New technologies are providing doctors and patients with more options for treatment and improved quality of life than ever before. Procedures once entailing long recovery times and scarring may now be done almost painlessly and without significant disfigurement. Drug therapies are being tailored to target specific aspects of a disease, and donor organs can be grown from sources from which rejection is eliminated. These approaches in medicine reflect a more focused ideology when confronted with injury and disease.

Minimally Invasive Surgery

Using high-tech devices and materials such as fiber optics, physicians can perform surgery without the trauma of invasive procedures. In minimally invasive surgery, miniaturized medical instruments enter the body via existing orifices or small incisions that leave the patient with less scarring and pain, and with faster recovery times and fewer complications than previous, more invasive methods. Major procedures such as angioplasty can be done with the body remaining “sealed.” As technology reached the micro level, many procedures became non-invasive: capsule- sized robots are now used to photograph a patient’s entire digestive tract in real time and in full color, identifying gastrointestinal conditions ranging from inflammation to cancer, and doing away with exploratory surgery.

Other procedures could not be done successfully until the advent of minimally invasive technology. The Seldinger technique, in which blood vessels are punctured with a fine, hollow needle for procedures such as angiography or chest drains, is the minimally invasive descendant of a procedure that had a high incidence of complications. Use of the Seldinger technique not only resulted in more successful surgeries, but also allowed the field of interventional radiology (image guidance) to expand and become a standard surgical practice. Total hip and knee arthroplasties also have been performed using minimally invasive procedures, proving the technology’s growing value in more complex surgeries.

PET Scanning

In a PET scan (right), lymphoma (yellow arrow) is more easily identified than in a CT scan (left). Green arrows indicate normal activity. (Boca Raton Community Hospital. Dr. Jonathan Stein, Director)

Before scanning takes place, a patient is injected with a short-lived radioactive isotope that emits a positron — the positively-charged opposite of an electron — upon decay. This isotope is also chemically incorporated into a metabolically active molecule (glucose) that during a waiting period accumulates in the tissue of interest. When the positron is emitted, it very quickly impacts an electron, and the two particles destroy each other. This event produces two highly energetic waves of gamma radiation moving in opposite directions. These rays are detected upon reaching scintillator material in the scanning device (scintillators are substances that absorb high energy radiation and fluoresce in response). This fluorescence is detected by photomultiplier tubes or silicon avalanche photodiodes to produce a 3D image.

Unlike computed tomography (CT) and magnetic resonance imaging (MRI), PET scanners capture molecular biology in sharp detail. PET scans are used to find the disease source in ontological, neurological, and cardiological applications, and also to identify dementia-inducing brain disorders. With lymphoma, PET scanning has an accuracy of 88%, while conventional techniques stand at 64%; PET’s accuracy in diagnosing cervical/uterine cancers is 87% over the 43% from conventional methods.