Among the thorniest health problems around is the upswing in Type II, or so-called adult onset, diabetes.
Diabetes is the leading cause of non-traumatic lower extremity amputations in the U.S., and approximately 14 to 24 percent of patients with diabetes who develop a foot ulcer will require an amputation. Foot ulceration precedes 85 percent of diabetes-related amputations. Obesity and Chronic conditions associated with an aging U.S. population – such as diabetes, neuropathy, circulatory insufficiency, or a combination of these pathologies – mirror the current increased incidence of foot ulcers.
Left untreated, it’s fatal; and before that certain eventuality, diabetes results in loss of feeling in extremities such as the feet—too often leading to amputations.
Diabetes and its related complications have placed an economic burden on the U.S. healthcare system–in 2007, $174 billion, a 3 percent increase since 2002. About a fifth of these costs are directly related to diabetic foot ulcers and amputations. Conventional noninvasive methods to assess skin, including visual inspection and palpation, may be valuable diagnostic methods, but usually they do not detect changes in skin integrity until skin breakdown has already occurred.
UND signals and systems expert Naima Kaabouch has been working for several years on technology that will—earlier than is currently possible—detect foot ulcers in people like diabetics before those ulcers break through the skin. Catching them early—before they become seriously problematic—means avoiding nasty health consequences such as amputation.
With collaborators around the world, Kaabouch is also working on the earlier detection of cancer by finding signals that tell clinicians about microcalcifications— they range from 0.1 mm to 0.5 mm in size and are the first sign of breast cancer in more than half of all cases.
They develop in several organs such a breast and prostate. Microcalcifications—very small calcium deposits—are the smallest particles that a mammography can detect. But, mammography exposes patients to ionizing radiation, which is not safe for patients, and it is also relatively ineffective in women with dense breasts.
“In many organs, cancer starts at a microscopic level,” said Kaabouch, who runs the Signal/Image Processing Lab at the UND College of Engineering & Mines.
“We are developing techniques that are safe and will enhance existing clinical ultrasound systems to show these microscopic hints about the potential for cancer before it becomes a tumor,” said Kaabouch. “Ultrasound devices use electromagnetic waves that are safer than x-rays used in mammogram, but these devices are currently unable to detect microcalcifications. Our objective is to develop super-resolution ultrasound techniques that remedy current deficiencies in the clinical ultrasound systems”.
Breast cancer is the second leading cause of cancer death in women.
In 2016, about one in eight women in the US will develop invasive breast cancer during their lifetime. The American Cancer Society’s estimates 249,260 new cases in US and 40,890 deaths. Men are also affected by this disease, but the incidence of breast cancer in men is less common; however, men with breast cancer have significantly lower survival rates than women.
“Every family in the world is affected by cancer,” Kaabouch said.
That includes her own family.
“My motivation to perform research in early detection of cancer comes from the fact that I lost several family members from cancer,” Kaabouch said. “For example, my grandmother passed away at the age of 60 from breast cancer.”
“For foot ulcers, it’s the same—we spend billions annually in this country on diabetes-related amputations,” said Kaabouch. “These diabetic ulcers start invisibly—when you see them, it’s too late. So we’re developing technologies to analyze the temperature flow of the foot—looking for areas on the foot where there are temperature differences, a sign that something is wrong.”
Among the ideas she and her team are working on—and are looking to develop—are temperature sensors in the shoes of diabetic patients.
— Juan Miguel Pedraza, Office of the Vice President for Research and Economic Development