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Safe Hb Concentration Measurement during Bladder Irrigation Using Artificial Intelligence
2021
Sensors
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We have developed a sensor for monitoring the hemoglobin (Hb) concentration in the effluent of a continuous bladder irrigation. The Hb concentration measurement is based on light absorption within a fixed measuring distance. The light frequency used is selected so that both arterial and venous Hb are equally detected. The sensor allows the measurement of the Hb concentration up to a maximum value of 3.2 g/dL (equivalent to ≈20% blood concentration). Since bubble formation in the outflow tract
doi:10.3390/s21175723
pmid:34502612
fatcat:hff3ddtx2vddnnrledstgqlvxe
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... nnot be avoided with current irrigation systems, a neural network is implemented that can robustly detect air bubbles within the measurement section. The network considers both optical and temporal features and is able to effectively safeguard the measurement process. The sensor supports the use of different irrigants (salt and electrolyte-free solutions) as well as measurement through glass shielding. The sensor can be used in a non-invasive way with current irrigation systems. The sensor is positively tested in a clinical study.
Radiomics Applications in Renal Tumor Assessment: A Comprehensive Review of the Literature
2020
Cancers
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Radiomics texture analysis offers objective image information that could otherwise not be obtained by radiologists′ subjective radiological interpretation. We investigated radiomics applications in renal tumor assessment and provide a comprehensive review. A detailed search of original articles was performed using the PubMed-MEDLINE database until 20 March 2020 to identify English literature relevant to radiomics applications in renal tumor assessment. In total, 42 articles were included in the
doi:10.3390/cancers12061387
pmid:32481542
pmcid:PMC7352711
fatcat:lif5qvsixjfr7at4xrnkedzxna
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... analysis and divided into four main categories: renal mass differentiation, nuclear grade prediction, gene expression-based molecular signatures, and patient outcome prediction. The main area of research involves accurately differentiating benign and malignant renal masses, specifically between renal cell carcinoma (RCC) subtypes and from angiomyolipoma without visible fat and oncocytoma. Nuclear grade prediction may enhance proper patient selection for risk-stratified treatment. Radiomics-predicted gene mutations may serve as surrogate biomarkers for high-risk disease, while predicting patients' responses to targeted therapies and their outcomes will help develop personalized treatment algorithms. Studies generally reported the superiority of radiomics over expert radiological interpretation. Radiomics provides an alternative to subjective image interpretation for improving renal tumor diagnostic accuracy. Further incorporation of clinical and imaging data into radiomics algorithms will augment tumor prediction accuracy and enhance individualized medicine.
Training in robotics: The learning curve and contemporary concepts in training
2014
Arab Journal of Urology
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To define the learning curve of robot-assisted laparoscopic surgery for prostatectomy (RALP) and upper tract procedures, and show the differences between the classical approach to training and the new concept of parallel learning. This mini-review is based on the results of a Medline search using the keywords 'da Vinci', 'robot-assisted laparoscopic surgery', 'training', 'teaching' and 'learning curve'. For RALP and robot-assisted upper tract surgery, a learning curve of 8-150 procedures is
doi:10.1016/j.aju.2013.10.005
pmid:26019925
pmcid:PMC4434504
fatcat:ntqm4zpdojbbncgga5m66pcu6u
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... ed, with most articles proposing that 30-40 cases are needed to carry out the procedure safely. There is no consensus about which endpoints should be measured. In the traditional proctored training model, the surgeon learns the procedure linearly, following the sequential order of the surgical steps. A more recent approach is to specify the relative difficulty of each step and to train the surgeon simultaneously in several steps of equal difficulty. The entire procedure is only performed after all the steps are mastered in a timely manner. Recently, a 'warm-up' before robotic surgery has been shown to be beneficial for successful surgery in the operating room. There is no clear definition of the duration of the effective learning curve for RALP and robotic upper tract surgery. The concept of stepwise, parallel learning has the potential to accelerate the learning process and to make sure that initial cases are not too long. It can also be assumed that a preoperative 'warm up' could help significantly to improve the progress of the trainee.
Prospects and Challenges of Artificial Intelligence and Computer Science for the Future of Urology
2020
World journal of urology
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. * Rodrigo Suarez-Ibarrola rodrigo.suarez@uniklinik-freiburg.de Arkadiusz Miernik arkadiusz.miernik@uniklinik-freiburg.de 1 Department of Urology, Faculty of Medicine, University of Freiburg -Medical ...
doi:10.1007/s00345-020-03428-0
pmid:32910230
fatcat:4qsin7rajrghpbrvfyk6mhxnai
Reasons for new MIS. Let's be fair: iTIND, Urolift and Rezūm
2020
World journal of urology
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To review and discuss the literature regarding iTIND, Urolift and Rezūm and investigate the precise clinical indications of all three different approaches for their application in benign prostatic hyperplasia (BPH) treatment. The PubMed-Medline and Cochrane Library databases were screened to identify recent English literature relevant to iTIND, Urolift and Rezūm therapies. The surgical technique and clinical results for each approach were summarized narratively. iTIND, Urolift and Rezūm are
doi:10.1007/s00345-020-03453-z
pmid:32960328
pmcid:PMC8332552
fatcat:shzbpvzh5fav7l4fxph5yqx4ou
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... and effective minimally invasive procedures for the symptomatic relief of lower urinary tract symptoms (LUTS) due to BPH. iTIND requires the results of ongoing prospective studies, a long-term follow-up and a comparison against a reference technique to confirm the generalizability of the first pivotal study. Urolift provides symptomatic relief but the improvements are inferior to TURP at 24 months and long-term retreatments have not been evaluated. Rezūm requires randomized controlled trials against a reference technique to confirm the first promising clinical results. However, clinical evidence from prospective clinical trials demonstrates the efficacy and safety of these procedures in patients with small- and medium-sized prostates. Although iTIND, Urolift, and Rezūm cannot be applied to all bladder outlet obstruction (BOO) cases resulting from BPH, they provide a safe alternative for carefully selected patients who desire symptom relief and preservation of erectile and ejaculatory function without the potential morbidity of more invasive procedures.
Metabolic Imaging by Simultaneous FLIM of NAD(P)H and FAD
2020
Current Directions in Biomedical Engineering
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AbstractWe describe a metabolic imaging system based on simultaneous recording of lifetime images of NAD(P)H and FAD. The system uses one-photon excitation by ps diode lasers, scanning by galvanometer mirrors, confocal detection, and two parallel TCSPC FLIM recording channels. Two lasers, with wavelengths of 375nm and 410 nm, are multiplexed to alternatingly excite NAD(P)H and FAD. One FLIM channel detects in the emission band of NAD(P)H, the other in the emission band of FAD. For both
doi:10.1515/cdbme-2020-3064
fatcat:6qwkcum7s5b6dae74w4x73bwfa
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... the data analysis delivers images of the amplitudes of the decay components, a1 and a2. We show that these are robust parameters to characterize the metabolic state of cells. FLIM results obtained from excised human-bladder tissue were in perfect agreement with histology.
Incidental prostate cancer after holmium laser enucleation of the prostate—A narrative review
2021
Andrologia
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Prostate cancer can be detected incidentally after surgical therapy for benign prostatic obstruction such as holmium laser enucleation of the prostate (HoLEP), thus called incidental prostate cancer (iPCa). We aimed to review the studies on iPCa detected after HoLEP and investigate its prevalence. A detailed search of original articles was conducted via the PubMed-MEDLINE, Web of Science, Wiley Online Library and Cochrane Library databases in the last 10 years up to 1 May 2021 with the
doi:10.1111/and.14332
pmid:34837229
fatcat:mo3bce72uzd4zk7wyukvquwcle
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... search string solely or in combination: "prostate cancer", "prostate carcinoma", "holmium laser enucleation of the prostate" and "HoLEP". We identified 19 articles to include in our analysis and divided them into six main categories: HoLEP versus open prostatectomy and/or transurethral resection of the prostate in terms of iPCa, oncological and functional outcomes, the role of imaging modalities in detecting iPCa, predictive factors of iPCa, the role of prostate-specific antigen kinetics in detecting iPCa and the management of iPCa after HoLEP. We found that the iPCa after HoLEP rate ranges from 5.64% to 23.3%. Functional and oncological outcomes were reported to be encouraging. Oncological treatment options are available in a wide range.
Wireless Acoustic-Surface Actuators for Miniaturized Endoscopes
2017
ACS Applied Materials and Interfaces
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This is an extended and revised edition of IWDE 92-06. Comments and corrections are gratefully accepted. This file may be used and printed, but for personal or educational purposes only.
doi:10.1021/acsami.7b12755
pmid:29148713
pmcid:PMC5730945
fatcat:h7rbbpg7zbejbpptffkbteil4a
Laser procedures in the treatment of BPH: a bibliometric study
2020
World journal of urology
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Miernik has received research funding from the Federal Ministry of Education and Research (BMBF), DE, coverage of travel expenses from the German Association of Urology (DGU), DE, European Association ...
doi:10.1007/s00345-020-03532-1
pmid:33263795
pmcid:PMC8405477
fatcat:amkijtv2fvh7vk7nv3ghi7xaiq
Robotic stone surgery – Current state and future prospects: A systematic review
2018
Arab Journal of Urology
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Miernik: Protocol/project development, data analysis, manuscript and figure writing/editing, supervision. Schoeb: Protocol/project development, data analysis, manuscript, figure writing/editing. ...
doi:10.1016/j.aju.2017.09.004
pmid:30140470
pmcid:PMC6104666
fatcat:dxpdyexydjg63bemxxvzb23kay
Modified salvage endoscopic combined intrarenal surgery in a single functional kidney with refractory staghorn stone
2019
Urology Case Reports
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Holmium laser vaporization and percutaneous removal of a migrated endothelialized biliary self-expanding metal stent
2019
VideoGIE
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DISCLOSURE Dr Miernik is an advisor to Richard Wolf GmbH and to Lisa laser OHG. The other authors disclosed no financial relationships relevant to this publication. ...
doi:10.1016/j.vgie.2019.01.014
pmid:31193940
pmcid:PMC6545356
fatcat:vykx2hpwpfhxfnbwvanoy4yq5m
Soft Urinary Bladder Phantom for Endoscopic Training
2021
Annals of Biomedical Engineering
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AbstractBladder cancer (BC) is the main disease in the urinary tract with a high recurrence rate and it is diagnosed by cystoscopy (CY). To train the CY procedures, a realistic bladder phantom with correct anatomy and physiological properties is highly required. Here, we report a soft bladder phantom (FlexBlad) that mimics many important features of a human bladder. Under filling, it shows a large volume expansion of more than 300% with a tunable compliance in the range of 12.2 ± 2.8 – 32.7 ±
doi:10.1007/s10439-021-02793-0
pmid:34002287
pmcid:PMC8455490
fatcat:x6pshmrpkrgbhbykl5njapksvi
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... 4 mL cmH2O−1 by engineering the thickness of the bladder wall. By 3D printing and multi-step molding, detailed anatomical structures are represented on the inner bladder wall, including sub-millimeter blood vessels and reconfigurable bladder tumors. Endoscopic inspection and tumor biopsy were successfully performed. A multi-center study was carried out, where two groups of urologists with different experience levels executed consecutive CYs in the phantom and filled in questionnaires. The learning curves reveal that the FlexBlad has a positive effect in the endourological training across different skill levels. The statistical results validate the usability of the phantom as a valuable educational tool, and the dynamic feature expands its use as a versatile endoscopic training platform.
Evaluation of the Ginsburg Scheme: Where Is Significant Prostate Cancer Missed?
2021
Cancers
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Systematic biopsy (SB) according to the Ginsburg scheme (GBS) is widely used to complement MRI-targeted biopsy (MR-TB) for optimizing the diagnosis of clinically significant prostate cancer (sPCa). Knowledge of the GBS's blind sectors where sPCa is missed is crucial to improve biopsy strategies. We analyzed cancer detection rates in 1084 patients that underwent MR-TB and SB. Cancerous lesions that were missed or underestimated by GBS were re-localized onto a prostate map encompassing Ginsburg
doi:10.3390/cancers13102502
pmid:34065418
pmcid:PMC8160743
fatcat:y363vj4ur5bfpepsdxj4b5odvi
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... ctors and blind-sectors (anterior, central, basodorsal and basoventral). Logistic regression analysis (LRA) and prostatic configuration analysis were applied to identify predictors for missing sPCa with the GBS. GBS missed sPCa in 39 patients (39/1084, 3.6%). In 27 cases (27/39, 69.2%), sPCa was missed within a blind sector, with 17/39 lesions localized in the anterior region (43.6%). Neither LRA nor prostatic configuration analysis identified predictors for missing sPCa with the GBS. This is the first study to analyze the distribution of sPCa missed by the GBS. GBS misses sPCa in few men only, with the majority localized in the anterior region. Adding blind sectors to GBS defined a new sector map of the prostate suited for reporting histopathological biopsy results.
Soft 3D-Printed Phantom of the Human Kidney with Collecting System
2016
Annals of Biomedical Engineering
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Arkadiusz Miernik: Study conception and design, drafting of manuscript, manuscript writing/editing, and supervision, critical revision. ...
Arkadiusz Miernik: a patent application of the presented work has been filed Consultant contract with Schoelly Fiberoptic GmbH, Denzlingen, Germany (unrelated to the presented work). ...
doi:10.1007/s10439-016-1757-5
pmid:27830490
pmcid:PMC5362658
fatcat:afzd7fyvs5hvxokp2bcgqw2xxq
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