Devising a better breast biopsy
A possible breast cancer diagnosis is frightening enough without the added stress of a painful biopsy.
Though an electrical engineering professor would seem an unlikely candidate to improve the diagnostic process, that’s exactly what Venkat Devarajan seeks to accomplish. He is collaborating with UT Dallas, UT Southwestern Medical Center, and the Texas Health Research Institute to develop a minimally intrusive approach that combines ultrasound-guided biopsy with “haptic,” or sense of touch, methods.
“Most oncologists use needle biopsy, but it requires a lot of experience to make the injection at just the right angle and depth to collect the tissue sample without damaging vital organs like the lungs and heart,” says Dr. Devarajan, who has built a prototype to help train doctors in laparoscopic methods for male hernias. It had to avoid damaging not only organs but also key arteries and veins.
“A laparoscopic hernia operation is a minimally invasive technique, and patients recover much quicker and without as much pain. But it requires precise angles and depths from the small incisions. While working with this problem, I became interested in breast cancer and how to make the whole process less painful.”
The medical community liked the concept so much that the “Haptic Guidance for Breast Biopsy System” received a concept grant from TxMED, a collaborative research funding program in medical technologies.
The idea behind the system is simple. Once a mass is detected, use either X-rays or ultrasound to pinpoint its location. Then create a mechanical and electronic device that provides artificial resistance to the physician’s fingers handling the biopsy needle unless the surgeon follows the optimal path to push the needle toward the mass.
This blend of imaging and touch would create a “can’t miss” biopsy in which the needle would bypass what Devarajan calls “zones of exclusion,” artery or nerve areas.
“Basically, it would make the biopsy a much more automated process than it is now,” he says. “With a bit of training, the inexperienced physician, nurse, or physician’s assistant would be able to quickly do the procedure with minimal pain to the patient.”
The haptic system also would double as a simulator, a training system for interventional radiology residents.
“Many physicians who have done the procedure many times without the benefit of this kind of system do it very well,” Devarajan says. “But they have trouble explaining or teaching how they do it. That doesn’t help the less experienced doctor.”
The procedure eventually may help with kidney or liver problems, as well as those in other parts of the body. Devarajan and his students consider the research to be in the validation stage, a process that includes consultations with medical professionals and even sociologists.
“It’s difficult to bring distinct disciplines like engineering and medicine together sometimes,” he says. “Doctors often don’t understand engineering, and they’re busy. Engineers certainly don’t understand medicine. But I think we’re making real progress with our collaborative, multidisciplinary approach.”