Biomedical/clinical engineering education and certification: fifty years of actions.

Health care is today technology driven and biomedical engineering is behind the impressive developments that reshaped medicine during the last 50 years. Biomedical Engineers (BMEs) as professionals are playing a vital role during the whole life cycle of Medical Devices (MDs), from the innovative idea to their final use and decommissioning. This rapid evolution creates a constant pressure for new knowledge and skills for the BMEs and therefore for continuous curriculum updates of education in BME, to meet current trends and market demands.

Health Technology Assessment and Biomedical Engineering: Global trends, gaps and opportunities.

The diffusion of medical devices is expanding at an astonishing rate. The increasing number of novel patents per year suggests this growth will continue. In contrast to drugs, medical devices are intrinsically dependent on the environment in which they are used and how they are maintained.

Breast tomosynthesis using the multiple projection algorithm adapted for stationary detectors.

Objective: The aim of this study is to investigate the validity of using the Multiple Projection Algorithm (MPA) for Breast Tomosynthesis (BT) using real projection images acquired with phantoms at a clinical setting.

Methods: The CIRS-BR3D phantom with ranging thicknesses between 3 cm and 6 cm was used for all image quality evaluations. Five sets of measurements were acquired, each comprised of a 2D mammographic image followed by a set of 25 projections within an arc length of 50°.

Evaluation of the effect of silicone breast inserts on X-ray mammography and breast tomosynthesis images: A Monte Carlo simulation study.

Purpose: Breast augmentation is one of the most popular cosmetic surgeries worldwide. The aim of this study is to investigate the effect of breast implant insertion on the detectability and visibility of lesions on mammography and breast tomosynthesis (BT) images.

Materials And Methods: Three software phantoms, composed of a homogeneous background with embedded silicone gel structures, and two types of breast abnormalities, microcalcifications (µCs) and masses, were generated.

Breast tomosynthesis with monochromatic beams: a feasibility study using Monte Carlo simulations.

The aim of this study is to investigate the impact on image quality of using monochromatic beams for lower dose breast tomosynthesis (BT). For this purpose, modeling and simulation of BT and mammography imaging processes have been performed using two x-ray beams: one at 28 kVp and a monochromatic one at 19 keV at different entrance surface air kerma ranging between 0.16 and 5.

Architecture and implementation for a system enabling smartphones to access smart card based healthcare records.

The healthcare researchers', academics' and practitioners' interest concerning the development of Healthcare Information Systems has been on a steady rise for the last decades. Fueling this steady rise has been the healthcare professional need of quality information, in every healthcare provision incident, whenever and wherever this incident may take place. In order to address this need a truly mobile health care system is required, one that will be able to provide a healthcare provider with accurate patient-related information regardless of the time and place that healthcare is provided.

Image quality evaluation of breast tomosynthesis with synchrotron radiation.

Purpose: This study investigates the image quality of tomosynthesis slices obtained from several acquisition sets with synchrotron radiation using a breast phantom incorporating details that mimic various breast lesions, in a heterogeneous background.

Methods: A complex Breast phantom (MAMMAX) with a heterogeneous background and thickness that corresponds to 4.5 cm compressed breast with an average composition of 50% adipose and 50% glandular tissue was assembled using two commercial phantoms.

Promoting harmonization of BME education in Europe: the CRH-BME Tempus project.

Biomedical Engineers should be prepared to adapt to existing or forecasted needs. There is a strong pressure on education, training and life long learning programs to continuously adapt their objectives in order to face new requirements and challenges. The main objective of the TEMPUS IV, CRH-BME project is to update existing curricula in the field of Biomedical Engineering (BME) in order to meet recent and future developments in the area, address new emerging inter-disciplinary domains that appear as a result of the R&D progress and respond to the BME job market demands.

Markov Chain Monte Carlo simulation for projection of end stage renal disease patients in Greece.

End stage renal disease (ESRD) treatment methods are considered to be among the most expensive procedures for chronic conditions worldwide which also have severe impact on patients' quality of life. During the last decade, Greece has been among the countries with the highest incidence and prevalence, while at the same time with the lowest kidney transplantation rates. Predicting future patients' number on Renal Replacement Therapy (RRT) is essential for health care providers in order to achieve more effective resource management.

Robust identification and localization of intramedullary nail holes for distal locking using CBCT: a simulation study.

Closed intramedullary nailing is a common technique for treatment of femur and tibia fractures. The most challenging step in this procedure is the precise placement of the lateral screws that stabilize the fragmented bone. The present work concerns the development and the evaluation of a method to accurately identify in the 3D space the axes of the nail hole canals.

Evaluation of an improved algorithm for producing realistic 3D breast software phantoms: application for mammography.

Purpose: This work presents an improved algorithm for the generation of 3D breast software phantoms and its evaluation for mammography.

Methods: The improved methodology has evolved from a previously presented 3D noncompressed breast modeling method used for the creation of breast models of different size, shape, and composition. The breast phantom is composed of breast surface, duct system and terminal ductal lobular units, Cooper's ligaments, lymphatic and blood vessel systems, pectoral muscle, skin, 3D mammographic background texture, and breast abnormalities.

Challenges of the biomedical engineering education in Europe.

Higher education in Europe has passed through a very dynamic period of changes during the last ten years. Since the signing of the Bologna Declaration in 1999 by the Ministers of Education from the EU states, European higher education system has aimed toward establishing harmonized programs enabling students and teachers to extensively exchange knowledge, ideas and skills. Education in the field of Biomedical Engineering has experienced changes also because of the research and development in the field which was more intensive than in other fields.

Evaluation of digital breast tomosynthesis reconstruction algorithms using synchrotron radiation in standard geometry.

Purpose: In this article, the image quality of reconstructed volumes by four algorithms for digital tomosynthesis, applied in the case of breast, is investigated using synchrotron radiation.

Methods: An angular data set of 21 images of a complex phantom with heterogeneous tissue-mimicking background was obtained using the SYRMEP beamline at ELETTRA Synchrotron Light Laboratory, Trieste, Italy. The irradiated part was reconstructed using the multiple projection algorithm (MPA) and the filtered backprojection with ramp followed by hamming windows (FBR-RH) and filtered backprojection with ramp (FBP-R).

Experimental validation of a radiographic simulation code using breast phantom for X-ray imaging.

Computer models and simulations of X-ray imaging systems are becoming a very precious tool during the development and evaluation of new X-ray imaging techniques. To provide, however, a faithful simulation of a system, all components must be accurately modelled and tested, followed by verification through experimental measurements. This paper presents a validation study of the XRayImagingSimulator, an in-house developed X-ray imaging simulator, which is extensively used as a basic tool in carrying out complex breast imaging simulations.

Simulation studies on the effect of absorbers on dose distribution in rotational radiotherapy.

The effect of cylindrical protector dimensions, material and distance from the source on the dose distribution in rotational radiotherapy was studied to assess the potential protection possibilities of small-sized radiosensitive structures, such as spinal cord. The dose distributions were evaluated in terms of dose at the protected region and surface dose, ratio of the dose at the protected region to the maximum dose, and dose gradient. High-density materials, such as lead, tungsten, gold and cerrobend, along with new polymer-metal composite ones were used in simulation studies, performed by an in-house developed Monte Carlo Radiotherapy Simulator.

Studies on circular isocentric cone-beam trajectories for 3D image reconstructions using FDK algorithm.

Image reconstruction from X-ray cone-beam projections collected along a single-circular source trajectory is commonly done using the Feldkamp (FDK) algorithm which performs well only with a small cone-angle. Although this method does not provide an "exact" reconstruction, the approximation is considered adequate for many purposes. In FDK reconstruction the degree of inaccuracy is highly object-dependent, and the largest errors are to be expected for planes parallel to and remote from the midplane.

A novel simulation algorithm for soft tissue compression.

This paper presents a novel general approach to simulation of soft tissue compression. A theoretical framework of the compression algorithm has been developed and implemented, based on the concept of a simple spring. The volume subjected to compression is divided into a number of "model elements", each one consisting of 27 nodes.

Quality of life of end-stage renal disease patients and study on the implementation of nocturnal home hemodialysis in Greece.

The aim of this study was to measure the overall health-related quality of life of patients receiving hemodialysis in Greece and to assess willingness, motivation, and concerns about participating in a nocturnal home hemodialysis program. This review measured successfully the quality of life of 146 end-stage renal disease (ESRD) patients undergoing hemodialysis in 10 hemodialysis centers all over Greece and studied the factors that affect their choice to adopt a specific treatment. Physical and mental health status and health-related quality of life, measured by the Kidney Disease Quality of Life Short Form accompanied by the demographic data gathered, provide information that can help to improve ESRD patient care in Greece.

Simulation studies of field shaping in rotational radiation therapy.

This article presents simulation studies of field shaping in rotational radiation therapy by means of two categories of beam modifying devices: protectors and shapers. The protectors used are diminished copies of the organs at risk (OARs) and stay parallel to them during gantry rotation. Thus, each protector always keeps the corresponding OAR in its shadow, significantly reducing the irradiation.

Dual-energy mammography: simulation studies.

This paper presents a mammography simulator and demonstrates its applicability in feasibility studies in dual-energy (DE) subtraction mammography. This mammography simulator is an evolution of a previously presented x-ray imaging simulation system, which has been extended with new functionalities that are specific for DE simulations. The new features include incident exposure and dose calculations, the implementation of a DE subtraction algorithm as well as amendments to the detector and source modelling.

Development and evaluation of an ODL course on Medical Image Processing.

Recent developments in the field of Biomedical Engineering have led to considerable improvement in health care delivery, but also impose continuous change and improvement in education and training schemes of its professionals, in order to assure appropriate front-line knowledge, competencies and skills. Open and distance learning provides a very effective means for continuous education and training purposes. Image processing may be used as an attractive case for exploring the Collaborative Learning Model (CLM) paradigm in Open Distance Learning (ODL).

A quality assurance program in dental radiographic units in western Greece.

Objective: This survey reports on successful efforts to establish a quality assurance (QA) program for 50 intraoral x-ray units in the public and private sectors in the region of Achaia, Greece. It was conducted in 2 phases, in 1996 and in 2003, including on-site inspections, QA tests, and standard questionnaires. The aim of the study was to assess equipment conditions, knowledge, and adoption of radiographic QA guidelines by general dentists and, more importantly, the impact of the recommendations and training provided.