The efficiency of electroporation (EP) has made it a widely used therapeutic procedure to transfer cell killing substances effectively to the target site. A lot of researches are being done on EP-based cancer treatment techniques. Electrochemotherapy (ECT) is the first EP-based application in the field of drug administration. ECT is a local and nonthermal treatment of cancer that combines the use of a medical device with pharmaceutical agents to obtain local tumor control in solid cancers. It involves the application of eight, 100µs, pulses at 1 or 5000 Hz frequency and specified electric field (V/cm) with a median duration of 25 minutes. The efficacy of chemotherapeutic drugs increases by applying short and intense electrical pulses. Several clinical studies proposed ECT as a safe and complementary curative or palliative treatment option (curative intent of 50% to 63% in the treatment of Basal Cell Carcinoma (BCC)) to treat a number of solid tumors and skin malignancies, which are not suitable for conventional treatments. It is used currently for treatment of cutaneous and subcutaneous lesions, without consideration of their histology. On the contrary, it is also becoming a practical method for treatment of internal, deep-seated tumors and tissues. A review of this method, needed instruments, alternative image-guided procedures (IGP) approaches, and future perspectives and recommendations are discussed in this paper.

Purpose Contact endoscopy (CE) is a minimally invasive procedure providing real-time information about the cellular and vascular structure of the superficial layer of laryngeal mucosa. This method can be combined with optical enhancement methods such as narrow band imaging (NBI). However, these techniques have some problems like subjective interpretation of vascular patterns and difficulty in differentiation between benign and malignant lesions. We propose a novel automated approach for vessel pattern characterization of larynx CE + NBI images in order to solve these problems.Methods In this approach, five indicators were computed to characterize the level of vessel’s disorder based on evaluation of consistency of gradient and two-dimensional curvature analysis and then 24 features were extracted from these indicators. The method evaluated the ability of the extracted features to classify CE + NBI images based on the vascular pattern and based on the laryngeal lesions. Four datasets were generated from 32 patients involving 1485 images. The classification scenarios were implemented using four supervised classifiers.Results For classification of CE + NBI images based on the vascular pattern, polykernel support vector machine (SVM), SVM with radial basis function (RBF), k-nearest neighbor (kNN), and random forest (RF) show an accuracy of 97%, 96%, 96%, and 96%, respectively. For the classification based on the histopathology, Polykernel SVM showed an accuracy of 84%, 86% and 84%, RBF SVM showed an accuracy of 81%, 87% and 83%, kNN showed an accuracy of 89%, 87%, 91%, RF showed an accuracy of 90%, 88% and 91% for classification between benign histopathologies, between malignant histopathologies and between benign and malignant lesions, respectively.Conclusion These promising results show that the proposed method could solve the problem of subjectivity in interpretation of vascular patterns and also support the clinicians in the early detection of benign, pre-malignant and malignant lesions.

The thyroid is one of the largest endocrine glands in the human body, which is involved in several body mechanisms like controlling protein synthesis and the body's sensitivity to other hormones and use of energy sources. Hence, it is of prime importance to track the shape and size of thyroid over time in order to evaluate its state. Thyroid segmentation and volume computation are important tools that can be used for thyroid state tracking assessment. Most of the proposed approaches are not automatic and require long time to correctly segment the thyroid. In this work, we compare three different nonautomatic segmentation algorithms (i.e., active contours without edges, graph cut, and pixel-based classifier) in freehand three-dimensional ultrasound imaging in terms of accuracy, robustness, ease of use, level of human interaction required, and computation time. We figured out that these methods lack automation and machine intelligence and are not highly accurate. Hence, we implemented two machine learning approaches (i.e., random forest and convolutional neural network) to improve the accuracy of segmentation as well as provide automation. This comparative study intends to discuss and analyse the advantages and disadvantages of different algorithms. In the last step, the volume of the thyroid is computed using the segmentation results, and the performance analysis of all the algorithms is carried out by comparing the segmentation results with the ground truth.

The automatic detection of epileptic seizures in EEG data from extended recordings can make an important contribution to the diagnosis of epilepsy as it can efficiently reduce the workload of medical staff. Methods: This paper describes how features based on cross-bispectrum can help with the detection of epileptic seizure activity in EEG data. Features were extracted from multi-channel intracranial EEG (iEEG) data from the Freiburg iEEG recordings of 21 patients with focal epilepsy. These features were used as a support vector machine classifier input to discriminate ictal from inter-ictal states. A post-processing method was applied to the classifier output in order to improve classification accuracy. Results: A sensitivity of 95.8%, specificity of 96.7%, and accuracy of 96.8% were achieved. The false detection rate (FDR) was zero for 10 patients and very low for the rest. Conclusions: The results show that the proposed method distinguishes better between ictal and inter-ictal iEEG epochs than other seizure detection methods. The proposed method has a higher accuracy index than achievable with a number of previously described approaches. Also, the method is rapid and easy and may be helpful in online epileptic seizure detection and prediction systems.

There are significant challenges in global healthcare delivery at the moment. Some countries have abundant services, but are stuck with a rather nimble and expensive system that focuses on incremental innovations. Other geographies are still in need of basic tools, infrastructure and require completely different, inexpensive, and with that more disruptive solutions to satisfy their healthcare needs.Next Generation Healthcare systems with a focus on prevention / early detection and pro-active therapy will employ exponential technologies (AI, Big Data, Blockchain, Sensor Technology, Synthetic Biology, Tissue Engineering, Robotics, 3D Printing, ...) that will surely lead to significant changes in the way we experience, think about, and deliver healthcare and in which a digitally empowered patient will play a more important role.In the coming years/decades we will experience a shift from the current SICK-CARE provision to real HEALTHCARE to a focus on personal HEALTH, supported by an integration of patient generated health data with other external diagnostic and therapeutic data components creating a digital health twin as a base for prevention and patient centered precision medicine.Education and training of Biomedical Engineers needs to be adjusted to these developments focussing on solving unmet clinical needs, which requires a solid understanding of current health problems (regional, global), future technologies, economic realities and global health markets.The paper will present and discuss some of these future global innovation needs and the subsequent need for a change in the biomedical engineering curriculum that needs to include learning-(creativity, critical thinking, collaboration) and life skills (flexibility, leadership, social), as well as basic economic and entrepreneurial training -all of which are currently not taught or emphasized.

The endoscopic detection of perpendicular vascular changes (PVC) of the vocal folds has been associated with vocal fold cancer, dysplastic lesions, and papillomatosis, according to a classification proposed by the European Laryngological Society (ELS). The combination of contact endoscopy with narrow-band imaging (NBI-CE) allows intraoperatively a highly contrasted, real-time visualization of vascular changes of the vocal folds. Aim of the present study was to determine the association of PVC to specific histological diagnoses, the level of interobserver agreement in the detection of PVC, and their diagnostic effectiveness in diagnosing laryngeal malignancy. The evaluation of our data confirmed the association of PVC to vocal fold cancer, dysplastic lesions, and papillomatosis. The level of agreement between the observers in the identification of PVC was moderate for the less-experienced observers and almost perfect for the experienced observers. The identification of PVC during NBI-CE proved to be a valuable indicator for diagnosing malignant and premalignant lesions.

Longitudinal and perpendicular changes in the vocal fold’s blood vessels are associated with the development of benign and malignant laryngeal lesions. The combination of Contact Endoscopy (CE) and Narrow Band Imaging (NBI) can provide intraoperative real-time visualization of the vascular changes in the laryngeal mucosa. However, the visual evaluation of vascular patterns in CE-NBI images is challenging and highly depends on the clinicians’ experience. The current study aims to evaluate and compare the performance of a manual and an automatic approach for laryngeal lesion’s classification based on vascular patterns in CE-NBI images. In the manual approach, six observers visually evaluated a series of CE+NBI images that belong to a patient and then classified the patient as benign or malignant. For the automatic classification, an algorithm based on characterizing the level of the vessel’s disorder in combination with four supervised classifiers was used to classify CE-NBI images. The results showed that the manual approach’s subjective evaluation could be reduced by using a computer-based approach. Moreover, the automatic approach showed the potential to work as an assistant system in case of disagreements among clinicians and to reduce the manual approach’s misclassification issue.

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