The early detection and treatment of disease are critical in patient healthcare. Numerous diagnostic tools have existed for decades including blood tests and swabbing. Although reliable, these tests are only a small piece of the medical diagnostic technology available and developing. Instead of patients following up for regular doctor appointments for the treatment of chronic disease, apps can be developed to monitor vitals and order prescriptions for the convenience of both the patient and doctor. In addition, by pairing with nanotechnology, different diagnostic imaging software can be enhanced to better view regions of cancer. Finally, immunosignature has the potential to allow for the early detection of numerous diseases at once, a feat no test could do before. Therefore, the advancements in diagnostic technology in the medical field have greatly improved the ability to accurately diagnose and treat disease.
With modern technology, there is a decreased need for in-person visits to healthcare providers for the management of diagnosed chronic conditions. Chronic disease is rampant in the United States as it is responsible for 70% of deaths yearly (Milani et al. 581). This statistic is largely due in part to the poor management of disease as many visit doctors’ offices too infrequently, as little as one to four 15-minute visits a year (Milani et. al 581). To combat this issue, a combination of apps and wearables to monitor disease, health stats, and prescriptions has been created. A particular pioneer, Ochsner Health Systems, has created an app known as “O Bar” that serves as an online doctor’s office (Milani et al. 581). One major feature of the app is the online prescription pads, which serve as additions to the app. The apps include nutrition, fitness, oncology, diabetes, and smoking. The overall response to these apps is positive as in a “recent survey of 2000 patients with chronic disease… [patients were] 50% more likely to fill a prescription for a health app than for a prescribed medication” (Milani et al. 581). In addition, there are also wearable device additions, such as a wireless scale, blood pressure monitor, and blood glucose monitor with Bluetooth to collect patient data remotely. Statistics show that the app “successfully reduced readmissions by 44% by sending patients home with wireless scales,” when daily weights are monitored (Milani 582). The app can also respond to excess weight gain by automatically prescribing medication or creating same-day appointments. This practice of daily recordings of weight can be used with blood pressures and blood glucose levels as well. With remote monitoring technology, there is hope that the treatment of chronic disease will improve.
Diagnostic imaging scans have been used since the mid 20th century. Currently, the use of nanoparticles has greatly enhanced all major imaging techniques to allow for better detection of disease. Nanoparticles are a broad spectrum of small particles that range in size between 1-100 nanometers or 100-2500 nanometers (Mandal). Common functions of nanoparticles include drug carriers, imaging contrast agents, photothermal agents, photoacoustic agents, and radiation dose enhancers (Siddique and Chow 1). To best optimize the effects of imaging, multiple types of imaging should be utilized to compensate for shortcomings in individual methods.
One of the most common medical imaging tools is known as magnetic resonance imaging (MRI). According to scientists, “in 2015, an estimate of 17 million MRI examinations were performed in the United States with the use of contrast agents” (Siddique and Chow 2). Nanoparticles serve as contrast agents that help enhance the images. The goal of contrast is for the particles to be detected in the body for a short period and to be eliminated without negative side effects. Current nanoparticles are prone to side effects such as allergic reactions, deterioration of kidney function, and other physiologic reactions (Siddique and Chow 2). Gadolinium has been a contrast agent for over 30 years and its function has been found to improve when exposed to Zinc ions. Zinc ions play an important role in enzyme-catalyzed reactions and can be used as a biomarker for insulin secretions (Siddique and Chow 2). When gadolinium interacts with an organ with a large number of Zinc ions, such as the prostate, the images are enhanced. In addition, zinc-enhanced gadolinium is more likely to attach to a target molecule in greater abundance, leading to increased contrast (Siddique and Chow 2). Therefore, by coupling MRI with gadolinium and Zinc ions, the imaging is enhanced for better detection of disease.
In addition to better imaging with MRI, positron emission tomography (PET), a type of nuclear imaging, can be enhanced with copper sulfide nanoparticles. The goal of PET is to visualize biological pathways without the need for exploratory surgery (Siddique and Chow 9). Radioactive copper sulfide can be used as a radiotracer, a type of molecule that accumulates in tumors or areas of inflammation. When combined with a peptide, “they have targeting ability and significantly higher tumour uptake (8.4 ± 1.4% injected dose/tissue)” (Siddique and Chow 9). Another method developed to increase their ability was the combination of copper and polyglucose, which have a higher antigen affinity and can be more specific in their targeting regions (Siddique and Chow 9). By pairing copper with other particles, the ability of PET to detect biological pathways has increased, allowing for better detection of tumors and other areas of inflammation.
The oldest of the three mentioned imaging techniques, ultrasound, has been around since the 1950s but is still widely used today. Ultrasound is most commonly used for the assessment of morphology, structure, and orientation of internal organs such as the uterus. Although used as a diagnostic tool, ultrasound plays an important role in the visualization of where to administer medications, or nanoparticles, for the treatment of cancer. Ultrasound uses nanobubbles, small particles with a gas core and stabilized shells (Siddique and Chow 14). Nanobubbles function by crossing the “capillary wall easily and have been used in many targeted therapies for cancer treatment, such as 5-fluorouracil loaded NBs for hepatocellular carcinoma” (Siddique and Chow 14). Another utilized nanoparticle, Chitosan, is becoming more popular due to its natural abundance, minimal toxicity, and easy portability. A study was conducted on cancer cells and determined that Chitosan nanobubbles have a high drug loading capacity and help to enhance ultrasounds (Siddique and Chow 14). By enhancing ultrasound technology with improving nanobubbles, the treatment of cancers and other diseases can become more specific and effective.
Besides managing chronic diseases and increasing diagnostic imaging effectiveness, the use of immunosignature technology has the potential to improve the detection of disease. According to scientists, “Immunosignature… is an emerging technology to predict impending disease by analyzing how an individual’s antibodies bind to proprietary arrays of random peptides…” (Hofmann et al. 1). Although not currently approved by the FDA, immunosignature has been tested in diabetes, Alzheimer’s disease, some infectious diseases, and cancer detections (Hofmann et al. 1). Through clinical trials, researchers can determine what peptides provide the best diagnostic evidence in each specific disease trial. Early trials have reported, “a high sensitivity for multiple diseases (95%)” (Hofmann et. al 1). Immunosignature allows for a potential diagnostic test that provides accuracy while testing for a wide range of diseases that previously could not be tested together before. Immunosignature tests are performed by diluting a blood sample and incubating the antibodies in an array of thousands of sequence peptides (Stafford et. al). Based on the bindings of the antibodies to the peptides, a pattern arises to determine what disease is present. Then, a chip-based computer program interprets the results (Legutki et. al 1). Although not currently approved, immunosignature provides an insight into the future of diagnostic testing by allowing for the detection of numerous diseases without the need for multiple tests or invasive procedures.
To conclude, the varying and widespread advancements in diagnostic technology are allowing for the better detection, management, and treatment of disease. By utilizing smartphone apps, those with chronic diseases can have an enhanced care plan with at-home monitoring. With imaging such as MRI, PET, and ultrasound, the use of nanoparticles can help to provide stronger contrast and increase image quality. Along with diagnostic imaging, immunosignature provides a new pathway to detecting disease using a small blood sample and antibody reactions to accurately detect the presence of numerous diseases and cancers at once. All in all, technology fosters the growth of the medical diagnostic field and anticipates a future where disease detection and treatment are available and reliable for all.
Works Cited
Hofmann, Bjørn, and H. Gilbert Welch. “New Diagnostic Test: More Harm than Good.” BMJ (Clinical Research Ed.), vol. 358, 2017, https://www.jstor.org/stable/26950168.
Legutki, Joseph Barten, and Stephen Albert Johnston. “Immunosignatures Can Predict Vaccine Efficacy.” Proceedings of the National Academy of Sciences of the United States of America, vol. 110, no. 46, 2013, pp. 18614–18619, https://doi.org10.1073/pnas.1309390110.
Mandal, Ananya. “What Are Nanoparticles?” News Medical, 26 Feb. 2019, https://www.news-medical.net/life-sciences/What-are-Nanoparticles.aspx.
Richard V. Milani, Robert M. Bober, Carl J. Lavie. “The Role of Technology in Chronic Disease Care.” Progress in Cardio, vol. 58, no. 6, Jan. 2016, pp. 579–593.Sakar Siddique, James C. L. Chow. “Application of Nanomaterials in Biomedical Imaging and Cancer Therapy.” Nanomaterials , vol. 10, no. 9, Aug. 2020, pp. 1–40.