The best ideas can come at the oddest of times.
Just ask oncology surgeon Nancy DeMore. While performing a lumpectomy, she asked herself why there wasn’t an easier way to do the procedure that wouldn’t involve two invasive procedures.
DeMore, who’s also a researcher at the Medical University of South Carolina, says it really wasn’t even a conscious thought. She just heard the question come out of her mouth and thought, why not find out. And, she knew just where to find a possible solution. She had done a talk at the 2015 Women’s Innovation Symposium at MUSC and met another presenter, Delphine Dean.
She was impressed by Dean, who holds a degree from MIT in electrical engineering and computer science and directs the Multiscale Bioelectromechanics Lab at Clemson University. Instead of just passing off her idea, she picked up the phone.
She described the problem to Dean. When a patient has an abnormal mammogram and the radiologist does a biopsy for a suspected cancer, a titanium clip is inserted to localize where the tumor is. If the patient needs a lumpectomy, the patient goes to radiology where a wire is inserted into the breast to localize the titanium clip. She then goes to the operating room where the surgeon removes the breast tissue around the wire. This two-step process is inefficient and inconvenient for patients, and sometimes causes pain from insertion of the wire.
The reason why the marker clip inserted into the breast is made of titanium is because it is very weak in electromagnetism, meaning that patients can have MRIs in the future, and it won’t set off metal detectors at airports.
DeMore’s question: Would it be possible to make a metal detector that could detect titanium? Her hunch was that if the surgeon could find the location of the titanium clip in the operating room with the metal detector, this would eliminate the need for wire localization.
Dean rose to the challenge, pitching the idea to students in her bioinstrumentation class who were intrigued by the project. Ideas and plans flew back and forth between MUSC and Clemson, with a group of Clemson students taking on the task and spending long hours in the lab.
Over time, all the brainstorming and work paid off. In August 2016, a patent was filed on the resulting hand-held detector. The prototype is set to go through pre-clinical trials and potentially will be on the market for use in two years, DeMore says.
Meanwhile, the idea and resulting design is getting rave reviews and winning awards. DeMore presented the idea at the Charleston Southeast Medical Device Association Pitch Rounds competition at MUSC's Drug Discovery Center, an event sponsored by MUSC and the Foundation for Research and Development. She won and now will be going on to compete in Atlanta later this month. DeMore says it was a tough competition. “There were some other outstanding technologies that were equally as worthy, so I was really surprised. I’m really impressed with the technologies that are being developed in this region.”
DeMore also recently presented at the Society of Surgical Oncology’s “Innovations in the Operating Room” and won that competition.
DeMore noted she isn’t the only surgeon frustrated by a process that’s inefficient and inconvenient for patients. “Surgeons constantly have ideas of how to improve techniques because we’re the ones who are doing this every day. Many times we may have the ideas, but we have no idea of how to implement, so we just go on to our next patient.”
In this case, DeMore is glad she didn’t. It’s important for surgeons to be interested in bringing innovations to their field, she says, and the innovation competitions help. “I’m so pleased to see the Society of Surgical Oncology put together the first session on innovations in the operating room — really highlighting the importance of this in our field.”
Team Science
What also really helps, though, are collaborations, DeMore says, adding how impressed she was with Dean’s team.
Dean agrees. “Sure, it’s four hours apart, but it doesn’t feel that far apart. The Clemson-MUSC collaboration works really well. We make a lot of effort in our state to bridge that gap in the biomedical space.”
She’s seen the payoff with her students, who are prone to think outside of the box and bring fresh ideas to the table when allowed to work on real-world projects. “When you learn in a classroom by looking at slides and listening to lectures is very different from talking to a clinician who uses these devices.”
Dean says she knows patients who’ve had to undergo the two-step process for a lumpectomy and how scary it was for them. It is gratifying to work on a project that will improve that experience and lower costs, and her students benefitted from the clinical knowledge they got from DeMore, who has been very responsive. How well the device is being received has surprised all of them. “It blew up, and there’s been a lot of interest from the outside. It was eye-opening for the students. The MUSC tech transfer office moved things forward quickly.”
The project challenged her students. It took a “lot of tuning” and customization for clinical purposes and computational modeling, but the team kept working.
Clemson University senior Scott Slaney says it’s the most rewarding thing he’s ever done during college. “We do a lot of learning about basic science behind these concepts, but seeing how all these moving pieces fit together to make a single working device is really a cool experience. To actually take something that sounds like it only has a few engineering principles and make it work in a medical environment is its own kind of beast to tackle. I was happy to learn about the need for this procedure and what seems to be an underserved community of the population,” he says.
Dean notes students often bring passion to their projects, as can be seen in the students who worked on the project, including Slaney and classmate Joey Wilson, who’s president of Clemson's undergraduate student government. As bioengineering students, they want to find creative solutions to problems within medicine, Wilson says.
“This is our why. This drives us and reminds us that this project is much bigger than ourselves. It could make a significant impact on the clinical cycle of care for hospitals and breast cancer patients — saving time, money, and operating room space, while preventing unnecessary human suffering.”
He really enjoyed the challenge of the project and taking a problem that no one has tackled to date. “It’s why the status quo has been maintained for so long. For us, the reasoning of ‘it's the way it has been done for a long time,’ is not sufficient. At Clemson and MUSC, I truly have surmised that we are thinkers, we are innovators, and we are believers.”
Wilson says the project, though challenging, brought amazing opportunities to the team. The collaboration with DeMore and their research mentor, Dean, was critical. The team also learned how broad the field of bioengineering is, he says, adding that what they had to learn about metal detectors went far beyond the basics of their bioinstrumentation class.
“We had to find creative ways to educate ourselves about metal detectors and all of the components that make them work. The idea behind them is relatively simple, but all of the ways that operational metal detectors are created are complex and were out of the scope of our curriculum,” Wilson says.
When it got tough, team members reminded each other why they were there.
“We’re inspired by the opportunity to improve patient outcomes and change lives for the better. In the uphill battle against cancer, we're making a little progress — and hopefully scientists will one day find a cure," Wilson says.
Dean says she expects to see more of these collaborations in the future, particularly given how well this one worked. “There’s no better way to teach our students than the real-world environment. It’s a win-win.”
It’s a win for MUSC as well, says DeMore. “It can save the patient from having to have the pain and inconvenience of having an invasive procedure to localize the clip, and it can improve the efficiency of the whole procedure for the patient and the hospital."