Design of a navigational catheter system for the targeted delivery of therapeutics within the suprachoroidal space.

Diseases of the posterior segment of the eye are common causes of blindness and can be difficult to treat due to their location. Recently, there has been increased interest in the use of the suprachoroidal space to deliver therapeutics to the posterior segment. This space is accessible through a trans-scleral approach and blunt dissection of the adjacent scleral and choroidal tissues. However, despite recent commercial interest, there are few tools designed specifically to provide targeted delivery of therapeutics to a localised region within the suprachoroidal space. Therefore, we designed and prototyped a novel navigational catheter system for the targeted delivery of payloads within the suprachoroidal space. The system consists of a customised catheter tip designed to minimise blunt dissection stresses on neighbouring tissues, a mechanism for controlled catheter navigation, and a method for targeted delivery of large payloads. A customised in vitro model of the eye was also designed to visually demonstrate the capability of the catheter system to controllably navigate within the suprachoroidal space and deliver a targeted payload. This system can enable the delivery of large therapeutic payloads to the eye for the treatment of posterior eye diseases, thereby impacting the development and availability of vision-saving treatments.

Constructing and Pilot Testing a Novel Prostate Magnetic Resonance Imaging/Ultrasound Fusion Biopsy Phantom.

OBJECTIVE: To describe the design and build of a novel phantom for magnetic resonance imaging (MRI)/ultrasound (US) fusion biopsy and present pilot testing results from a multicenter urology resident training session. METHODS: We cast our phantom from polyvinylchloride-plastisol that features 10 mm and 5 mm blue clay tumors, a urethral lumen, and an echogenic capsule. T2-weighted images were acquired with a 3T MR750 scanner (GE Healthcare, Boston, MA). Fusion testing was performed on the bkFusion system (BK ultrasound, Peabody, MA) with MIM Symphony software (MIM, Cleveland, OH) and an 18-gauge Bard Monopty disposable gun (Bard, Murray Hill, NJ). Twenty residents from 6 urology programs in Chicago performed proctored user testing. RESULTS: The per phantom material cost was $12. The phantom was compatible with all necessary equipment to create a MRI/US fusion data set. MRI and US imaging characteristics were excellent with hypointense lesions. Image fusion was achieved through both end and side fire ultrasound probes. The phantom allowed for biopsies to be performed, and target lesion hits were confirmed by visual inspection of core samples. 38% (8/21) of urology resident pilot testing participants had previously performed a fusion biopsy. The mean postsession survey scores were (1-10 [best]): realism 9.0, usefulness 9.4, ease of use 9.1, ease of orientation 8.9, and overall experience 9.3. CONCLUSION: This simple and inexpensive phantom allows for training and accuracy testing of MRI/US fusion biopsy hardware and software platforms.

Novel device for male infertility screening with single-ball lens microscope and smartphone.

OBJECTIVE: To investigate the usefulness of a novel semen analysis device consisting of a single-ball lens microscope paired with a state-of-the-art smartphone equipped with a camera. DESIGN: Laboratory investigation. SETTING: University research laboratory. PATIENT(S): A total of 50 semen samples obtained from volunteers were analyzed for count, concentration, and motility with an 0.8-mm ball lens and three types of smartphone. Comparisons were made with results obtained with a laboratory-based computer-assisted sperm analysis (CASA) system. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Sperm concentration; sperm motility. RESULT(S): Sperm concentration counted with a ball lens and each smartphone showed a very strong correlation with the CASA results. Likewise, sperm motility calculated with our device showed significant correlations to CASA. If eight spermatozoa or fewer were found on the field of view of an iPhone 6s, the semen specimens were considered to be below the lower reference limit for sperm concentration of World Health Organization 2010 guidelines (15 × 10(6) spermatozoa/mL). The sensitivity was 87.5%, and specificity was 90.9%. CONCLUSION(S): Smartphones have great potential to analyze semen because they are portable, contain excellent digital cameras, and can be easily attached to a microscope. A single-ball lens microscope is inexpensive and easy to use for acquiring digital microscopic movies. Given its small size and weight, the device can support testing for male fertility at home or in the field, making it much more convenient and economical than current practice. This single-ball lens microscope provides an easy solution for global users to rapidly screen for male infertility.