Axel Boese

• Dr.-Ing.
• Senior Researcher at Otto-von-Guericke University Magdeburg

This research explores the acquisition and analysis of vibroacoustic signals generated during tissue-tool interactions, using a conventional aspiration needle enhanced with a proximally mounted MEMS audio sensor, to extract temperature information. Minimally invasive temperature monitoring is critical in thermotherapy applications, but current meth...

Joint diseases are one of the significant challenges that come with age. The pain that these diseases cause can affect the quality of life of the patient, especially if the disease is causing aches in a high-load-bearing joint like the knee. Most patients these days choose to undergo total joint arthroplasty. However, some patients cannot do the su...

Minimally Invasive Robotic Surgery (MIRS) has emerged as a transformative approach in surgical practice, offering reduced patient trauma and enhanced precision. However, challenges persist, including the loss of tactile feedback for surgeons. This study explores the application of machine learning algorithms, specifically variational autoencoders,...

This work presents a novel approach for detecting underlying pulsatile structures with laparoscopic tools by using proximal vibroacoustic sensing. This new method could detect pulsations at a depth of up to 1.5 cm. The outcome of this work indicates the potential of identifying deep-seated pulsatile structures during robot-assisted laparoscopy, whe...

The interaction between the surgical instrument and tissue is a yet little-exploited source of information. Vibroacoustic signals resulting from an interaction can be analyzed to extract relevant information related to the tissue. This work presents a summary of feasibility studies with synthetic-, animal-, and ex-vivo tissue specimen. A standard p...

Introduction It is not possible to clearly delineate pathological changes in the inner vessel wall with digital subtraction angiography. Angioscopy enables the detection of endothelial pathologies, as demonstrated in the cardiovascular system.[1] In the case of the internal carotid artery, angioscopic imaging has the potential to visualize patholog...

Laparoscopic access, a critical yet challenging step in surgical procedures, often leads to complications. Existing systems, such as improved Veress needles and optical trocars, offer limited safety benefits but come with elevated costs. In this study, a prototype of a novel technology for guiding needle interventions based on vibroacoustic signals...

This study addresses the challenge of treating skin cancer effectively, especially in visible areas like the face, where traditional methods may be undesirable. Current options, including surgery and radiation therapy, have limitations such as complexity, expense, and imprecise dose delivery. The proposed solution involves additively manufacturing...

This article provides a comprehensive analysis of the feature extraction methods applied to vibro-acoustic signals (VA signals) in the context of robot-assisted interventions. The primary objective is to extract valuable information from these signals to understand tissue behaviour better and build upon prior research. This study is divided into th...

The endoscopic examination of subepithelial vascular patterns within the vocal fold is crucial for clinicians seeking to distinguish between benign lesions and laryngeal cancer. Among innovative techniques, Contact Endoscopy combined with Narrow Band Imaging (CE-NBI) offers real-time visualization of these vascular structures. Despite the advent of...

Current treatment for glioblastoma includes tumor resection followed by radiation, chemotherapy, and periodic post-operative examinations. Despite combination therapies, patients face a poor prognosis and eventual recurrence, which often occurs at the resection site. With standard MRI imaging surveillance, histologic changes may be overlooked or mi...

Image-guided and minimally invasive procedures still require confirmation on having reached a target. Intraoperative imaging is not always sufficient or conclusive as it comes with artifacts that can come with a certain amount of ambiguity and inaccurate location information. As an alternative to imaging, we want to explore sounds produced by the b...

The overall complication rate during laparoscopic access is estimated to be as high as 14 %. Surgeons have to rely heavily on their experience and haptic perception while inserting the Veress needle or a trocar into the peritoneal cavity. Surgical Audio Guidance (SURAG) is a promising alternative to current techniques. It acquires instrument-born v...

According to [1]-[3], the healthcare systems are suffering from severe personnel shortages with a lack of medical care workers, operating room nurses, and surgical technicians. This deficiency will become worse in the upcoming decades. Automatization of highly standardized procedures could be a promising approach to address this issue. We designed...

Vascular diseases like aneurysms or atherosclerosis belong to the leading causes of death. For diagnosis and treatment, medical imaging is essential. Standard imaging methods are Ultrasound, X-ray-based Angiography, Computed tomography or Magnet Resonant Imaging. Additionally, Intravascular Ultrasound or Optical Coherence Tomography are available f...

This paper presents the use of vibro-acoustic sensing to augment laparoscopic surgery procedures by analyzing the signals produced during cutting and palpation tasks on various tissue samples. Vibro-acoustic signals were acquired during an experiment on a dedicated phantom covered in dense foam, where three trocars were inserted into the phantom to...

Background: The shift towards minimally invasive surgery is associated with a significant reduction of tactile information available to the surgeon, with compensation strategies ranging from vision-based techniques to the integration of sensing concepts into surgical instruments. Tactile information is vital for palpation tasks such as the differe...

The direct tactile assessment of surface textures during palpation is an essential component of open surgery that is impeded in minimally invasive and robot-assisted surgery. When indirectly palpating with a surgical instrument, the structural vibrations from this interaction contain tactile information that can be extracted and analysed. This stud...

There is a hurdle between the creative innovator and the successful business creator in the medical device industry: the standards and laws regulating market access! As the names already reveal, standards and regulations do not correlate with free-minded and creative acting. Nevertheless, innovation is only an innovation when it arrives at the mark...

Knee arthroplasty follow-up involves only a limited number of X-ray-based implant condition assessments at extended intervals. Polyethylene (PE) wear of knee endoprosthesis often progresses unnoticed until symptomatic adverse effects become apparent or implant failure occurs. A PE wear measuring concept, consisting of an implanted passive sensor an...

Retractors are used in surgery for the displacement of tissue and organs and to keep the surgical area open. The retraction can lead to a tissue compression that can cause irritation on nerves, perfusion deficits, hematoma or late sequelae like wound healing disorders, pain and numbness. The retraction force and thus the load on the tissue can not...

This paper presents the proof-of-concept study of an adaptor allowing the combination of a gamma probe with ultrasound (US) imaging, intending to improve the detectability of sentinel lymph nodes (SLNs). The performance of the adaptor in US imaging, in terms of depth of penetration and distance accuracy, and gamma scanning, in terms of sensitivity...

Ultrasound (US) imaging is used for the diagnosis and also evaluation of thyroid nodules. A Thyroid Imaging Reporting and Data System (TIRADS) is used for the risk stratification of thyroid nodules through US images. The composition of thyroid nodules plays an important role in the risk-stratification process. The percentages of cystic and solid co...

For treatment decision of Eustachian tube (ET) dysfunction, a reliable diagnosis of the reason for this dysfunction is of interest. Imaging methods like CT or MRI do not show enough details today. Endoscopy is challenging but can show at least superficial structures at the pharyngeal orifice. To look into the deeper tissue layers vascular imaging m...

Minimal-invasive procedures come with significant advantages for the patient. They also come with problems as the navigation/guidance of the devices to a target location is either based on pre-operatively acquired images and then performed free-hand or is accompanied by intraoperative imaging such as MRI or CT that is expensive, complicated and pro...

Creating surgical access is a critical step in laparoscopic surgery. Surgeons have to insert a sharp instrument such as the Veress needle or a trocar into the patient’s abdomen until the peritoneal cavity is reached. They solely rely on their experience and distorted tactile feedback in that process, leading to a complication rate as high as 14% of...

One of the most applied imaging methods in medicine is endoscopy. A highly specialized image modality has been developed since the first modern endoscope, the “Lichtleiter” of Bozzini was introduced in the early 19th century. Multiple medical disciplines use endoscopy for diagnostics or to visualize and support therapeutic procedures. Therefore, th...

(1) Background: Contact Endoscopy (CE) and Narrow Band Imaging (NBI) are optical imaging modalities that can provide enhanced and magnified visualization of the superficial vascular networks in the laryngeal mucosa. The similarity of vascular structures between benign and malignant lesions causes a challenge in the visual assessment of CE-NBI image...

Auscultation methods allow the non-invasive diagnosis of pathological conditions (e.g., of the lung, heart or blood vessels) based on sounds that the body produces (e.g., breathing, heartbeat, swallowing or the blood flow). Through regular homebased examinations and Big Data combined with Machine learning techniques like Deep Learning, these could...

About 50 % of complications during laparoscopy occur when surgical access is created. The Veress needle and proposed technical alternatives do not provide reliable information to support the surgeons in guiding the needle, or the feedback is not clearly perceivable. Based on acoustic emissions, Surgical Audio Guidance (SURAG) proposes a non-invasiv...

Ultrasound (US) imaging is used as a preliminary diagnostic tool for the detection, risk-stratification and classification of thyroid nodules. In order to perform the risk stratification of nodules in US images physicians first need to effectively detect the nodules. This process is affected due to the presence of inter-observer and intra-observer...

Polyethylene (PE) inlays of knee endoprostheses are exposed to constant mechanical stress causing particle abrasion and volumetric wear. With the current inlay surveillance strategy, significant change often can be only detected when the implant has already failed. To reduce medical complications arising from implant malposition or failure, early a...

Introduction : The grade of reperfusion after endovascular treatment of ischemic stroke e.g. mechanical thrombectomy is determined based on the mTICI score. The mTICI score shows significant interrater variability; it is usually biased towards better reperfusion results if selfassessed by the operator. We therefore developed a semiautomated image p...

The use of catheters and guide-wires in minimally invasive therapeutic approaches is an important part of clinical practice. In the neurovascular field, the unique nature of cerebral blood vessels necessitates very thin-walled and flexible catheters. The blood vessels in question are highly branched and at the same time can be less than one millime...

Irreversible Electroporation (IRE) is a non-thermal tumor ablation treatment applicable for prostate cancer. IRE uses ultra-short but strong electrical pulses to destroy cancer cells nonthermally [1]. Clinically available IRE therapy requires two or more needle electrodes placed around the target tissue to apply the electric fields. A pre-requireme...

Today's healthcare challenges with unmet clinical needs, high regulation and certification standards, and increasing costs demand faster innovation and technical translation. To address this challenge, Stanford released a fellowship called Biodesign, where need-based healthcare innovation is taught with the approach identify, invent and implement....

We have witnessed impressive advances in preoperative imaging of cancer and the development of dualmodality scanners. However, there is a need for a scanner with functional and anatomical imaging capability suitable for surgical settings and radioguided surgery. The current paper introduces a handheld gamma-ultrasound scanner prototype and illustra...

Auscultation methods allow a non-invasive diagnosis of cardiovascular diseases like atherosclerosis based on blood flow sounds of the carotid arteries. Since this process is highly dependent on the clinician’s experience, it is of great interest to develop automated data processing techniques for objective assessment. We have recently proposed a co...

Background: Biometric sensing is a security method for protecting information and property. State-of-the-art biometric traits are behavioral and physiological in nature. However, they are vulnerable to tampering and forgery. Methods: The proposed approach uses blood flow sounds in the carotid artery as a source of biometric information. A handhe...

Purpose Percutaneous needle insertion is one of the most common minimally invasive procedures. The clinician’s experience and medical imaging support are essential to the procedure’s safety. However, imaging comes with inaccuracies due to artifacts, and therefore sensor-based solutions were proposed to improve accuracy. However, sensors are usually...

Introduction According to a study conducted in 2019, the German health care industry is suffering under severe personnel shortage with a lack of over 50.000 medical care workers, operating room nurses, and surgical technicians. This need will become worse in the upcoming decades. Automatization of highly standardized procedures could be a promising...

Under-staffing of nurses is a significant problem in most countries. It is expected to rise in the coming years, making it challenging to perform crucial tasks like assessing a patient's condition, assisting the surgeon in medical procedures, catheterization and Blood Transfusion etc., Automation of some essential tasks would be a viable idea to ov...

Background The mTICI score used to assess the degree of reperfusion after mechanical thrombectomy is an independent predictor of patient outcome after acute ischemic stroke. Its inter-rater reliability, however, is low and interventionalists often overrate their own performance.¹ Objectives We devised an image-processing based semi-automated gradi...

This paper presents the setup, network environment, and some of the initial results and learn ings from developing Innolab IGT, a medical, technology and innovation laboratory at a university clinic in Germany over four years. We created a learning environment that had short distances between operating rooms and labs, quick, responsive communicatio...

Background: Feature extraction is an essential part of a Computer-Aided Diagnosis (CAD) system. It is usually preceded by a pre-processing step and followed by image classification. Usually, a large number of features is needed to end up with the desired classification results. In this work, we propose a novel approach for texture feature extracti...

Longitudinal and perpendicular changes in the blood vessels of the vocal fold have been related to the advancement from benign to malignant laryngeal cancer stages. The combination of Contact Endoscopy (CE) and Narrow Band Imaging (NBI) provides intraoperative realtime visualization of vascular pattern in Larynx. The evaluation of these vascular pa...

Endoscopy is an important modality in medical imaging. Thin flexible endoscopes are for example used to examine the upper airways, for gastroscopy procedures or lung inspection. With standard flexible endoscopes one can change the direction of view by bending the tip with the disadvantage of large space required due to the bending radius. With firs...

Arthroscopic surgery is a technically challenging but common minimally invasive procedure with a long learning curve and a high incidence of iatrogenic damage. These damages can occur due to the lack of feedback and supplementary information regarding tissue-instrumentcontact during surgery. Deliberately performed interactions can be used however t...

For assessing clinically relevant structures in the neck area, especially the thyroid, it has been shown that 3D or tomographic ultrasound (3D US or tUS) is able to outperform standard 2D ultrasound [1] and computed tomography [2] for certain diagnostic procedures. However, when using a freehand and unassisted scanning method to acquire a 3D US vol...

Vascular endoscopic imaging is known for a long time but has never made its way into clinical routine. Reasons for that are the complexity, lack of low-cost portable systems, and the lack of suitable endoscopes providing high image quality with small dimensions. In addition, an interruption of the blood flow caused by the device and the opacity of...

Photodynamic therapy (PDT) is a potential option for treatment of cancer since it can be performed non- invasive for superficial cancers or minimal-invasive with low traumatization. But PDT is intrinsically inefficient due to the complex accumulation of the photosensitizing drug inside the tumor and the processes of heme syntheses to create the nee...

Novel challenges and developments require adaptations on skill set, content, and associated education. A biomedical engineer will require a broad range of skills - which to a large extent are currently not taught - in the coming years to meet the development needs of future healthcare: intensive interdisciplinary team work, advanced communication s...

In robot-assisted procedures, the surgeon controls the surgical instruments from a remote console, while visually monitoring the procedure through the endoscope. There is no haptic feedback available to the surgeon, which impedes the assessment of diseased tissue and the detection of hidden structures beneath the tissue, such as vessels. Only visua...

Introduction Atherosclerotic diseases of the carotid are a primary cause of cerebrovascular events such as stroke. For the diagnosis and monitoring angiography, ultrasound- or magnetic resonance-based imaging is used which requires costly hardware. In contrast, the auscultation of carotid sounds and screening for bruits – audible patterns related t...

PRELIMINARY DATA Ex-vivo Lungenperfusions-Systeme (EVLP) erhalten das Organgewebe strukturell und funktionell außerhalb des Körpers. Neben der klinischen Anwendung in der Transplantationsmedizin werden EVLP-Systeme für translationale Forschungsansätze in der Lungenmedizin benötigt. Kommerziell erhältliche Système sind bei vielen experimentellen Ans...

Accurate needle placement is highly relevant for puncture of anatomical structures. The clinician’s experience and medical imaging are essential to complete these procedures safely. However, imaging may come with inaccuracies due to image artifacts. Sensor-based solutions have been proposed for acquiring additional guidance information. These senso...

Photodynamic diagnostic (PDD) is an optical enhancement option for the endoscope to support the detection of cancer, for example in the bladder. In real application PDD efficiency suffers due to the complex accumulation of the photosensitizing drug inside the tumor and the associated processes of heme syntheses to create the fluorescent components...

During thermal ablation in a target tissue the information about temperature is crucial for decision making of successful therapy. An observable temporal and spatial temperature propagation would give a visual feedback of irreversible cell damage of the target tissue. Potential temperature features in ultrasound (US) B-Mode image sequences during r...

This work aims to demonstrate the feasibility that haptic information can be acquired from a da Vinci robotic tool using audio sensing according to sensor placement requirements in a real clinical scenario. For that, two potential audio sensor locations were studied using an experimental setup for performing, in a repeatable way, interactions of a...

Longitudinal and perpendicular changes in the vocal fold’s blood vessels are associated with the development of benign and malignant laryngeal lesions. The combination of Contact Endoscopy (CE) and Narrow Band Imaging (NBI) can provide intraoperative real-time visualization of the vascular changes in the laryngeal mucosa. However, the visual evalua...

TURBT (transurethral resection of bladder tumor) is a standard treatment for bladder cancer. Gas bubble formation is caused by the heating of the RF-electrode from the resectoscope, which causes visual impairments and can also lead to explosive gas formation. The purpose of this work is to find a proper technical solution for removing the air bubbl...

Epilepsy is a neurological disorder that happens because of the propagation of abnormal signals produced by clusters of neurons in the brain. The majority of those with epileptic seizures can be treated by drug therapies and surgery. However, 25% of the patients with diagnosed epilepsy continue to have seizures. Seizures can cause serious injuries...

The patent illustrates a concept that is a basis for developing a hybrid gamma-ultrasound scanner. This scanner, which is capable of acquiring both physiological and anatomical information, can be held with one hand. This feature of the scanner makes it a suitable device for use in image-guided surgery as well as small-field-of view imaging.

The patent describes a method for superficial skin cancer radiation therapy using beta-emitting isotopes, with 3D printing technology in its foundation. The therapeutic models/patches are printed based on tumor imaging information. Therefore, the offered treatment will be patient-specific with a dose profile matching the tumor shape.

The endoscopic detection of perpendicular vascular changes (PVC) of the vocal folds has been associated with vocal fold cancer, dysplastic lesions, and papillomatosis, according to a classification proposed by the European Laryngological Society (ELS). The combination of contact endoscopy with narrow-band imaging (NBI-CE) allows intraoperatively a...

The healthcare industry is consistently developing a constant supply of medical equipment, e.g. radiation protection wear. These must be inspected regularly to ensure safety and quality. As this equipment keeps on moving from department to department, it has to be located in one place for annual inspection and must be properly documented after qual...