P. Sánchez-González

Universidad Politécnica de Madrid | UPM · Biomedical Engineering and Telemedicine Centre

Training with real patients is a critical aspect of the learning and growth of doctors in training. However, this essential step in the educational process for clinicians can potentially compromise patient safety, as they may not be adequately prepared to handle real-life situations independently. Clinical simulators help to solve this problem by p...

The combination of visual assessment of whole body [18F]FDG PET images and evaluation of bone marrow samples by Multiparameter Flow Cytometry (MFC) or Next-Generation Sequencing (NGS) is currently the most common clinical practice for the detection of Measurable Residual Disease (MRD) in Multiple Myeloma (MM) patients. In this study, radiomic featu...

Objective: To study the correlation between a static PET image of the first-minute-frame (FMF) acquired with 18F-labeled amyloid-binding radiotracers and brain [18F]FDG PET in patients with primary progressive aphasia (PPA). Material and methods: The study cohort includes 17 patients diagnosed with PPA with the following distribution: 9 nonfluen...

Introduction Training tools should follow a thorough validation process that assure their value before their wider use. In this regard, three online modules for laparoscopic cholecystectomy, lumbar punction and knee arthroscopy have been created for an integrative Learning Management System (LMS) that connects external assets, therefore allowing tr...

Neurodegenerative parkinsonisms affect mainly cognitive and motor functions and are syndromes of overlapping symptoms and clinical manifestations such as tremor, rigidness, and bradykinesia. These include idiopathic Parkinson’s disease (PD) and the atypical parkinsonisms, namely progressive supranuclear palsy (PSP), corticobasal degeneration (CBD),...

Automatic surgical workflow analysis (SWA) plays an important role in the modelling of surgical processes. Current automatic approaches for SWA use videos (with accuracies varying from 0.8 and 0.9), but they do not incorporate speech (inherently linked to the ongoing cognitive process). The approach followed in this study uses both video and speech...

Background The effects of stress on surgical residents and how stress management training can prepare residents to effectively manage stressful situations is a relevant topic. This systematic review aimed to analyze the literature regarding (1) the current stress monitoring tools and their use in surgical environments, (2) the current methods in su...

Purpose Due to the high morbidity and mortality of infective endocarditis (IE), medical imaging techniques are combined to ensure a correct diagnosis. [ ¹⁸ F]FDG PET/CT has demonstrated the ability to improve diagnostic accuracy compared with the conventional modified Duke criteria in patients with suspected IE, especially those with prosthetic val...

Objective The aim of the study was to assess the impact of clinical and metabolic parameters derived from ¹⁸ F-FDG PET/CT (positron emission tomography–computed tomography) in patients with locally advanced cervical cancer (LACC) on prognosis. Methods Patients with LACC of stage IB2-IVA treated by primary radiochemotherapy followed by brachytherap...

Background and Objectives The last few years have been crucial in defining the most appropriate way to quantitatively assess [¹⁸F]FDG PET images in Multiple Myeloma (MM) patients to detect persistent tumor burden. The visual evaluation of images complements the assessment of Measurable Residual Disease (MRD) in bone marrow samples by multiparameter...

The Objective Structured Clinical Exam (OSCE) is an assessment tool used as a reliable method for clinical competence evaluation of students. This paper presents an investigation focused on the chain of survival, its related exploration, management, and technical skills, and how Virtual Reality (VR) can be used for the creation of immersive environ...

This chapter will analyse personalization within the context of technological innovation. It will first of all clarify the conceptual terms used in the debate, in particular patient, person-centered and people-centered care and their various uses and limitations. It will then focus on specific issues of personalization and technology in emerging ar...

Background & Aims Sarcopenia is a muscle disorder associated with loss of muscle mass, strength and function. Early screening, diagnosis and treatment may improve outcome in different disease conditions. A wide variety of tools for estimation of muscle mass is available and each tool has specific technical requirements. However, different investiga...

Modern surgical education is focused on making use of the available technologies in order to train and assess surgical skill acquisition. Innovative technologies for the automatic, objective assessment of nontechnical skills are currently under research. The main aim of this study is to determine whether personal resourcefulness can be assessed by...

Purpose: Chemotherapy-induced cardiotoxicity is one of the main complications during and after cancer treatment. While echocardiography is the most used technique in clinical practice to evaluate left ventricular (LV) dysfunction, a multimodal approach is preferred for the early detection of anthracycline-induced cardiotoxicity. In this paper, an...

Brain Health is defined as the development and preservation of optimal brain integrity and neural network functioning for a given age. Recent studies have related healthy habits with better maintenance of brain health across the lifespan. As a part of the Barcelona Brain Health Initiative (BBHI), a mHealth platform has been developed with the purpo...

Dynamic early-phase PET images acquired with radiotracers binding to fibrillar amyloid-beta (Aβ) have shown to correlate with [18F]fluorodeoxyglucose (FDG) PET images and provide perfusion-like information. Perfusion information of static PET scans acquired during the first minute after radiotracer injection (FMF, first-minute-frame) is compared to...

In this article, we described a new mobile-Health (mHealth) supported clinical pathway of care for people living with medically stable HIV in terms of platform acceptability, usability and technical feasibility. The EmERGE mHealth platform was codesigned with clinicians and the community, developed using Scrum agile methodology, integrated with hos...

Manual segmentation of muscle and adipose compartments from computed tomography (CT) axial images is a potential bottleneck in early rapid detection and quantification of sarcopenia. A prototype deep learning neural network was trained on a multi-center collection of 3413 abdominal cancer surgery subjects to automatically segment truncal muscle, su...

Amyloid positron emission tomography (PET) brain imaging with radiotracers like [18F]florbetapir (FBP) or [18F]flutemetamol (FMM) is frequently used for the diagnosis of Alzheimer’s disease. Quantitative analysis is usually performed with standardized uptake value ratios (SUVR), which are calculated by normalizing to a reference region. However, th...

Surgeons’ procedural skills and intraoperative decision making are key elements of clinical practice. However, the objective assessment of these skills remains a challenge to this day. Surgical workflow analysis (SWA) is emerging as a powerful tool to solve this issue in surgical educational environments in real time. Typically, SWA makes use of vi...

Aim The aim was to develop and implement a virtual reality tool based on eye-tracking technologies that allow to evaluate the characteristics of the gaze patterns of glaucoma patients in order to have a better understanding of the limitations that these patients experience in their daily life. Setting This study took place on the Ophthalmology dep...

Chronic thromboembolic pulmonary hypertension (CTEPH) is confirmed by visual analysis of single-photon emission computer tomography (SPECT) ventilation and perfusion (V/Q) images. Defects in the perfusion image discordant with the ventilation image indicate obstructed segments and the positive diagnosis of CTEPH. A quantitative metric and classific...

Introduction: Effectiveness of e-learning diminishes without the support of a pedagogical model to guide its use. In minimally invasive surgery (MIS), this has been reported as a limitation when technology is used to deliver contents without a sound pedagogical background. Material and methods: We describe how a generic pedagogical model, the 3D pe...

MIS-SIM is a virtual reality (VR) environment designed and developed for the creation of virtual scenarios that can be used to train and acquire basic and advance laparoscopic skills. The environment is composed by a task editor where a content creator design and develop tasks for the simulator to play. Once they are completed, objective metrics ar...

VR P300-based BCI has proven to be a suitable method for training social attention skills in youngsters with autism spectrum disorder (ASD). In this study, we present a method that could be used in such an application to identify which object the user is paying attention to in a virtual environment by means of EEG recordings only. Temporal and time...

Although the total number of ureteroscopy interventions during the past years has significantly increased, current flexible ureteroscopy procedures still present some limitations to urologic surgeons. However, nowadays different robotic systems have been developed in order to reduce those limitations. Flexible ureteroscopy robots provide a technolo...

Brain health refers to the preservation of brain integrity and function optimized for an individual’s biological age. Several studies have demonstrated that our lifestyles habits impact our brain health and our cognitive and mental wellbeing. Monitoring such lifestyles is thus critical and mobile technologies are essential to enable such a goal. Th...

Depression is a mental disorder which can become a serious health problem. This research line is focused on creating a depression detection service from text analysis. Sentiment Analysis and Natural Language Processing methods will be used to develop this service. The service will classify text in positive or negative depending on the emotions infe...

Healthy daily activities have a positive influence on many aspects of our lives. Habits have a deep impact on our health, they help to prevent the appearance of chronic and neurodegenerative diseases and will provide a healthy and active aging. This research work is aiming to analyze the need of new approaches on monitoring daily life activities, i...

Positron emission tomography (PET) with amyloid binding tracers and 18F-fluordesoxyglucose (FDG) is used in the diagnosis of Alzheimer’s disease and other dementias. The dual-phase amyloid PET protocol acquires an early perfusion image immediately after the radiotracer injection that resembles FDG images. We studied the correlation of early phase 1...

This research presents a novel low-cost pedagogical environment oriented to ease the use experiential learning methods for training on image-guided robotic surgery technologies. The environment proposes a simplified surgical simulation use case: the movement of insertion and extraction of a needle, similar to an image-guided biopsy situation. The t...

Introduction: Motion analysis is a valuable tool for assessment of psychomotor skills in laparoscopy. Nonetheless, it requires technologies for tracking the activity of the laparoscopic instruments during training. This paper presents a sensor-free system to track the movements of laparoscopic instruments based on an orthogonal camera system and v...

Background: Motion analysis parameters (MAPs) have been extensively validated for assessment of minimally invasive surgical skills. However, there are discrepancies on how specific MAPs, tasks, and skills match with each other, reflecting that motion analysis cannot be generalized independently of the learning outcomes of a task. Additionally, the...

Background: The increasing number of patients with acquired brain injury and the current subjectivity of the conventional upper extremity (UE) assessment tests require new objective assessment techniques. Objective: This research proposes a novel objective motor assessment (OMA) methodology based on the Fugl-Meyer assessment (FMA). The goals are...

We propose a fully automated methodology for hexahedral meshing of patient-specific structures of the human knee obtained from magnetic resonance images, i.e. femoral/tibial cartilages and menisci. We select eight patients from the Osteoarthritis Initiative and validate our methodology using MATLAB on a laptop computer. We obtain the patient-specif...

Introduction: E-learning web environments, including the new TELMA platform, are increasingly being used to provide cognitive training in minimally invasive surgery (MIS) to surgeons. A complete validation of this MIS e-learning platform has been performed to determine whether it complies with the three web quality dimensions: usability, content a...

Eye tracking is a powerful tool for an objective assessment of surgeons' visual search strategy. This technology allows for recording the eye movements and point of gaze fixation. Some studies have assessed differences in eye metrics between expert and novice surgeons in basic operations of minimally invasive surgery [1]. However, advanced laparosc...

Due to limitations in conventional medical imaging and the restrictions imposed by both the anatomy and the surgical approach in pancreatic cancer, there is a need for methods to support intraoperative imaging in order to improve their accurate anatomical localization and the characterization of their nature. Laparoscopic ultrasounds (LUS) images a...

Motion analysis is employed to assess minimally invasive surgical psychomotor skills in box trainers. Tracking of laparoscopic instruments requires sensor-based systems that can be expensive, limit movements and modify their ergonomic properties. We evaluate the feasibility of using Leap Motion as a cheap, unobtrusive alternative. Four experiments...

Background: Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients' quality of life. Cognitive rehabilitation aims to promote patients' skills to achieve their highest degree of personal autonomy. New technologies such as virtua...

A correct patient-specific identification of the abdominal aortic aneurysm is useful for both diagnosis and treatment stages, as it locates the disease and represents its geometry. The actual thickness and shape of the arterial wall and the intraluminal thrombus are of great importance when predicting the rupture of the abdominal aortic aneurysms....

Acquired Brain Injury (ABI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and therefore patients’ quality of life. Cognitive rehabilitation aims to promote patients’ skills to achieve their highest degree of personal autonomy. New technologies such as...

The present work covers the first validation efforts of the EVA Tracking System for the assessment of minimally invasive surgery (MIS) psychomotor skills. Instrument movements were recorded for 42 surgeons (4 expert, 22 residents, 16 novice medical students) and analyzed for a box trainer peg transfer task. Construct validation was established for...

Objective assessment of psychomotor skills has become an important challenge in the training of minimally invasive surgical (MIS) techniques. Currently, no gold standard defining surgical competence exists for classifying residents according to their surgical skills. Supervised classification has been proposed as a means for objectively establishin...

Cognitive impairment is the main cause of disability in developed societies. New interactive technologies help therapists in neurorehabilitation in order to increase patients' autonomy and quality of life. This work proposes Interactive Video (IV) as a technology to develop cognitive rehabilitation tasks based on Activities of Daily Living (ADL). A...

Analysis of minimally invasive surgical videos is a powerful tool to drive new solutions for achieving reproducible training programs, objective and transparent assessment systems and navigation tools to assist surgeons and improve patient safety. This paper presents how video analysis contributes to the development of new cognitive and motor train...

This paper presents the AMELIE Authoring Tool for e-health applications. AMELIE provides the means for creating video-based contents with a focus on e-learning and telerehabilitation processes. The main core of AMELIE lies in the efficient exploitation of raw multimedia resources, which may be already available at clinical centers or recorded ad ho...

Introduction: The EVA (Endoscopic Video Analysis) tracking system is a new system for extracting motions of laparoscopic instruments based on nonobtrusive video tracking. The feasibility of using EVA in laparoscopic settings has been tested in a box trainer setup. Methods: EVA makes use of an algorithm that employs information of the laparoscopi...

Introduction: Motion metrics have become an important source of information when addressing the assessment of surgical expertise. However, their direct relationship with the different surgical skills has not been fully explored. The purpose of this study is to investigate the relevance of motion-related metrics in the evaluation processes of basic...

Background: Cognitive skills training for minimally invasive surgery has traditionally relied upon diverse tools, such as seminars or lectures. Web technologies for e-learning have been adopted to provide ubiquitous training and serve as structured repositories for the vast amount of laparoscopic video sources available. However, these technologie...

One of the most important revolutions in the past few decades in clinical practice has been motivated by the introduction of Minimally Invasive Surgery (MIS) techniques, which have spread amongst almost all surgical specialities. MIS training is a principal component of the education of new surgical residents, with an increasing demand for knowledg...

Automatic analysis of Minimally Invasive Surgical video has the potential to drive new solutions for alleviating needs of safe and reproducible training programs, objective and transparent evaluation systems and navigation tools to assist surgeons and improve patient safety. Surgical video is an always available source of information, which can be...