of cell pathophysiology. They highlight the principles behind quantitative phase imaging, to further understand mechanisms of biochemical pathways and pathogen interaction in the cell. In their conclusions, the authors make a case for the relevance of cellular imaging in medicine and the importance of a multidisciplinary approach in the diagnosis and treatment of disease. Xia and Fu’s review also highlights the importance of pathology studies at the molecular level. Using the Stochastic Optical Reconstruction Microscopy for single molecule localization, they can observe endothelial surface glycocalyx covering blood vessels and how their ultrastructure organization is affected under bacterial infection. This technique further highlights how biomedical imaging of the cell can be relevant for further understanding of diseased cellular conditions.

The importance of bridging clinical and biological imaging for medicine is most highlighted in the Francis and Heinrich review of mechanisms of single-cell behavior in bioscience. Francis and Heinrich’s review presents and discusses the importance of understanding how individual cells “sense, process, and respond to chemical and physical stimuli” and their importance for medical innovation as we move towards personalized medicine. Moreover, it highlights examples in which micromanipulation of individual immune cells is able to address medical questions unanswerable through other traditional methods.

This issue also highlights advances in medical treatments and patient care. An important field in medicine involves stem cell research. Stem cells provide the opportunity to regenerate or repair damaged tissue in humans. Therapeutic benefits of stem cells are immense and span across fields of research. Stem cells have been used to develop therapies in diabetes, cancer, heart disease, and spinal cord injuries. De Los Angeles, Pho, and Redmond highlight the importance of stem cells in organ transplantation. In their mini-review, they discuss the generation of human organs in large animals to overcome the shortage of human organ availability in the need of transplants. Moreover, organs can be developed through blastocyst complementation in large animals with human donor pluripotent stem cells. Their review comprehensively discusses both current and future steps of these methods, as well as ethical implications revolving them. Salehi et al. also review methods for improvement in the field of organ transplantation. Also referencing the sad reality of limited availability for organ transplantation, they discuss improvements in the perfusion system for solid organ preservation in order to maintain organs longer for future use. They describe the history of the field and current downsides to the system of organ preservation to then highlight how these limitations are being addressed with new technology and the field’s future directions.

Another manuscript that discusses the evolution of current medical tools is Soler et al., looking specifically at cerebral shunts. Shunts are used in cases of hydrocephalus to ameliorate accumulation of cerebrospinal fluid in the brain. This review allows the reader to understand how shunts work and the need to monitor them in case of obstruction. Moreover, they provide insights into current progress being made in the development of sensors for shunts to ensure patient safety and care.

Waynforth also makes a thorough report on another medical tool, assisted reproductive technology (ART). By analyzing data from the United Kingdom, he follows the outcome of children born through ART methods to measure child health and developmental impact later in life. His results show health problems and developmental struggles related to some forms of ART. Moreover, he outlines which ART methods should be improved for conception.

The intersection of medical technology advances and patient care is explored in Mazer’s personal perspective on technology and compassion in medicine. It explores the topic of improvement in medical technology and the experiences of doctor and patient care through it.

Medical technology started centuries ago and will continue to evolve with the ultimate goal of improving the human condition. Our issue hopes to capture a snapshot of this multidisciplinary field to promote further learning and support.

Glossary

ART

assisted reproductive technology