Advancing Microwave-Based Imaging Techniques for Medical Applications in the Wake of the 5G Revolution - Emerald
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Advancing Microwave-Based Imaging
Techniques for Medical Applications
in the Wake of the 5G Revolution
Jean-Charles Bolomey
University Paris Sud, France
jch.bolomey@gmail.com
Special Session
CS33 Horizon 2020 research and innovation session (EMERALD):
ElectroMagnetic imaging for a novel genERation of medicAL
Devices
(http://www.msca-emerald.eu/)
OUTLINE
• FEW QUESTIONS ON MICROWAVE-BASED IMAGING
FOR MEDICAL APPLICATIONS
• PART I: WHERE ARE WE ARRIVED ?
• PART II: WHAT COULD BE TRIED/DONE ?
• CONCLUSIONS
Special Session
CS33 Horizon 2020 research and innovation session (EMERALD):
ElectroMagnetic imaging for a novel genERation of medicAL
Devices
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 2
MICROWAVE-BASED MEDICAL IMAGING
FACTS AND QUESTIONS …
• SINCE EARLY 80’s… “MICROWAVES ARE
CLAIMED TO OFFER PROMISES AS IMAGING
MODALITY”
L.E. Larsen and J.H. Jacobi
(Diagnostic Imaging in Clinical Medicine, 11, 44-47,1982)
• WHAT EXACTLY MICROWAVES ARE
PROMISING OF ? AND BY WHEN ?
• INDEED, ALMOST 40 YEARS LATER,
MICROWAVES ARE STILL CLAIMING TO
OFFER PROMISES… BUT ONLY GAINED A
MODEST CLINICAL ACCEPTANCE
• IN FACT, THE JOURNEY WAS MORE
COMPLICATED THAN EXPECTED BUT THE
RESULTS COLLECTED FROM RECENT
CLINICAL TRIALS SEEMS SUGGESTING A
POSSIBLE EXIT OF THE TUNNEL…
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 3
SIMPLIFIED CLASSIFICATION CHART
OF MICROWAVE-BASED APPLICATIONS
ACTIVE/PASSIVE
Industrial
SHORT RANGE LONG RANGE
Scientific
DIELECTOMETRY RADAR
Medical
I S M
COMMUNICATIONS TRANSFER/HARVESTING
MICROWAVE ISM APPLICATIONS AT THE CROSS-ROAD
OF SIGNALING/SENSING/POWERING TECHNOLOGIES
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 4
VARIOUS ASPECTS OF MICROWAVES
FOR MEDICAL APPLICATIONS
« Low » « High »
Power Medical Power
[1] [2]
DIAGNOSIS
THERAPY
BIO- HYPER-
SENSING THERMIA
IMAGING ABLATION
[1] M.F. Iskander and C.H. Durney, “Electromagnetic Techniques [2] A.W. Guy, “History of Biological Effects and Medical Applications
for Medical Diagnosis: a Review”, Proc. IEEE, 68, 226-132, Jan. 1980 Of Microwave Energy”, IEEE Trans. MTT-32, 226-132,Sept. 1984
MICROWAVE-BASED MEDICAL IMAGING
IS THE “LAST COMER” ISM APPLICATION
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 5TIME LINE OF MAJOR IMAGING MODALITIES
MICROWAVES AS “LAST COMER”
1940 1950 1960 1970 1980 1990 2000 2010
DIGITAL BREAST
MAMMO- CT X-rays
RADIOGRAPHY GRAPHY SCANNER RADIOGRAPHY TOMO-
SYNTHESIS [1]
SONAR NDT US US
SCANNER [2]
MAGNETIC MRI MRI
RESONANCE SCANNER [3]
RADIO- NUCLEAR PET PET-CT PET
NUCLEIDES MEDECINE SCANNER [4]
1ST DIAG. EARLY IMAGING MW
APPL. INVESTIGATIONS [5]
RADAR NDT ORGAN MVTS. BIOLOGICAL TARGETS PATHOLOGY ORIENTED
LUNG DISEASE ISOLATED ANIMAL ORGANS (BREAST, BRAIN, LUNG, BONES…)
… HUMAN IN-VIVO (FOREARM)
HYPERTHERMIA CONTROL
[1] R. Ciernak, “X-Ray Computed Tomography in Biomedical Engineering”, Springer-Verlag London Limited, 2011
[2] J. Woo, “A short history of the Real-time ultrasound scanner”, http://www.ob-ultrasound.net/history-realtime.html
[3] T. Geva, “Magnetic Resonance Imaging: Historical Perspective”, Journ. Cardiovascular Magnetic Resonance, 8, 573-580, 2006
[4] G. Bernal, “History of PET scanners”, http://large.stanford.edu/courses/2014/ph241/bernal1/
[5] J.Ch. Bolomey, “Crossed Viewpoints on Microwave-based Imaging for Medical Diagnosis: From Genesis to Earliest Clinical outcomes ”,
in The World of Applied Electromagnetics, A. Lakhtakia, C.M. Furse (eds), Springer 2018
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 6GLOBAL VIEW OF MEDICAL IMAGING MARKET
WHAT PLACE FOR MICROWAVES ?
• SALIENT MARKET FEATURES: MEDICAL IMAGING
– Global Market size worth 29.48 billions and
NUCLEAR Advanced
Modalities EQUIPMENT MARKET
projected to reach 46.18 by 2024, (Transparency Market Research,
MRI
– Market growth supported by the rise of geriatric 49%
transparencymarketresearch.com)
population and the increased prevalence of CV
diseases, CT
– Expected Growth Rate: 6.56%, over the forecast
Basic
period 2016 - 2024 US Modalities
GLOBAL MEDICAL
– X-ray first; fastest growth expected for CT/PET IMAGING MARKET
(earlier disease detection), 51% (Pictures of the Future,
Medical Imaging:Facts and Forecasts,
– Larger growth expected for emerging markets. X-RAY siemens.com)
– Global market shared by only a few big companies.
• KEY GROWTH DRIVERS: A PRIORI
– Miniaturization and portability, ✔ MICROWAVES Emerging
Markets Developped
– Digitization of measured data, ✔ LOOK ALMOST 36% Markets
– Hybrid imaging systems, ✔ PERFECT 64%
– Use of non-ionizing modalities, ✔
– Non-invasive and easy-to-use equipment, ✔
– Inexpensive, energy saving, ergonomic medical ✔ BUT, A
equipment with low maintenance requirements … POSTERIORI…
NOT SO SIMPLE !
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 7sensitivity for breast cancer detection, especially for cases where the use of mammography
and ultrasound has been equivocal. However, MRI is almost always considered as an addition
to, rather than a replacement for, digital mammography in Europe today. Constraints of cost
and availability for MRI mean it is reserved only for high-risk patients; only in Austria and Italy
MICROWAVES AS “CHALLENGER” TECH ?
is MRI more commonly offered for regular screening in addition to digital mammography. Given
MRI resource constraints, it is hard to see MRI realistically becoming a significant challenger to
digital mammography anytime soon.
Comparison of 'challenger' breast screening technologies
'Challenger'
Measure DBT ABUS MRI
tech
From: Stephen Holloway, AuntMinnie.com contributing writer March 6, 2019
“DBT is well-positioned as successor in European breast screening”
European Congress of Radiology, Vienna, Feb. 27 – March 3, 2019
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 85. Plateau of Productivity
Mainstream adoption starts to take off. Criter ia for assessing
HYPE CYCLE FOR EMERGING TECHNOLOGIES
legitim ate provider s are m or e clearly defined. The technology’s
APPLICATION TO MICROWAVE-BASED MEDICAL IMAGING
broad m arket applications and relevance are under stood.
NUMERICAL
& PHANTOM
MODELS
?
CLINICAL
ADOPTION AND
DISSEMINATION
EXPECTATION
CLINICAL ▪ Acceptance
TRIALS threshold
FUNCTIONAL
PROTOTYPES
▪ prototype-to-product
PHANTOMS, conversion,
ISOLATED ▪ regulatory approval,
ORGANS ▪ commercialization
EXPERIMENTS ▪ instrument development, …all in the face
▪ preclinical testing,
▪ clinical prototyping of competing
RF technologies !
DOSIMETRY
TRIGGER
Slope of
TIME
Peak of Through
MATURITY of
Innovation Inflated Disilliusonment Enlightenment
Trigger Expectations
Machines are becom ing better at under standing hum ans and the
(Adapted from https://www.gartner.com/en/research/methodologies/gartner-hype-cycle)
environm ent — for exam ple, recognizing the em otion in a
person’s
J.Ch. Bolomey
voice — and hum ans are becom ing better at
13th EuCAP, Krakow, March 2019 9DEVELOPMENT
MICROWAVES FLOW-CHART
FOR BIOMEDICAL APPLICATIONS
FOR MICROWAVE-BASED IMAGING
SIMPLIFIELD FLOW-CHART
“INSIDE” MICROWAVE Encouraging results…
COMMUNITY
MICROWAVE EXPERTISE Good candidate… EARLY PROOF
(HARD/SOFTWARE) OF CONCEPT
IDENTIFIED NUMERICAL SIMULATION
& CLINICAL ON-PHANTOM EXPERIMENT
SUPPOSED SPECIFIC TARGET
ADVANTAGES OF
MICROWAVES DUE TO
LIVING TISSUE DIELECTRIC TARGET PROTOTYPE
PROTO
PROPERTIES ADJUSTMENT REVISION TEST CASES
“Technology” pull PRE-CLINICAL
ASSESSMENT
CLINICAL NEEDS
?
NO
« MAJOR » CLINICAL
EXISTING PERF/COST TRIALS
HEALTH MODALITIES BENEFIT
ISSUES YES INTER-COMPARISON
MULTI-MODALITY
LARGE SCALE VALIDATION
“Market” push
ACCESS TO CLINICAL
“Technology” transfer
“OUTSIDE” MICROWAVE MARKET PRACTICE
COMMUNITY
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 10MICROWAVE SCANNERS FOR EARLY IN-VIVO IMAGING
SOME EXAMPLES…
Carolinas Heart Inst (USA). Keele Univ. (UK)
INVERSE F=2.45GHz F=1GHz F=1-2.3GHz
SCATTERING Nt=Nr=32 N=32 N=24 Univ. of Calgary (CA)
(TOMOGRAPHY) F=50MHz-15GHz
T N=1
RADAR
MULTI-
MU VIEW
MO MONO- whole-body functional animal MO breast imaging
VIEW T T animal imaging imaging T case study
1990 1995 2000 2005 2010 2015
human forearm NIT on animal breast imaging on volunteers and patients
F=0.3-3GHz F=4-8GHz F=2-4GHz
N=16 N=60 N=16
F=2.3GHz T T T MU MU
N=64
UPC Barcelona (SP) Thayer School of Engng. Dartmouth (USA) Univ. of Bristol (UK) McGill Univ (CA).
J.Ch. Bolomey COST MiMed, 20-22 June, 2016 11MICROWAVE IMAGING SYSTEMS
ENGAGED IN (PRE)CLINICAL TRIALS
MANY DATA ACQUISITION AND PROCESS
ACQUISITION TIME MODALITIES
NUMBER OF 25000
CHANNELS
MARIA MICRIMARIA (2006)
1.5-8 GHz MARIA
11
MIST (1995)
MIST
Multi-static, 60 slot antennas
0.5-3 1/2 spherical RADAR
DARTMOUTH Coll. GHz
Multi-static,16 monopoles SUST
Cylindrical, Variable height, 4-8.5 GHz SUST-SHENZEN
TOMOGRAPHY Multi-static, , 2 antennas
5 rings, 360 positions/ring,
mech./scan, Cylindrical RADAR
Mc Gill Univ.
Multi-static, 16 antennas
Wearable, RADAR
TSAR UoCALGARY
MEDFIELDS DIAG. (2005) MGU Monostatic, 2 vivaldi antennas
2-4 TSAR Cylindrical/Conformal,
Head adjustable, 8 slot antennas 1.5-9 GHz mech./scan RADAR
CLASSIFICATION GHz
EM-Tensor (2012)
Cylindrical
5x32=160 slot antennas
TOMOGRAPHY FREQUENCY (GHz)
Adapted from: “Microwave Breast Imaging: Clinical Advances and Remaining Challenges”, D. O’Loughlin, M. O’Halloran, B.M. Moloney et al.;
IEEE Transactions on Biomedical Engineering ( Volume: 65 , Issue: 11 , Nov. 2018 )
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 12WHAT HAS ALREADY EMERGED ?
OUTCOMES A FEW OPERATIONAL SYSTEMS
ENGAGED IN CLINICAL TRIALS :
* BREAST, BRAIN, BONES, LUNG
* ENCOURAGING” SENSITIVITY
* SPECIFICITY TO BE VALIDATED
- SIGNIFICANT ACHIEVEMENTS
* EXTENSIVE NUMERICAL AND
EXPERIMENTAL MODELING,
* RECONSTRUCTION ALGORITHMS
(TOMOGRAPHY, RADAR, HOLOGRAPHY),
* TISSUE CHARACTERIZATION,
* PROTOTYPE DEVELOPMENT,
* PHANTOM DEVELOPMENT/EXPERIMENT,
*ETC…
- BUT…
SOME PERSISTENTLY “OPEN” ISSUES:
* LACK OF SYNTHESIS AND BENCHMARKING
* A PRIORI INFORMATION
* DIELECTRIC CHARACTERIZATION
* PATIENT INTERFACE OPTIMIZATION
EFFORTS * IMAGE RELEVANCE (SPECIFICITY)
WHAT COULD BE TRIED / DONE ?
LOOK AT EMERAD PROGRAM… AND THREE SUGGESTIONS
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 13SUGGESTION 1
“BETTER” DATA ACQUISITION TECHNIQUES
• EXPLOITING ALREADY EXISTING OR SUPPOSEDLY RAPIDLY
AVAILABLE MICROWAVE TECHNOLOGIES FOR OBTAINING “BETTER”
DATA ACQUISITION TECHNIQUES:
– INTRODUCING THE BEST OF WIRELESS TECHNOLOGIES USED FOR
EXISTING COMMUNICATION, RADAR, SENSOR GRID SYSTEMS
(MODULATION/DEMODULATION SCHEMES, OFDN, MIMO PROCESSING,…)
– APPLICATION-DEDICATED AND/OR PATIENT ADAPTIVE OPTIMIZATION OF
THE PROBE ARRAY
– INCREASING DYNAMIC RANGE TO REDUCE MULTI-PATH CORRUPTION
– TAKING PROFIT OF 5G, IoT OR IoE DEVELOPMENTS
(MINIATURIZATION, ARRAYS OF INTEGRATED PROBES, …)
– REDUCING FABRICATION/EXPLOITATION/MAINTENANCE COSTS BY
MEANS OF APPROPRIATE ARCHITECTURES
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 14MICROWAVES MM-WAVES SPECTRUM
MEDICAL IMAGING VS 5G FREQUENCY BANDS
VISIBLE (Source: Qualcomm)
FREQUENCY (GHz)
0.6 GHz 6 GHz 24 GHz 100 GHz
BRAIN TOMOGRAPHY
MEDICAL
BREAST UWB RADAR IMAGING
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 15SUGGESTION 2
“BETTER” DATA PROCESSING
AND ALGORITHMS
• EXPLOITING/ANTICIPATING GROWING COMPUTING POWER
• RADAR: TOWARD REAL-TIME, FAST PRE/POST PROCESSING
• INVERSE-SCATTERING IMAGING: DECREASING MODEL NOISE, FULL
3D ACCURATE MODELING (INCLUDING INTERACTIONS AND MUTUAL
COUPLING…)
• INCREASING AMOUNT OF DATA
• IMPROVING SPATIAL RESOLUTION
• QUANTUM COMPUTERS ? BEYOND MOORE’s LAW ?
– USING OTHER IMAGING MODALITIES
• A PRIORI INFORMATION (WHEN NEEDED)
• MICROWAVE DATA FUSION WITH OTHER MODALITIES FOR AI/ML/DL
ALGORITHMS
– CONSIDERING “NON IMAGING-BASED” MICROWAVE SENSING
PROTOCOLS (SENSOR NETWORKS GRIDS, ARTIFICIAL/AUGMENTED
INTELLIGENCE, MACHINE LEARNING, CLASSIFICATION, NEURAL
NETWORKS, ETC.)
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 16MOORE’s LAW EXTRAPOLATIONS
OF COMPUTATIONAL POWER
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 17SUGGESTION 3
INCREASING INTERACTIONS WITH BIOLOGISTS
AND “END-USER” MEDICAL COMMUNITY
• RETURNING TO BASIC MW/BIO INVESTIGATIONS
▪ TISSUE DIELECTRIC CHARACTERIZATION (LOCAL PROBE, MRI,
SCANNING MICROSCOPY,…)
▪ PHYSICAL OR HEURISTIC MODELS FOR FREQUENCY DEPENDENCE
▪ FOCUSING ON DIELECTRIC SPECIFICITY AND SENSITIVITY
ASSESSMENTS
▪ QUANTIFYING DIELECTRIC IMAGES IN TERMS OF BIO-PHYSIOLOGICAL
FACTORS
• INCREASING INTERACTIONS WITH “END USER” MEDICAL
COMMUNITY
▪ IDENTIFYING REAL NEEDS AND LOOKING FOR THE MOST
MICROWAVE-FRIENDLY AND CLINICALLY RELEVANT SCENARIOS
▪ CASE BY CASE VALIDATION THANKS TO LARGE SCALE /MULTIMODALITY
CLINICAL ASSESSMENT CAMPAIGNS
▪ GUIDING TECHNICAL ADVANCES BY CLINICAL RETURNS
▪ HYBRIDIZING WITH OTHER MODALITIES
▪ FOLLOWING UP IMPROVEMENT OF OTHER IMAGING MODALITIES:
MAN-PORTABLE MRI, DIGITAL TOMOSYNTHESIS, LOW-DOSE PHASE
CONTRAST X-RAYS, ETC.
▪ NOT UNDERESTIMATING THE CHANGES IN THE MEDICAL PRACTICE
INDUCED BY AI / ML DEVELOPMENTS
▪ ATTENDING MEDICAL MEETINGS, LOOKING AT MEDICAL JOURNALS, ETC.
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 18FUTURE MEDICAL IMAGING FACING REVOLUTIONARY
AI AND ML CHALLENGES (EXAMPLES)
▪ “Look Ahead: The Future of Medical Imaging”∑
James H. Thrall, radiology imaging, August 1, 2015
▪ “How Artificial Intelligence Will Change Medical Imaging”
D. Fornel, artificial intelligence, February 2017
▪ “What is the Future of Medical Imaging Equipment ?”
M. Taschetta-millane, radiology imaging, July 2018
▪ “Technologies to Watch in Breast Imaging”
J. Zagoudis, radioimaging, July 2018
▪ “Artificial Intelligence in Radiology: Hype or Hope ?”
M.B. Massat, pp. xx-yy, March, 2018
▪ “A Promising future for AI in breast cancer screening”
M. B. Massat, pp. 22-25, September 2018
∑
▪ “Demystifying Artificial Intelligence”
Part I, “Simplifying AI and Machine Learning”, E. Siegel, pp. 26-28, May, 2018
Part II, “An Imaging Tool Ready to Explode”, L.N. Tanenbaum,pp. Search26-27,
the site... July 2018
Part III, “Going Beyond Escape”, R.B. Shrestha, pp. 8-11, November 2018
▪ “Machine (Deep) Learning Methods for Image Processing IEEE Trans. Radiation and
Plasma Medical Sciences
and Radiomics”, M. H. Latim, C. Parmar, J. QiI, I. el Naqa
Vol. 3,pp.104-107, March 2019 ∑
SPECIAL ISSUE ON MACHINE LEARNING FOR IMAGE PROCESSING AND RADIOMICS
J.Ch. Bolomey 13th EuCAP, Krakow, March 2019 19CS33 Horizon 2020 research and innovation session (EMERALD):
ElectroMagnetic imaging for a novel genERation of medicAL Devices
CONCLUSIONS
• AFTER A LONG MATURATION PERIOD, MICROWAVE-BASED
IMAGING SYSTEMS ARE BEGINNING TO PROVIDE CLINICAL
RESULTS
• FUTURE DEVELOPMENTS MUST:
– TAKING PROFIT OF 5G TECHNOLOGY AND DEEP LEARNING ALGORITHMS
– ACCOUNTING FOR THE EVOLUTION OF THE MEDICAL PRACTICE, MORE
PARTICULARLY IMAGING MODALITIESUNDER THE IMPACT OF ARTIFICIAL
INTELLIGENCE
• DUE TO THEIR NECESSARY SPECIFICITY, NEW SYSTEMS
MUST BE FOCUSED ON REAL CLINICAL NEEDS FOR:
– COMPLETING/SUPPLEMENTING OTHER IMAGING MODALITIES
– ADDRESSING SPECIFIC REQUIREMENTS FOR DEVELOPPING COUNTRIES
• A
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