ECE 282 - Medical Measurements

Lecture 1: Introduction to Medical

Measurements and Instrumentation

Instructor: Zhenyu (Jerry) Li

08/30/2010
Syllabus
 Textbook

$30 used, from

Amazon.com

Medical Instrumentation: Application and Design, John G. Webster, 4/e

 Covered Topics
• Sensors: Basic Characteristics and Principles
• Thermal Measurements
• Optical Measurements, Light Sources and Lasers
• Amplifiers: Characteristics and Medical Applications
• Processing and Analysis of Medical Signals
• Biopotential Electrodes
• Blood Pressure Measurements
• Measurements of Cardiac and Vascular Functions
• Respiratory System Measurements
• Medical Imaging Systems
• Therapeutic and Prosthetic Devices
• Next Generation Diagnostics: Molecular Diagnostics, qPCR,
genome sequencing, mass spectrometry…
• Lab-on-a-Chip: microfluidics, bioMEMS…
 Course Goal
• Familiarize students with the concepts
and techniques of a wide range of
medical devices and instruments.

• The basic principles and practice of

medical measurements and
instrumentation.
Diagnosis and Treatment

Diagnosis Requirements: Sensitive, Specific, Fast, Reasonable Cost,

Minimally Invasive, Easy to Use, Patient Comfort …
 Diabetes
• Metabolic diseases in which a person has high
blood sugar, either because the body does not
produce enough insulin, or because cells do not
respond to the insulin that is produced.
• 23.6 million children and adults in the United
States—7.8% of the population—have diabetes.
• Total cost of diabetes in the United States in
2007 is $218 billion, more than 10% of total
health care cost.

Data from the 2007 National Diabetes Fact Sheet

 Glucose Test

healthguide.howstuffworks.com/glucose-test-picture.htm

Chapter 10.7 in the textbook

 Glucose Oxidase Method

o-dianisidine

Page 487 in the textbook

 One Touch UltraMini
Glucose Test

Page 488 in the textbook

 Classification of Medical
Instrumentation
• From different viewpoints:
– Quantity that is measured: pressure, flow,
temperature, glucose concentration, etc.
– Principle of transduction: resistive, inductive,
capacitive, ultrasonic, electrochemical, optical,
etc.
– Organ system: cardiovascular, pulmonary,
nervous, endocrine, etc.
– Clinical medicine specialty: pediatrics, obstetrics,
cardiology, radiology, etc.
 Examples of Medical
Instrumentation
1. Biochemical analysis – blood, urine test for
viruses, bacteria, toxins, metabolites, etc.
2. Physiological measurement devices –
electrocardiogram (ECG,EKG),
electromyogram (EMG), pulse oximeter, etc.
3. Medical imaging devices – x-ray, MRI, CT,
ultrasound, PET, etc.
4. Therapy devices – radio-therapy, ultrasound
therapy, laser, etc.
 Example 1: Biochemical
Analysis

DNA, RNA, Protein…

Example 2: Physiological
Measurements
Electrocardiography ECG

adameducation.com www.davita-shop.co.uk/ecg-instruments.html
today24news.com
Example 3: Medical Imaging
MRI

www.k-state.edu

www.magnet.fsu.edu
 Example 4: Therapy Device
Laser Eye Surgery
• Laser-Assisted In Situ
Keratomileusis (LASIK)
– LASIK is used for treating
astigmatism,
nearsightedness and
farsightedness. It involves
cutting a flap from the outer
and middle layers of the
cornea and then the use of
an excimer laser to reshape
tissue under this flap. This
procedure usually takes
about one minute per eye.

www.eyeclinicpc.com
 Molecular Diagnostics
• Detect Molecular Biomarkers: DNA, RNA,
Protein, Metabolites
• Example: quantitative polymerase chain reaction
(qPCR)
– Exponentially amplify the number of specific nucleic
acids in a sample, use fluorescence to quantify the
amount
– Used in 2009 H1N1 pandemic for new virus strain
identification
• Highly specific and sensitive
 DNA Sequencing
• Read the species’ genome letter by
letter
– Personalized Medicine
– Identify new pathogens: virus,
bacterium, fungi…
• Next generation sequencing
machines
– Single molecule
– High parallelism
– Low cost: $1000/human genome
• Challenge: interpreting the data
www.nanoporetech.com

Video: Cracking the Code of Life, www.pbs.org/wgbh/nova/genome/

 Lab-on-a-Chip
1 meter
10cm

Conventional DNA Sequencer On-chip Sanger DNA Sequencer

Large R. Mathies Group at Berkeley
R.G. Blazej, et al, PNAS, vol. 103, no. 19,
Expensive 7240-7245, (2006)
“Slow”
 Miniaturization
Electronics

Vacuum Tube Transistor Integrated Circuit

faster, cheaper,
Smaller
lower power,
easier to use
 Miniaturization
Fluidics

Microchannels,
Pipette Valves & Pumps Microfluidic Circuit

faster, cheaper,
Smaller
lower power,
easier to use
new functionalities
 Small Sample Volume
• Single Cell Studies (m, sub-nanoliter)

• Single Molecule Studies (nm, sub-femtoliter)

C. Merten, EMBL
Pacific Bioscience
 Automation and Parallelism

Factory-scale Robotics

1cm by 1cm automated chip

performing 4096 reactions

Micropipette Microtiter plate

 Integration
Compact Devices

Point-of-Care Diagnostics Personalized Healthcare Environmental Monitoring

 Microfluidics
Plumbing at mm Scale

7mm
7mm

C.L. Hansen, et al. PNAS. 101(40),14431-6, (2004).

Microfluidics
Single Cell Trapping

P2

P1

20m
Break
 Generalized Medical
Instrumentation System

from: Medical Instrumentation: Application and Design, John G. Webster, 4/e

 Development Process of a
Medical Instrument
• Invention
• Prototype Design
• Product Development
• Clinical Testing
• Regulatory Approval
• Manufacturing
• Marketing
• Sale
 Medical Device Requirements

Page 36
 Measurands
• Measurands:
– A physical quantity, property, or condition that the system
measures.
– It may be internal (blood pressure).
– It may be on body surface (ECG).
– It may emanate from body (IR radiation).
– It may be derived from a tissue sample removed from the body.
• Measurands can be grouped into:
– Biopotentials
– Pressure
– Flow
– Dimensions
– Displacements
– Electrical, acoustical or other impedance
– Temperature
– Chemical concentrations
– Optical absorptance, scattering, spectrum, refractive index…
 Medical Parameters

Page 10
 Medical Signal: Example

The fluctuation of blood sugar (red) and the sugar-lowering hormone

insulin (blue) in humans during the course of a day with three meals.
One of the effects of a sugar-rich vs a starch-rich meal is highlighted.
Wiki
 Transducers and Sensors
• Transducer:
– Converts one form of energy to another.
• Sensor:
– Converts a physical measurand to an electric output.
• Some key aspects of sensors:
– Specificity
– Sensitivity
– Speed
– Minimally invasive
– Safety
– Cost
• Examples of sensors
– Diaphragm converts pressure to displacement.
– Strain gauge converts displacement into electrical signal.
 Specificity and Sensitivity
• Sensitivity - the proportion of actual positives which are
correctly identified as such (i.e. the percentage of sick
people who are identified as having the condition).

• Specificity - the proportion of negatives which are

correctly identified (i.e. the percentage of well people
who are identified as not having the condition).

• Which one leads to false positive, and which one to false

negative?

from Wikipedia
 False Results
• Example: Infectious Disease
 Accuracy and Precision
• Accuracy:
– How close the mean of a group of repeated measurements is to the true
value.
– May be expressed in either absolute or fractional units.
• Precision:
– How tightly a group of repeated measurements cluster together,
independent of the accuracy.
– Sometimes called reproducibility or repeatability.
– May be expressed in either absolute or fractional units or as a Signal-To-
Noise ratio.
Accuracy and Precision
Statistics
Standard Deviation &
Standard Error
 p-Value
• A measure of probability that a difference
between groups during an experiment
happened by chance. For example, a p-value
of .01 (p = .01) means there is a 1 in 100
chance the result occurred by chance.
• Statistical significance – p-value < 0.05
• Student’s t-test
– Small samples: calculated mean and
standard deviation may deviate from ‘real’
– The t-test assesses whether two sets of
data are really different?
 Correlation Coefficient
• Coefficient of Variation: standardizes the
variation.

• Correlation Coefficient:
– A measure of the degree to which two variables
are linearly related
– Ranges from -1 to 1
Reproducibility and Resolution
Noise, Interference and
Modifying Inputs
 Example: ECG Measurements

Page 13 Textbook
Techniques to Reduce Interfering and
Modifying Inputs
Negative Feedback
 Signal Sampling

• Nyquist Theorem fs > 2B

 Signal Conditioning
• Amplification
• Filtering
• Impedance matching
• Digitizing
• Averaging (i.e., reduction of noise)
• Time-domain to frequency-domain
conversion
Filtering
Example: ECG Signal Filtering
Heart-Lung Machine
Catheter Angiographic
Procedures
Robotic Surgery
 Medical Imaging

Prof. Jason Zara’s Medical Imaging course ECE 285.

Pill Endoscopy
 Artificial Pancreas

• 1 - Continuous glucose sensor monitors blood sugar level

• 2 - Data transmitted for the computer program to work out insulin
dose
• 3 - Insulin pump delivers the dose

http://news.bbc.co.uk/2/hi/health/8498993.stm