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Theranostic devices for tailored diagnosis and therapy

What if there was an implant which is capable of diagnosing an ailment and monitoring the individual therapy progress almost instantly? What if this smart device could not only monitor its surroundings, but also its own structural wear, while continuously giving feedback on the efficiency of the treatment? This is basically the concept of theranostics, a hybrid made of therapy and diagnostics. In recent years, physicians and engineers worked together to realize and improve theranostics devices, which can be implanted into the body to diagnose and treat diseases simultaneously and in a save manner. By taking into account the patient’s individual biology, predispositions and the knowledge of how the patient adapts to a certain therapy, the efficiency of the treatment can be increased significantly. The monitored data can also be used by the device to detect and impart its own rate of wear. 1

Theranostics are made of Sensor-Actuator-Systems which can sense surrounding information and react immediately. Progression in the fields of nanoscience, information and communication technology as well as advanced manufacturing are leading the field of theranostics to grow rapidly. Major applications in healthcare are3:

Theranostic prosthetics

Theranostic implants, e.g. for hip or knee, can be used for long-term replacement of human joints or bone parts. Conventional hip or knee replacements are very costly, while not providing perfect long-term success, as altering of body conditions as well as ageing are strongly affecting their functionality. Therefore, replacements of the implants after one or two decades is a common surgery. A theranostic implant can solve this problem by monitoring changes in in vivo conditions and adapting accordingly. Moreover, by detecting early signs of loosening they can prevent complications, by facilitating early anticipation. They can provide information about osseointegration and implant load metrics. Currently, a smart hip endosprosthesis is tested which detects loosening in early stages by measuring small scale vibration changes with inbuilt sensors. The recorded values are then transferred to the external control unit, where they can be processed, via RFID. Is the loosening greater than a certain threshold, the integrated actuators become active and regulate positioning and fit of the prosthesis. This is performed using electric, magnetic as well as thermal energy, which introduce material change in the implant. The required energy is transferred from the external control unit wireless. As arthroses is a common disease and especially increasing with the ageing of the population, using smart hip prostheses can potentially benefit a quite large number of patients. 2

Neurological implants

Through theranostic implants which are located at the site of disease or defect in the brain, exact doses of necessary drugs can be delivered directly at the target area over a period of time. Thus, brain tumours for example can be treated more efficiently and damage of surrounding tissue is prevented. However, neurological devices are still the developmental state as they require an enormous amount of precision and accuracy at nanoscale.

Cancer

Not only tumours in the brain can be treated using theranostic implants, but also other cancers like breast, prostate or thyroid cancer. Implants at the source of cancer can help administering the quantification and qualification of antibodies needed to treat the tumour sufficiently.

Cardiovascular

Continuously monitoring blood pressure, pulse, temperature or blood levels of specific substances can be of high value for those suffering from chronic diseases like hypertension or diabetes. Current diagnostic methods take up a lot of time and effort as well as discipline. Instead, blood levels could be tracked continuously and used as base for fast treatment adaption. Moreover, even though not the target area, these devices could also be used for self-monitoring in terms of self-optimization.

Though still in its infancy, the technology of theranostics has been introduced into to applications in the therapeutic and diagnostic field, recently. The main advantages of theranostics are the facilitating of patient-specific diagnostics and treatments as well as the enabling of precise, punctual and granular therapy approaches. However, research is still trying to make applications even smaller and increase long-term stability as well as safety.

Though still in its infancy, the technology of theranostics has been introduced into to applications in the therapeutic and diagnostic field, recently. The main advantages of theranostics are the facilitating of patient-specific diagnostics and treatments as well as the enabling of precise, punctual and granular therapy approaches. However, research is still trying to make applications even smaller and increase long-term stability as well as safety.


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References

1 Töppel, Thomas. Structural Integration of Sensors/Actuators by Laser BeamMelting for Tailored Smart Components. 2019

2 https://www.fraunhofer.de/de/forschung/fraunhofer-initiativen/fraunhofer-leitprojekte/fraunhofer-theranostische-implantate.html

3 https://www.dr-hempel-network.com/digital-health-technolgy/theranostic-implants/

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