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NUCLEAR MEDICINE AND ROBOTS-THE NEW WAY FORWARD? HERE’S WHAT WE KNOW ABOUT THEM




ROBOTS WILL TAKE OVER THE WORLD BY THE YEAR 2050- well, we’re already almost halfway there. There’s also an article saying robots could take over 20 million jobs by the year 2030.


Although there is some truth in these articles, robots or AI have also been a huge help to the world including the healthcare profession. The same is said for nuclear medicine.


Nuclear medicine has made imaging very easy and proceeds to do so through its use for the production of innovations.

As each year these sciences advance to crazy new levels, even more advances are made in healthcare that we should know about.


Read on to know how these sciences have evolved this year.




  1. RADIOLIGAND THAT FACILITATES IMAGING OF ALPHA-SYNUCLEIN AGGREGATES IN PATIENTS OF MSA






















NUCLEAR MEDICINE differs from X-RAYS. In nuclear medicine, radioactive material is injected/ingested and imaging is done showing where and how the tracer is absorbed.

Positron emission tomography (PET) is a non-invasive imaging technique that uses radioactive substances to quantify target expression and drug occupancies.


This year, the newest advancement in nuclear medicine is the development of a radioligand that facilitates the imaging of alpha-synuclein aggregates in patients with MSA.


Alpha-synuclein is a neuronal protein that modulates synaptic vesicle trafficking and neurotransmitter release. This alpha-synuclein misfolds forming aggregates called Lewy bodies. These aggregates are formed in a diverse group of diseases which are together known as synucleinopathies. Synucleinopathies include Parkinson’s disease, dementia, and multiple system atrophy(MSA).


The diagnosis of synucleinopathies is mainly based on clinical criteria, leading to frequent misdiagnosis, as underlined by autopsy studies

Therefore, methods to trace alpha-syn are highly sought after but face several challenges:


  1. Αlpha-syn is low in abundance within the brain which necessitates the development of a high-affinity ligand

  2. α-syn depositions are predominantly localized intracellularly, limiting their accessibility.

  3. Ligand selectivity over structurally similar amyloids

  4. Αlpha-syn lacks a definite structure.


Recent advances have been made through the development of tests able to detect in vivo pathologic α-synuclein such as immunofluorescence analysis of skin nerves, alpha-syn PET traces, and real-time quaking-induced conversion (RT-QuIC) of CSF.


Talking about MSA here,

MSA, i.e, multiple system atrophy is a progressive neurodegenerative disorder that affects the autonomic system and movement. Symptoms seen are fainting spells, problems with heart rate, bladder control, motor impairments like tremor, rigidity, loss of muscle coordination, etc. the disease symptoms are quite similar to Parkinson’s disease and is difficult to distinguish.





In MSA, filamentous components of alpha-synuclein are not only found in neurons but also within oligodendrocytes and in the cytoplasm of nerve cells

To visualizeα-synuclein aggregates in the brains of patients, the team of researchers developed a radioligand, 18F-SPAL-T-06, to be used as a probe for positron emission tomography (PET).

promising results were seen during studies on the binding properties of 18F-SPAL-T-06 which were conducted on the postmortem brain tissue of patients with MSA and healthy individuals before the clinical assessments. For the first-in-human imaging studies, three patients were enrolled by the researchers who were clinically diagnosed with MSA and one 72-year-old healthy control (HC). Among the three patients with MSA, two were identified as having MSA with predominant Parkinsonism (MSA-P) and one with MSA with predominant cerebellar ataxia (MSA-C). On all the patients' PET scans with 18F-SPAL-T-06 were performed and specific binding was estimated by the radioligand retention in the tissue.



"Remarkably, we observed enhanced 18F-SPAL-T-06 retention in the putamen, pons, and cerebellar white matter and peduncles of the patients with MSA-P and MSA-C, in sharp contrast to minimal radio signals in the corresponding areas in the brain of the HC," explains Dr. Higuchi.

The researchers also found that 18F-SPAL-T-06 has a high affinity for MSA-type α-synuclein aggregates and that it does not cross-react with other off-target components, indicating

its high specificity and consequent potential use as a probe for MSA diagnosis.






This has the potential to be groundbreaking research as the feasibility to detect alpha-syn aggregates will not only help in the diagnosis of MSA but also the other synucleinopathies like Parkinson's disease, etc


2.MICROROBOTICS IN ENDODONTIC TREATMENT





How small are these microrobots? As small as a pin, maybe?

Microrobots are smaller than a millimeter. Maybe we can compare it to the thickness of a graphite lead pencil, although it is smaller than that.

Since they are tiny, they have been shown by researchers to reach difficult surfaces during procedures like a root canal with controlled precision.

Like the smurfs, they can go everywhere and anywhere. They also help retrieve samples for diagnostics, treating, and disrupting biofilms.



"We see potential applications of microrobotics systems for both at-home oral care as well as in the dental office for more precise and effective tools for clinicians," says Dr. Koo.


Ever had a root canal done? It is a painful and a very tedious job.


The root canal within the oral cavity, having many irregularities and anatomical complexities, is a challenging clinical space.

During root canals, biofilm not fully cleared from the nooks and crannies of the canals leads to a failure of treatment-this is the leading cause of treatment failure and persistent endodontic infections.

As there are limited means to diagnose or assess the efficacy of disinfection, clinicians have come up with a new way to overcome these challenges with the help of microrobots.





Iron nanoparticles(NPs) having both catalytic and magnetic activity has been used as building blocks for the microrobots in both the platforms. It has also been FDA approved for other uses.

For the first platform, NPs were concentrated in aggregated microswarms and controlled to the apical area of the tooth to disrupt and recover biofilms using a magnetic field through a catalytic reaction. In the second platform, 3D printing was used to create miniaturized helicoid robots embedded with iron oxide NPs. These helicoids’ movement within the root canal is guided by magnetic fields, transporting bioactives or drugs that can be released on site.


So far, UPenn researchers have tested the microrobots in 3D-printed replicas of human teeth that they inoculated with various endodontic bacteria. Successful manipulation of a swarm of microrobots into the root canal disrupted the cultured biofilm, removed a sample of the bacteria, and then confirmed through microscopy that after the procedure all the nanoparticles were extracted from the canal


“One important aspect is the ability to have diagnostic as well as therapeutic applications. In the microswarm platform, we can not only remove the biofilm but also retrieve it, enabling us to identify what microorganisms caused the infection. In addition, the ability to conform to the narrow and difficult-to-reach spaces within the root canal allows for more effective disinfection in comparison to the files and instrumentation techniques presently used.” said Michael Koo, a researcher involved in the study.

Although microbots and nanorobots face many technical, regulatory, and market challenges, advances in medical robots hold the promise of modern medicine and quality of life improvements.


3. CHATBOTS IN HEALTHCARE





A chatbot- in simple words, is a computer program that conducts online chats with humans via text.

To give an example, Siri in iPhone users can also be considered a conversational AI.

Chatbots are gaining popularity all over the world, especially in healthcare


Health is important and precious and it is provided at your doorstep using these chatbots.

Although it sounds pretty ordinary, the sad truth is, everyone is glued to their phones, and having an app that reminds you to take meds, go to the doctor's appointment, etc is very helpful.


Healthcare is among the top 5 industries that benefit from the chatbot. more than $1 billion is the market size expected of chatbots


Recently, Northwell Health, an AI company developing chatbots that will help patients navigate cancer care, says more than 96 percent of patients who used its post-discharge care chatbots found it very helpful, demonstrating increased client engagement.


With that being said, let's get into the functions and benefits of these chatbots:





  • Provide informational support

Chatbot algorithms are trained on massive healthcare data, including disease symptoms, diagnostics, markers, and available treatments. Public databases are used to continuously train chatbots. Conversational chatbots with different intelligence levels can understand the questions of the user and provide answers based on predefined labels in the training data.

For example:

Healthily app provides information about different diseases’ symptoms, assessments of overall health, and tracks patient progress.


  • Scheduling appointments

Scheduling appointments is a tedious job. The chatbots can schedule doctors' appointments according to the doctor’s availability.

chatbots can be programmed to communicate with the hospital systems to help the medical team in keeping track of patient visits and a follow-up appointment

  • Collecting patients information

The patient's information like name, age, address, current symptoms, and doctors frequently visited is collected by the app and stored. Through software, they can store this information in the medical database thus enhancing the ease of the patient's admission process.


Other functions are:


  1. Recommendation of healthcare plans and programs

  2. Patients feedback

  3. Monitoring(Awareness and tracking behavior, anxiety, and weight changes to encourage developing better habits.)

  4. Anonymity

  5. Personalization

  6. scalability(ability to react with numerous users at the same time)




Risks with chatbots:


  • Risk of worsening health


As the chatbot only has information that is fed into the system, the information given by the patients may be passed off as a minor injury or disease.

Patients may sustain serious injuries or even pass away if the AI chatbot is unable to comprehend the exact situation. The effects of using the wrong medicine can be terrible.


  • failure of trust


Humans are social people. As a result, they cannot trust chatbots and will always require the healthcare workers

Also, there is always a risk of data hacking.


  • Absence of emotions


Emotions expressed by the Healthcare worker, especially empathy, make a patient feel better.

There's always an essence of comfort that comes with speaking to the doctor about one’s illness

Also, a healthcare worker is always accountable whereas a chatbot cannot be accountable




One thing to be kept in mind is that chatbots are not to replace doctors but to help reduce the burden of the healthcare workers as well as provide a way to take better care of a patient's health.




 


Amazed yet? .These were the 3 advancements in modern medicine which hold a promising future to improve and better the quality of life.

Maybe those tiny robots will make a trip to the dentist’s more fun now.

Let us know in the comments of any other such amazing fusions of medicine and AI.


Also, let us know about how you think robots could affect the routine checkups and visits to the doctor!


Read further:


  1. https://www.mdpi.com/1244354

  2. https://www.qst.go.jp/site/qst-english/20220831.html

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9310945/

  4. https://www.sciencedaily.com/releases/2022/08/220809141136.htm

  5. https://blog.seas.upenn.edu/applying-microrobotics-in-endodontic-treatment-and-diagnostics/

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205473/

  7. https://www.medgadget.com/2022/08/magnetic-microrobots-assist-with-root-canal-treatment.html

  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610261/

  9. https://research.aimultiple.com/chatbot-healthcare/


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