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Inside Out Technology

In the sci-fi movie classic Fantastic Voyage — released more than 50 years ago — a tiny submarine travels through a person's body to find and destroy a blood clot.

Although there's no such submarine yet, doctors routinely use technology almost as remarkable to peer inside the body to diagnose, treat and monitor diseases.

Here’s just a sample of some of the new technology doctors at Rush are using:

DIAGNOSIS
Innovation: Endobronchial ultrasound (EBUS)
Uses: Biopsy for lung cancer

This less-invasive way to biopsy for lung cancer eliminates the need for even minor surgery. In the procedure, doctors thread a bronchoscope with an ultrasound sensor on its tip through the mouth and into the airways around the lungs. If they spot something suspicious, they can pass a hollow needle through the bronchoscope to get a sample of tissue or fluid to test for cancer cells.

Advantages: In a standard needle biopsy, doctors may have to go through the lung to get a sample of cells or make a cut in the neck to pass the tube through. But since EBUS goes through the mouth, it doesn't leave a wound. EBUS can also detect smaller abnormalities than a standard biopsy, which helps with early diagnosis.

TREATMENT
Innovation: NanoKnife
Uses: Zap tumors

NanoKnife works by zapping tumors with bursts of electricity. "This creates microscopic holes in cancer cells, which kills them," says Bulent Arslan, MD, an interventional radiologist at Rush. The electricity is delivered through needle-like probes, which doctors thread through the skin (using CT or ultrasound guidance) and place in and around tumors. Rush is one of only a few Chicago-area hospitals using this technology to attack hard-to-reach tumors.

Advantages: Though it kills cancer cells, NanoKnife leaves any nearby blood vessels and healthy tissue unharmed. As a result, it's an option for people with tumors — such as kidney cancer, lung cancer, liver cancer or bone cancer — near blood vessels and the bowel, which surgery and other treatments are likely to damage. "Patients with tumors that were once untreatable can now be helped," says Arslan.

TREATMENT
Innovation: Ocelot System
Uses: Treat peripheral vascular disease (PVD)

This system allows doctors to restore blood flow to leg arteries severely blocked with plaque from peripheral vascular disease (PVD). It can help people with PVD avoid invasive bypass surgery and amputations. Doctors guide a catheter with a camera and drill at its tip to the blocked artery. They then blast away the plaque and use tools, such as a balloon or stents, to open the arteries.

Advantages: Typically, doctors use X-ray images to maneuver catheters through arteries. But with the Ocelot System, doctors can actually see inside the artery while doing the procedure. Ocelot's camera also helps doctors avoid puncturing arteries with the drills they need to dislodge plaque. "Our success rate at opening arteries with this system, along with our existing technologies, is more than 99 percent," says Arslan.

TREATMENT
Innovation: Radioactive microbeads
Uses: Treat liver cancer

Doctors bombard inoperable tumors in the liver with millions of miniature radioactive beads. To target the tumors, doctors guide a tiny catheter until it reaches blood vessels near the cancer. They then inject a liquid containing microbeads, which give off high doses of radiation for several days. "Since the radiation travels only a very short distance, it has no significant impact on other organs. It mostly affects just the tumor," says Arslan.

Rush is one of the few medical centers nationwide to use this therapy both for cancerous tumors that begin in the liver and those that spread to the liver from another part of the body, such as the colon or breast.

Advantages: This therapy can extend the lives of people with inoperable liver tumors. And it may shrink tumors enough to make surgery or a liver transplant possible.

I don't need to wait three months to discover a problem at the next office visit. I'm alerted via the Internet [if] a heart rhythm changes.

MONITORING
Innovation: Wireless monitoring of pacemakers and defibrillators
Uses: monitor arrhythmias

You might already know that pacemakers and defibrillators help hearts with an irregular rhythm (arrhythmia) beat normally again. But this may surprise you: Nowadays, both devices use wireless antennas to send crucial updates about patients' heart activity and rhythms to their cardiologists. The devices also send updates about equipment status, such as when a battery is running low.

Advantages: Once checked only in a doctor's office, data from these devices can now be transmitted wirelessly from patients' homes, typically while they sleep. "I don’t need to wait three months to discover a problem at the next office visit," says Kousik Krishnan, MD, an electrophysiologist — a doctor who specializes in irregular heart rhythms — at Rush. "I’m alerted via the Internet. If a heart rhythm changes and a blood thinner is necessary, I can prescribe it right away."

MONITORING
Innovation: CardioMEMS HF system
Uses: Manage heart failure

This new tool helps doctors monitor patients with heart failure. A small wireless sensor is placed in the pulmonary artery. It automatically checks the blood pressure in the artery and sends daily readings to doctors. A rise in pressure — which happens before symptoms — indicates heart failure is worsening.

Advantages: Traditionally, heart failure management has relied on patients reporting symptoms and related information after heart failure has already worsened. CardioMEMS allows for proactive care. "With the sensor's early warning, doctors can adjust treatment and prevent flare-ups," says Krishnan.

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