Dean’s Distinguished Lecture Focuses on Engineering in Medicine

From left: G.P. Li, Roderic Pettigrew and Gregory WashingtonWith a nod to the necessity of cross-disciplinary collaboration, the director of the NIH’s National Institute of Biomedical Imaging and Bioengineering delivered a Samueli School Dean’s Distinguished Lecture April 7 in the Calit2 auditorium.

Dr. Roderic Pettigrew, who before assuming his post at the NIBIB was a professor of radiology, medicine and cardiology at Emory University and professor of bioengineering at the Georgia Institute of Technology, spoke about the importance of merging life sciences, physical sciences and engineering with medicine in order to ensure positive healthcare outcomes in a changing world.

Citing rising healthcare costs combined with an aging population beset by chronic illness, Dr. Pettigrew said there is a need, in the U.S. and globally, to integrate “engineering into medicine, and medicine into engineering until all the boundaries vanish. It’s absolutely critical to the kind of innovation that will be needed to increase access, provide higher quality care to more people, and do that with restrained costs.”

Precision medicine, including precision diagnostics and therapeutics – what Pettigrew called “precision theranostics” – is also a priority of the Obama administration, Pettigrew said, adding that the NIH is “very active” in its quest to achieve this vision.

Precision theranostics involves the ability to diagnose and treat disease simultaneously, at the cell and molecular level. Pettigrew told the audience the concept brings to mind the tricorder – a device which did just that – featured on the television show “Star Trek.”

“This is about being accurate and precise, based on our understanding of the cell and molecular mechanisms of disease; identifying those mechanisms and then tailoring the treatment to the individual in accurate fashion,” he said. “It’s about precise measurement, precise diagnostics and precise delivery based on that precision-based information.”

Progress is steady. The ability to visualize complex data sets and view them on mobile devices, along with advances in sensor technology, is leading to development of biomedical devices that can be used even in developing countries, which don’t always have consistent access to electricity.

Another Obama administration initiative, announced in 2012 and called BRAIN (Brain Research Advanced through Innovative Neurotechnologies) is helping scientists and doctors understand the brain’s neural networks better. One early advance involves improved imaging and spatial/temporal resolution in MRI technology, which allows the brain’s axons to be tracked. Another is progress in identifying an Alzheimer’s gene by examining fiber integrity.

Pettigrew showed the audience two videos that depicted awe-inspiring medical advances: one featured a woman suffering from severe depression who got relief from electrodes placed in her brain; the other showed patients paralyzed by spinal cord injuries who were able to move their limbs – and even play catch – after electrical stimulation of their spinal cords.

Pettigrew said six paralyzed patients have received the spinal cord treatment, and all of them regained not only voluntary motor movement but also a return of bladder, bowel and sexual function. “There has been a tremendous improvement in their quality of life,” he said.

Other advances in medicine enabled by cross-disciplinary collaboration include a microfluidic device that can detect one cancerous cell in a blood sample of a billion cells, and a technology that utilizes fluorescence to identify cancer cells and nerves during surgery, allowing doctors to more easily excise the cancerous cells without damaging surrounding nerves.

These advances, Pettigrew summarized, have resulted from the emerging interfaces between technologies in engineering and medicine. “Engineering is central to driving advances in many areas to improve public health,” he said. “It’s about improving our fundamental knowledge of how nature works and using that knowledge to improve health with technologies that will allow us to make diagnoses at point of care, and improve therapeutics so they’re more specific, more focused and targeted to the problem at hand.”

- Anna Lynn Spitzer