Engineering in Medicine and Biology : interview with Prof. Cerutti
After a very brief summer break, MiCo (Milano Congressi) reopened for business again, hosting from August 25th to 29th last the 37th edition of the Annual Conference of the IEEE Engineering in Medicine and Biology Society. An event of absolute world importance that gathered together in Milan the world’s leading Biomedical Engineering operators and researchers. For Milan and for Italy a source of pride and satisfaction, bearing in mind that this marks the first time that a great scientific Biomedical Engineering society has chosen our country for an appointment of such extraordinary call.
The themes of the congress were as many as the various “specialities” of which Biomedical Engineering or Bioengineering are composed, from nanotechnologies to biomedical imaging, and from cellular and tissue biomaterials to robotics and telemedicine, to mention just a few.
For an assessment of the meeting – albeit summary in view of the issues dealt with and the scope of the undertaking – in which over 3,200 delegates from the whole planet representing more than 50 different countries participated – we hear Prof. Sergio Cerutti of the Polytechnic of Milan, Chairman of the conference together with Prof. Paolo Bonato of the Harvard Medical School of Cambridge.
MiCo: Professor Cerutti, can the choice of Milan, and of Italy in general, be interpreted as recognition of the quality of our research in the biomedical field?
Cerutti: It certainly can. In the more traditional biomedical sciences such as Biology, Physiology and Medicine, our research has always been in the forefront in terms of specific contributions. And that is borne out by objective data, especially when viewing the results of the research against the number of active researchers and against the public and private investment in our country, which are always significantly lower even compared with other European countries. This holds true as well for Biomedical Engineering or Bioengineering, which is a relatively recent research discipline that came into being the 1960s and 1970s, and which has given rise to specific courses of study in the sector, set up in Italy beginning from 1992. Right from the start the research performed in the sector in Italy has always been in line and highly competitive with the most renowned centres on an international scale, and the choice of Italy and of Milan is certainly an important acknowledgement of this.
MiCo: Which are the centres of excellence in our country? And where in Italy and in the world does Biomedical Engineering work in closest contact with the medico-clinical facilities?
Cerutti: I must say that almost always the centres of excellence in the Biomedical Engineering sector have formal or informal points of contact with hospital structures to verify “in the field” the real effectiveness of innovative instruments in the Life Sciences for diagnosis, therapy and rehabilitation. In our country there are various universities that have developed specific skills and that are recognized internationally: the Polytechnic of Milan was the first to undertake the teaching of Biomedical Engineering and to introduce formal courses of study in the sector.
Next the University of Genoa and University of Padua; then the University of Pisa and the “Scuola Superiore Sant’Anna” of Pisa and the Polytechnic of Turin. But also the various universities of Rome (“La Sapienza,” “Tor Vergata,” “Roma 3” and the Biomedical University Campus, as well as “Federico II” University of Naples. Moreover, important CNR (National Research Council) structures engage in important activities in the sector, as does the “Istituto Superiore di Sanità” health institute of Rome and IIT (Italian Institute of Technology) with headquarters in Genoa. Then there are various Institutes of Hospitalization and Care of a Scientific Nature (IRCCS), such as the Don Gnocchi Foundation, San Raffaele Hospital, the “C. Besta” Neurological Institute, the “Monzino” Cardiology Centre, or the National Cancer Institute, the “Istituto Auxologico” in Milan, the Medea Foundation in Bosisio Parini and many more.
At the international level the list of the centres of excellence that have important points of contact with clinical reality would be too long. Here I want to mention just MIT, Harvard University, Case Western Reserve University and the University of Minnesota at Minneapolis St. Paul in the United States, the Federal Polytechnic of Lausanne and of Zurich in Switzerland, Twente University in Holland, etc., in addition to various centres in Japan, Australia and Israel.
MiCo: Let’s get to the conference. Which themes were dealt with and which were the most interesting reports? Which are the most advanced areas in biomedical research?
Cerutti: The research topics dealt with were:
- Biomedical Signal Processing;
- Biomedical Imaging and Image Processing;
- Bioinstrumentation, Biosensors and Bio-Micro/Nanotechnologies;
- Bioinformatics and Computational Biology;
- Systems Biology and Modelling Methodologies;
- Cardiovascular and Respiratory Systems Engineering;
- Neural and Rehabilitation Engineering;
- Cellular and Tissue Engineering and Biomaterials;
- Biomechanics and Robotics;
- Therapeutic and Diagnostic Systems, Devices and Technologies and Clinical Engineering;
- Healthcare Information Systems and Telemedicine;
- Biomedical Engineering Education;
- Technologies for Active Ageing and Wellbeing.
As you can see, all the most interesting and current problems in the vast area of Biomedical Engineering are included.
We also had a Symposium on “Major Challenges in Brain Research in Europe and the USA,” where the visions were compared with regard to the two largest funded projects on the brain, in Europe (Human Brain Project) and the United States (BRAIN Project), which recently have got underway.
Other noteworthy events included Workshops/Tutorials, Mini-symposiums and Guest Sessions with focus ranging from the behaviour of biological systems in the absence of gravity (in collaboration with ESA/ASI) to the most sophisticated mind/brain communication systems (Brain-Computer Interfaces) for rehabilitation and individuals with motor or cognitive handicaps, to new wearable IT devices for the remote monitoring of patients with various pathologies, as well as of healthy individuals to evaluate their physical efficiency also during the aging process. Not by chance the Meeting was called “Biomedical Engineering: A Bridge to Improve the Quality of Healthcare and the Quality of Life,” aimed at giving more Life to the Years and not just more Years to Life.
MiCo: From valves to cellular materials, from robotics to diagnostics and to anti-aging technologies, what more can we expect from Biomedical Engineering? Which paths will be taken in the near future?
Cerutti: The possibility of realizing a truly “personalized” medicine appears very promising, crossing case-history data with data coming from more and more sophisticated instrumental investigations using images and signals, with data coming from the genome and from the proteome of the single patient, all of which for the purpose of reaching a better understanding of the onset of pathologies in individuals who may be predisposed in terms of family history, as well as of performing the segmentation of patients to distinguish those who certainly will benefit from a certain therapy from those who will not be “responsive”; think, for example, of oncologic therapies that present numerous side effects and that thus can be better singled out and more easily hit the target.
Furthermore, ever increasingly more advanced neuro-technological techniques and robotics will make it possible to increase the sensory abilities of handicapped individuals or even to entirely replace improperly functioning sensory organs (with, for example, the artificial retina, the artificial ear, the artificial skin and pancreas, and also to correct various other motor and sensory functions, by means of new biotechnologies realized with stem cells and/or with more and more advanced biomaterials).
MiCo: How does the physician’s role change with biomedical engineering? Is it the physician who becomes an engineer or the engineer who acts as a physician?
Cerutti: With the technological evolution so driven both the engineer and the physician certainly will have to change with respect to their traditional roles up to now. But certainly both the engineer and the physician will have to maintain two quite distinct professional areas and with tasks that are certainly different.
However, the two figures will have to collaborate and to integrate their knowledge and skills to provide both the world of research and that of clinical applications with the innovation that in the future will only come fruitfully from figures inclined to take an interdisciplinary approach. And this is what today’s society is calling for: more “intelligent” care making use of the most modern technological instruments, which is truly personalized and not just corroborated by favourable statistical data.
MiCo: What are you working on in the Department of Electronics, Information and Bioengineering of the Polytechnic of Milan of which you are a part?
Cerutti: The principal lines of research in the Biomedical or Bioengineering sector are:
- Biomimetics and micro-nanotechnologiess. Study of the molecular and cellular level of phenomena that are significant for regenerative medicine, the development and characterization of biomimetics systems, the study of the bimolecular bases of pathologies, and the design and realization of micro-fluid platforms for diagnostics and therapy.
- Physiological models, clinical diagnostics, health and e-health systems. Integration of different types of information (signals and images) for an understanding of the mechanisms of the functioning of physiological systems, the identification of early signs of pathology, the development of innovative diagnostic approaches and the integration thereof in patient-specific procedures and services.
- Technologies for therapy: Design, prototyping and application of technologies for assisted surgery and radiotherapy. Specific research interests regard methods and instruments for pinpointing in three dimensions, navigation in mini-invasive surgery, medical robotics and microrobotics, the pinpointing of the surgical target, and surgical planning.
- Technologies for functional assessment and rehabilitation: The activity is aimed at the improvement of the condition of patients with disturbed movement (infantile cerebral paralysis, Down’s syndrome, Parkinson’s disease, food disorders, cranial traumas, amputees, etc.) through quantitative movement analysis, with particular focus on the development and implementation of experimental set-ups, and methods for data processing and representation in the clinical sphere.