Minimally invasive diagnostics

For a host of reasons, nonlinear optical spectroscopy is a valuable tool for biochemical applications v/here minimally invasive diagnostics is desired. Biochemical Applications of Nonlinear Optical Spectroscopy presents the latest technological advances and offers a perspective on future directions in this important field. 

Helmreich-Becker, I., Meyer zum Buschenfelde, K.-H., Lohse, A.W. Safety and feasibility of a new minimally invasive diagnostic laparoscopy technique. Endoscopy 1998 30 756-762... 

Minimally invasive diagnostic and therapeutic procedures are well-suited for the pediatric urinary tract. It seems that the advantages of the percutaneous approach may be ideal for treating children and are especially cost-effective. Thus, one can expect that the interventional approach will continue to grow with a broadening of indications. 

Biotinidase has been detected in all tissues and body fluids investigated so far [6, 20] with highest specific activities measured in kidney, liver and adrenal gland, and also plasma, allowing the use of this easily available and minimally invasive material for diagnostic purposes. 

Biomarkers in clinical pathology can be established on evidence that supports the performance characteristics of the test—analytical accuracy and reproducibility—and in which the use of the test is supported by toxicological, pharmacological, or physiological in vivo evidence. Some biomarkers are designed to confirm either the theoretical principle or the mechanism of action of a drug. Ideally, a biomarker should apply to all laboratory animal species, have similar diagnostic value, and be predictive for human safety the biomarker should be specific, sensitive, and minimally invasive. Unfortunately, many biochemical markers in current use are not ideal in these respects. 

First, better smart and multifunctional orthopedic nanomaterials with more capabilities are expected. In the near future, nanomaterial platforms are expected that integrate diagnostic, imaging or monitoring, therapeutic, and tissue regenerative abilities and can be minimal-invasively deployed or administrated. Such nanomaterial systems would complete several tasks that are currently performed individually by different materials or devices with better efficacy and safety. In addition, as implied by the example of a smart hip implant in Section 8.1.1, rapid development of N/MEMS may also contribute to the emergence of novel orthopedic implants based on such novel nanomaterials. 

Optical fiber endoscopes are minimally invasive tools used in medical diagnosis and therapy. Optical fibers facilitate the combination of low power diagnostic functions (imaging and sensing) with high power for therapeutic functions (surgery) in the one device. Optical sources with very different characteristics in both wavelength and peak and... 

Hricak H, Powell CB, Yu KK, Washington E, Subak LL, Stern JL, Cisternas MG, Arenson RL (1996) Invasive cervical carcinoma role of MR imaging in pretreatment workup-cost minimization and diagnostic efficacy analysis. Radiology 198 403-409... 

Diagnostic chip probing the stratum comeum of the skin Si interface layer (in between the skin and MEMS) is micromachined and electrochemically etched to produce pSi Minimally invasive sampling from the skin Bhansali et al. 2002... 

The number of percutaneous femoral arterial catheterizations has increased exponentially in recent years with several million procedures performed worldwide annually. A direct consequence of that explosion in number of percutaneous diagnostic and interventional catheterizations is the increasing number of vascular complications due to the percutaneous creation of that vascular access mainly using the femoral artery. Potential complications are pseudoaneurysm, arteriovenous fistula, uncontrollable groin and/or retroperitoneal bleeding, in situ arterial thrombosis, and peripheral embolization. In order to deal with these complications, there is an increasing need for quick and optimal diagnosis and for efficient and, by preference, minimally invasive treatment. 

As previously noted, medical devices are developed and marketed under strict regulatory requirements to ensure safety and efficacy. The transcutaneous nature of the minimally invasive CGM systems on the market and in development creates additional requirements on the materials, processes, packaging, and delivery of the devices. In vitro diagnostic devices are considered to be a subclass of medical devices, and a separate EU regulation (98/79EC) applies. In contrast to in vitro diagnostic devices, medical devices need, e.g., a biocompatibility assessment, and for invasive sensors also sterilization, disinfection requirements apply. As such, the materials used in the constmction of the transcutaneous part of the sensor, and the complete sensor itself, must be biocompatible in the sense that the sensor exhibits no toxicity toward the surrounding tissue. 

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