Biomedical Devices and Instrumentation Commons^™

Quantitative Fluorescence Imaging Using A Paired Agent Approach For Improving Surgical Decision Making, Sanjana Pannem

Dartmouth College Ph.D Dissertations

Surgical resection remains to be the cornerstone of treatment for most solid tumors, where the primary objective is to remove all visible and microscopic disease. However, the extent of tumor resection is inherently limited by the surgeon’s ability to distinguish tumor from normal tissue, intraoperatively. As a result, positive surgical margins (PSM), where residual tumor remains after surgery, are a common occurrence and are associated with increased recurrence, need for adjuvant therapies, dismal patient outcomes, and high healthcare costs.

Fluorescence guided surgery (FGS) has emerged as a promising technique to enhance intraoperative visualization of tumors and may help reduce the …

Methods For Radiation-Sparing Navigation In Endovascular And Spine Surgery, William Ross Warner

Dartmouth College Ph.D Dissertations

Modern surgical navigation systems improve procedural accuracy, limit complications, and can reduce reliance on intraoperative ionizing radiation, yet their adoption remains uneven across surgical domains. Informed by clinical immersion, this thesis identifies and addresses two unmet needs revealed through contrasting image-guidance practices in endovascular and spine surgery, where existing guidance techniques are costly, intermittent, or fundamentally limited. Specifically, these needs include (1) the absence of radiation-sparing navigation techniques for endovascular procedures, which rely heavily on 2D x-ray angiography, and (2) the need for dynamic registration methods in open spine surgery, where navigation accuracy can degrade after initial registration and intraoperative …

Patterned Magnetic And Plasmonic Nanostructures In Microfluidics For Extracellular Vesicle Screening And Drug Loading, John H. Molinski

Dartmouth College Ph.D Dissertations

Extracellular vesicles (EVs), once dismissed as shuttles for cellular waste, have emerged as vital nanoscale biomolecules, facilitating intercellular communication through transfer of host-cell specific molecular cargo. Tumor-derived EVs, released by cancer cells, hold potential as diagnostic biomolecules due to their links to cancer cells, abundance within biofluids, and potential for direct extraction and detection. More broadly, EVs from a wide array of cellular origins have been explored as therapeutic carriers, stemming from their innate function as cargo carriers, high biocompatibility, and their ability to evade immune detection. However, harnessing EVs for diagnostic or therapeutic applications necessitates efficient isolation, purification, and …

Toward Electrical Impedance Sensing Surgical Drill For Tissue Boundary Detection, Harshavardhan Devaraj

Dartmouth College Ph.D Dissertations

Dental implantation is an increasingly common procedure used to treat missing teeth. However, surgical drilling to place the implant poses a high risk of injury to critical anatomy, such as inferior alveolar nerve injury or maxillary sinus perforation. A real-time surgical feedback system sensing proximity of these critical anatomy could reduce injury risks. This dissertation investigates the development of such a system that incorporates an electrical impedance sensor into the tip of a surgical drill.

A simulation framework based on finite element method (FEM) was developed to optimize the sensor as it approached a high impedance boundary. The accuracy of …

Surgical Navigation In Image-Guided Transoral Robotic Surgery, Yuan Shi

Dartmouth College Ph.D Dissertations

Transoral robotic surgery (TORS) is a minimally invasive approach in treating head and neck cancers and has demonstrated improved surgical outcomes with reduced morbidity when compared to traditional open surgery. However, the lack of haptic feedback makes it more difficult to assess the tumor extent and locate critical structures (e.g., artery and nerves). In standard-of-care TORS, preoperative imaging is used as guidance; however, it becomes inaccurate intraoperatively: the patient’s neck is hyper-extended, surgical instruments are introduced, and soft tissues deform significantly. As a result, the surgeon is required to mentally predict intraoperative deformation, which can lead to bleeding complications and …

An Fpga-Based Eit System For Deep Space Medical Imaging, Kendall R. Farnham

Dartmouth College Ph.D Dissertations

Dangers associated with high radiation and microgravity exposure in space are critical challenges inhibiting us from exploring deep space and pursuing long-duration missions, as current medical systems are unable to monitor, diagnose, or treat tissue injury within physical spacecraft constraints and communication limits. Ultrasound (US) is the current imaging system used on the International Space Station, but this technology relies on telemedical support (or onboard artificial intelligence/autonomous capabilities) for both operation and diagnosis, posing challenges for crews isolated in deep space. Electrical impedance tomography (EIT) is a non-invasive, non-ionizing technology that produces images of the electrical properties of tissues and …

Design Of Asic Based Electrical Impedance Tomography Microendoscopic System For Prostate Cancer Surgical Marginal Assessment, Mohsen Shahghasemi

Dartmouth College Ph.D Dissertations

Prostate cancer is the second most common cancer in the United States. It is typically treated by surgically excising the cancerous section of the prostate. Because there is not always a visible distinction between the healthy and cancerous sections, surgery often leaves some cancerous tissue behind. This is referred to as a positive surgical margin and it requires adjuvant treatment with adverse side effects. Electrical impedance tomography (EIT) is a low-cost low-form-factor method that can be used to assess surgical marginal intraoperatively to ensure that no cancerous tissue is left behind. EIT-based surgical margin assessment works on the principle that …

Piezoelectric And Conductive Polymer Based Flexible Devices Enabling Cardiovascular Health Sensing And Energy Harvesting, Andrew Closson

Dartmouth College Ph.D Dissertations

Piezoelectric materials show great promise for low-power wearable and implantable sensing, but their rigidity makes it challenging to integrate them with biological tissue. To address this, researchers have started exploring polymer-based functional materials that offer flexibility and are suitable for interfacing with the human body. However, these materials are still in their early stages, and a framework is necessary to illustrate how these materials, in conjunction with novel fabrication techniques and device designs, can enable the development of multi-functional sensing and energy harvesting devices.

This thesis utilizes highly scalable fabrication methods for functional polymers to build and test a flexible …

Zinc Oxide Based Nanomaterials And Device Designs - For Bioenergy Harvesting, Sensing And Water Purification, Congran Jin

Dartmouth College Ph.D Dissertations

Biomechanical energy harvested from the human body can power implantable electronics such as cardiac pacemakers, replacing conventional batteries and offering a lifelong energy solution. The electrical signals converted from biomechanical motions contain vital physiological information, making them suitable as a sensor to monitor one's health condition. Zinc Oxide (ZnO) is a versatile material with various intriguing properties, including piezoelectricity, photo-catalytic and piezo-catalytic properties. This thesis aims to exploit and enhance these properties of ZnO by rationally designing its nano- and micron-structures and employing them, along with other functional materials, in the development of novel biomechanical energy harvesting, water purification, and …

Advanced Tools For Time-Resolved Imaging Of Tissue Metabolism, Arthur Petusseau

Dartmouth College Ph.D Dissertations

Medical imaging is a crucial tool in diagnosing and treating diseases, and by far the most common set of tools used for point-of-care guidance between a physician and patient are optical devices. For example, visible light imaging has unique applications in endoscopy, dermatology, microscopy, and this range of devices utilize a wide range of optical signals for sensing the tissue. Fluorescence imaging has become a niche but growing methodology in medical diagnostics and treatment because of its simplicity and the ability to integrate reporter molecules, that can reveal detailed information about cellular structures, metabolism, signaling, and other biomolecular features of …