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Cell phones as doctors' tools
By Betsy Mason Contra Costa Times
May 09, 2008
Medical imaging equipment is too expensive to buy and maintain for most rural health clinics in the developing world, and training to use the machines is scarce. But that could soon change.
UC Berkeley bioengineer Boris Rubinsky has devised a way to make medical imaging, such as ultrasound, cheap and easy for these remote populations using one of the world's most ubiquitous gadgets: the cell phone.
"In the industrialized world, we take it for granted that there is medical imaging," Rubinsky said. "But a big part of the world's population doesn't have access to these technologies."
In fact, the World Health Organization estimates that about 75 percent of people aren't benefiting from medical imaging that has dramatically revolutionized health care in the developed world, including X-rays, CT scanning, magnetic resonance imaging, or MRI, and ultrasound.
Even when this expensive equipment is donated to rural clinics, it often goes unused because it is too expensive to repair and maintain, and the proper training is hard to come by.
But the explosion of wireless communication has connected the world in an entirely new way.
"Throughout my travels, I've noticed that even in the remote areas of India, people have a cellular phone in their hands," Rubinsky said. "I wanted to build something that is simple and robust and has the cellular phone as a component.
Most medical imaging machines are self-contained units that hook up to the patient to get the data, convert that raw data into a digital image and then display the image.
Rubinsky's idea is to take the most complicated and costly part of that process, conversion of the raw date into an image, and put it at a central location where it can be maintained by trained technicians.
He tested his idea with electrical impedance tomography, or EIT, which makes a map of the electrical properties of tissues. Diseased tissue stands out in the image because electrical currents pass through it differently than healthy tissue.
Rubinsky's team built a simple power supply hooked up to 16 electrodes that create a current in the area of the patient that needs to be imaged, and an additional 16 that record the voltage.
The system attaches to a cell phone, which can transmit the data to another location for processing into an image as easily as if it were a text message. Then the image can be sent back to the cell phone and displayed on the screen for the doctor.
Using a container filled with gel that has properties similar to breast tissue containing a tumor, Rubinsky demonstrated the technique. The results are in the journal Public Library of Science ONE.
The same technique could be used with other types of imaging such as ultrasound.
Antonio Hernandez of the World Health Organization said places like Latin America and the Caribbean where there are large, remote expanses of land with very little population could benefit from what he calls "telemedicine."
Many of those areas have only a physician right out of school with very little experience, or just a nurse, or even someone with less training. Telemedicine could connect these people with the support they need for imaging and other help such as second opinions.
"From my perspective it's a really rapidly growing field, mostly because of the penetration of the cellular market," Hernandez said. "So telemedicine will be the way to provide services to underserved populations." Both Rubinsky and Hernandez envision the technology being extended to home health care.
Now Rubinsky is hoping private industry will take an interest in the idea and help bring it to market.
"I believe the technology has commercial value, even in developed countries," he said.
Betsy Mason covers science and the national laboratories. Reach her at 925-952-5026 or bmason@bayareanewsgroup.com .
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