A better, faster and simpler way of diagnosing insufficient blood flow in the gastrointestinal tract will soon be possible thanks to new technology and cooperation with Technical Medicine professionals. This says Prof Bob Geelkeren, who is a vascular surgeon, in his inaugural speech at the University of Twente.
The ‘Medisch Spectrum Twente’ hospital in Enschede, in which Geelkerken works as a vascular surgeon, is an internationally renown expertise centre on mysenteric ischemia. This means that the blood flow, and thus oxygen supply, in the gastrointestinal tract is disturbed. From all over The Netherlands, patients are referred to the Centre for Mysenteric Ischemia in Enschede, around 400 patients per year. The number one problem of this relatively rare but potentially dangerous disease is diagnostics: the typical symptoms like chronic stomach pain can be caused by many other things. The current test involves CO2 measurements at the intestinal wall during a cycle test or other activities. This test, developed by Geelkerken and his colleague Jeroen Kolkman, is labour intensive and error prone. Together with the University of Twente, the team is now investigating two alternatives: bio marker detection in blood and lactate detection in the portal vein.
When a patient has chronic or acute abdominal pain, the presence of bio markers in his or her blood can indicate the probability that the pain is caused by disturbed blood flow. A lab-on-a-chip system will therefore analyse a droplet of blood and detect the presence of the markers. For this project, the researchers received a ‘Pioneers in Healthcare’ innovation voucher in 2016. Lab-on-a-chip specialist Dr. Loes Segerink is one of the UT participants.
MRI CycLe test
The other idea is to look at the flow of lactate from the intestines to the liver, through the portal vein. If there’s a short of blood in the intestine, the level of lactate goes up. A bike test on the MRI scanner will prove if a peak in lactate can be measured: during the exercise, the cycling legs will ‘steal’ some blood from the intestines and the lactate can be measured. Several Technical Medicine students worked on this, leading to a reliable test in the near future, Geelkerken expects.
In many other fields, the MST vascular surgeons and UT scientists cooperate. In searching for an alternative imaging technique for X-ray, visualising even the smallest veins: is low-field MRI a possible and less harmful alternative? Another example is the so-called diabetic foot: measuring blood flow using photoacoustics can help determining if a wound can still heal or if amputation is necessary and, if so, at what level. UT scientists also look at the lifetime of vascular prostheses, inserted through the femoral artery: will it be possible to extend this lifetime in the future?
Health care professionals in 2025
With these examples, Geelkerken underlines the importance of the young discipline Technical Medicine, initiated by the University of Twente. Technical Medicine professionals now prove to be very valuable members of specialist medical teams. Their profile fits the ‘2025 medical specialist’ profile very well. Defined by the Dutch Federatie Medische Specialisten, one of the key characteristics of this future professional is ‘developing, judging, implenting and upscaling of healthcare innovations’. In his own profession, Geelkerken predicts that in 2025, nano size robots will be able to repair vessel damage. A ‘personal MedApp’ simply indicates that it is time for that.
Healthcare innovations will only be possible through close cooperation of healthcare and technology professionals. Geelkerken emphasizes the need of lowering the thresholds for cooperation of the hospitals in the region. Only in this way, the best possible care for around a million people is guaranteed, together with the university that had the vision and guts of starting the Technical Medicine, a study programme that received high recognition several times, Geelkerken states.
Prof Geelkerken held his inaugural speech ‘Samenwerken’, in Dutch, on March 30, as the newly appointed Professor of Clinical Translation of Advanced Technologies for Diagnosis and Treatment of Vascular Disorders.