Michael Friebe

Otto-von-Guericke-Universität Magdeburg | OvGU · Faculty of Medicine and University Clinic Magdeburg

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...

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...

Background: Thyroid nodules are very common. In most cases, they are benign, but they can be malignant in a low percentage of cases. The accurate assessment of these nodules is critical to choosing the next diagnostic steps and potential treatment. Ultrasound (US) imaging, the primary modality for assessing these nodules, can lack objectivity due...

What were our product development goals in medical imaging and image-guided therapies in recent decades [...]

Purpose: Early detection of tumors and their spread, particularly in lymph node illnesses, is critical for a full recovery. However, it is currently difficult due to a lack of imaging or detection devices that provide the necessary spatial depth and location information. Consequently, it would be beneficial to have a simple and cost-effective sens...

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...

This book highlights the reasons for an urgently needed revision of the current global healthcare setup, discusses the needed mindset for a future of health, and provides a comprehensive development toolset for disruption (and for the needed incremental innovations towards disruption). Today’s biomedical and health innovation related research in un...

HTIG was initiated at AGH in the autumn/winter semester of 2021/2202. The project classes HTIG is a micro-scale experience of healthcare innovation generation where students learn dedicated tools and techniques the hard way (Learning by Doing, Problem-Based Learning, Design Thinking). To reinforce this educational experience useful tools to maintai...

The tools and canvases that are recommended for the 8 segments of the Purpose Launchpad Health in the Exploration and Evaluation phase are listed here, including short explanations on how to use them. Additionally, the course information are including and in some cases also a link to available online guidance tools or documents. All canvases and to...

Healthcare Innovation ideas originating from biomedical engineering departments are rarely based on a deep understanding of a problem, but are often based on coming up with an engineering solution that does not meet an Unmet Clinical Need, is too complicated, bulky, costly, and does not consider global developments. For an impactful innovation desi...

Digital based and vastly accelerating technologies are called exponential. They lead to new insights, more inventions, more discoveries and when combined to even faster acceleration. They will change existing approaches significantly and will doubtless have a huge impact on health and health delivery eventually leading from current continuous care...

Design Thinking—following a path from Empathize/Problem DEFINITION/Solution IDEATION/PROTOTYPE creation/and TESTING—leads to more successful and sustainable innovations compared to other conventional problem-solving methods in health care and other public health adjacent fields. Applying Design Thinking to health care could improve patient-, provid...

A future can be painted, can be wished for, can be reasoned, but best is to actively work toward a future that benefits the individual and the society. It is a good practice—and we do it for this article as well—to analyze the current situation and formulate a future goal. Healthcare is complicated and many stakeholders are involved that have—also...

This chapter describes in further detail the motivations to write this book. It also shows how the author, with a background as a medical technology entrepreneur and also as a university professor, developed his belief that we need a different approach to health innovation. A new and agile approach powered by a set of human skills that are not taug...

To evolve initial ideas into viable healthcare innovations and scalable businesses, the Purpose Launchpad framework dedicated to Health Innovations is introduced. Both authors are certified Purpose Launchpad Mentors (Master Level) and contributed to the development of the Purpose Launchpad Guide and Innovation Meta-Methodology. For each of the thre...

We will explain the Purpose Launchpad Health (PLH), a dedicated version of the Purpose Launchpad that was already presented. For each of the 8 segments, specific tools are recommended and their use is explained using two medical technology case studies (one more disruptive—Bodytune, the other fitting into the category of radical innovation—EASYJECT...

Innovation is needed everywhere, but for sure in Health. But what actually is the definition of INNOVATION. Incremental/routine, architectural, disruptive, and frugal, as well as radical will be explained. For the health innovation process, different methodologies and approaches are presented that all are putting the problem definition and evaluati...

Demographic changes toward the aging population are accompanied by the increasing rate of non-communicable (NCDs) chronic diseases, in which the high demand for continuous patient monitoring, treatment access, prolonged hospitalizations, as well as financial issues represent a global concern affecting the entire healthcare system and management. Ho...

One Health is built on the simple understanding that the human health, animal health, and the health of our shared environmental nature (Planetary Health) are part of a deeply interconnected system. In addition, the Concept of One Health is the unity of multiple practices that work together locally, nationally, and globally to help achieve optimal...

There are significant challenges in global healthcare. Some countries have abundant services, but are stuck with a rather nimble and expensive system that focuses on incremental innovations. Other geographies are still in need of basic tools, infrastructure and require completely different, inexpensive, and with that more disruptive solutions to sa...

Innovation is the translation of technologies and inventions to a market. There are different starting and obviously different ending points. And with exponential and converging technologies, huge challenges in health delivery to solve, and the need for a novel approach to health, there are a lot of opportunities for health innovators. This paper w...

New forms of interaction between doctors and patients are facilitated by a transformation of the patient journey. The advent of better data integration through digital twins allows for completely new forms of interaction, decision-making in unprecedented frequencies. The Digital Twins will also allow a more personalized data analysis leading to pre...

Three actual Health Innovations from the editors’ lab are presented and used in the subsequent chapters as case studies to illustrate some of the process steps of the presented innovation methodologies. They represent frugal, disruptive, radical, and traditional/incremental innovations. All are still active (April 2022) and public information as we...

In this short paper, some basic rules and to-do’s are listed with respect to securing the intellectual property (IP) of your innovation. This is not a comprehensive summary, but it should help to make some initial decisions. IP is not limited to patents, but includes—especially in the world of digitization and data—software code, algorithms, blockc...

Will we still recognize healthcare in 10 years from now as the disease care in today’s world? This question is currently puzzling a lot of people from all around the world. We still live in the mindset that healthcare will be the biggest burden on the shoulder of our economies. Debates are mainly about the ongoing increase of expenditure due to agi...

This chapter will provide some advise for the Intrapreneurs turned Entrepreneurs, because their concept is too far away from the current business model of the mother company and for the typical start-up Entrepreneur. The needs and requirements are generally the same with a slight advantage for the Edge solution that may come with some initial finan...

Exponential technologies are generally described as something that will in a given time period double data generation/evaluation and/or half the associated cost with it. A Medical technology example is the cost of genome sequencing that has dropped from millions to thousands and now to under USD 1.000 within a little more than a decade. In many oth...

Alle Lebensbereiche befinden sich aktuell in einer Transformation, dies zieht auch ein neues Denken nach sich. Erst wenn wir in der Lage sein werden, vernetzt zu denken, steht der erfolgreichen Umsetzung der Digitalisierung nichts mehr im Wege. Die Zukunft der Digitalisierung in der Medizin beginnt deshalb über die Ausbildung eines neuen Mindsets....

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...

In previous work, we demonstrated the potential of blood flow sounds for biometric authentication acquired by a custom-built auscultation device. For this purpose, we calculated the frequency spectrum for each cardiac cycle represented within the measurements based on continuous wavelet transform. The resulting spectral images were used to train a...

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...

Cerebrovascular diseases like atherosclerosis pose a great threat to health and wellbeing of people worldwide. To enable early diagnosis and treatment of a gradually progressing occlusion of the carotid arteries, we propose the BODYTUNE system. Consisting of a custom-built auscultation device and a mobile application, it aims at enabling the monito...

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...

Healthcare Innovation ideas originating from biomedical engineering departments are rarely based on a deep understanding of a problem, but are often based on coming up with an engineering solution that does not meet an Unmet Clinical Need, is too complicated, bulky, costly, and does not consider global developments. For an impactful innovation desi...

Industry 4.0 and digital transformation will likely come with an era of changes for most manufacturers and tech industries, and even healthcare delivery will likely be affected. A few trends are already foreseeable such as an increased number of patients, advanced technologies, different health-related business models, increased costs, revised ethi...

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...

Radiography is one of the most widely used imaging techniques in the world. Since its inception, it has continued to evolve, leading to the development of intelligent and automated radiography systems that are able to perceive parts of their environment and respond accordingly. However, such systems do not provide a complete view of the examination...

(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...

Treating of cancer is an important task e.g. in the liver which is one of the solid organs with high incident of tumor. Due to the technical improvement on biomedical systems and minimal invasive therapies currently microwave ablation (MWA) therapy as an invasive minimal therapy gets a lot of attention for destroying the cancer cells in its locatio...

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...

Health longevity, cost reduction, prevention-based healthcare, personalized medicine, predictive diagnostic, transformed care delivery, de-aging, healthy lifestyle trends, and implementation of intelligent technologies should lead to a more democratized (availability for everyone on this planet) healthcare provision. Forecasting the future of healt...

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...

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...

The typical curriculum of training and educating future clinicians, biomedical engineers, health IT, and artificial intelligence experts lacks needed twenty first-century skills like problem-solving, stakeholder empathy, curiosity stimulation, entrepreneurship, and health economics, which are essential generators and are pre-requirements for creati...

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...

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...

5G is the next generation mobile cellular network, with significant advantages over other wireless networking technologies, including data throughput, latency, real-time multi-casting, ad-hoc peer-to-peer, and data encryption, to name a few. A critical sector for potential 5G disruptive solutions is within healthcare and its current IoMT infrastruc...

With the advent of the fourth industrial revolution accompanied by the Internet of Things, the implementation of smart technologies and digitalization already had a great impact in our society, especially when considering exponential innovation and human development. In this context, some types of employment have already been replaced or have been...

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...

Fatty liver disease (FLD) is one of the prominent diseases which affects the normal functionality of the liver by building vacuoles of fat in the liver cells. FLD is an indicator of imbalance in the metabolic system and could cause cardiovascular diseases, liver inflammation, cirrhosis and furthermore neoplasm. Detection and specification of a FLD...

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...

The short-range and sharp dose fall-off of beta particles in tissue make them an interesting option for use in the radiation therapy of superficial skin tumors. This can be used to protect bony or other sensitive structures located right beneath the tumor. In a previous study, we studied the feasibility of using 3D printing technology to create 2D...

Introduction Endoscopy is an important modality in medical imaging. Thin flexible endoscopes are for example used to exam-ine 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 ra...

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-instrument-contact during surgery. Deliberately performed interactions can be used however...

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...