Category: 8. Health

Samuel Bateman is a senior associate and patent attorney, and Chris Froud is a partner and patent attorney, at European IP firm, Withers & Rogers. Both specialise in advising innovative companies and developers in electronics and computing.

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The combination of enhanced imaging technologies and AI-powered robotic tools are improving diagnostics and leading to better patient outcomes. But are patients ready to accept the benefits they could bring?

The core technologies used for medical imaging, such as MRI, X-ray, CT, and ultrasound, have remained largely unchanged for decades. However, advances in AI modelling and the development of sophisticated robotic systems are providing clinicians with more accurate and reliable image data than ever before and giving them access to otherwise hard-to-reach areas of the human body.

A novel robotic bronchoscopy that uses advanced imaging technology has been heralded as a breakthrough in the safe, timely, and accurate diagnosis of lung cancer. Developed by US robotics and biotechnology company, Intuitive Surgical, the patented Ion Endoluminal System is currently being used by doctors at Wythenshawe Hospital in south Manchester in the UK. Designed for use by a human operative, it is essentially a mechanically controlled robotic tool, but its ultrathin design and advanced manoeuvrability means it can identify very small spots or lesions within hard-to-reach areas of the lung. A key benefit of the system is that it can facilitate the early detection of cancer, leading to better patient outcomes. 

The miniaturisation of advanced robotic technologies makes them ideally suited for novel invasive diagnostic tools for use before or during surgery. For example, the idea of swallowing a camera in a pill form so doctors can get a close-up view of what is happening inside a patient’s body, is nothing new. However, the inability to steer the camera meant that successfully imaging difficult to reach parts of the body, such as the point where the small intestine connects directly to the pylorus of the stomach, depended on the chance of the camera facing the right direction as it passed through the relevant part of the body.  To tackle this problem, wirelessly-operated robotic systems, taken in the form of a pill, can now perform a precise remote-controlled “capsule endoscopy”, making it much easier to record the data required by the clinician. 

For example, US company Endiatx have developed and filed a series of patent applications, including WO2023225228, towards a pill-sized robot that incorporates a series of motors, allowing the orientation of the robot and, by extension, a camera on the robot, to be controlled remotely as it passes through a patient’s body. This means that the robot is better able to obtain the images and data needed by the clinician as part of the diagnostic process.

Other advancements in robotic technologies are improving the efficacy of core imaging technologies such as CT scans and X-rays, whilst protecting patients from excessive exposure to harmful electromagnetic (EM) radiation. In the case of a whole-body CT scan, the patient is typically required to lie on a table, which enters a large ring-shaped scanner. They are then surrounded by a rotating x-ray source, which takes cross-sectional or ‘sliced’ images of the body. Modern robotic tools, which are capable of fine control, can scan the patient and generate images from various angles. This provides the clinician with a better quality and more accurate 3D image of the patient’s body without excessive exposure to electromagnetic radiation. 

Among the software advances coming through are various AI-powered platforms to speed the process of technological advancement. For example, Nvidia has recently launched its Isaac for Healthcare Medical Device Simulation Platform to support the development of the technologies involved in robotic surgery and digital imaging. Utilising pre-trained AI models for sensors and anatomy, the platform allows device manufacturers to test their systems in a virtual environment. As a result of an early-access collaboration, GE HealthCare has confirmed that it intends to use the platform to build autonomous imaging systems comprising both X-ray and ultrasound hardware, which is controlled by robotic arms that responds to a patient’s position using machine vision technologies.  For example, this AI-driven autonomous approach might be applied to GE HealthCare’s OEC 3D imaging C-arm, for which the company has a number of recently filed and granted patents, such as US2024341706A1 and US11266360B2.

A key problem that has slowed the development of useful AI-based platforms for device developers is a lack of high-quality training data. Collecting sufficient high-quality imagery of surgical or diagnostic procedures has proved challenging, and access to new banks of simulated or synthetic training data has provided a breakthrough. However, the use of such training data in the development of surgical robotic tools, and other devices used for invasive clinical applications, is a source of controversy.

Developers of AI-powered and robotic tools for applications in this area are aware that patient acceptance is critical to uptake, however there is currently a great deal of scepticism. Even though the robotic tools developed for such purposes are at best semi-autonomous, requiring a human operative, patients are naturally concerned about the risks they might pose. A recent study, published in Nature, demonstrating the efficiency of AI-powered analytical models used in clinical diagnosis has shown that whilst most can outperform a general physician, they can’t match the more nuanced capability of a medical expert with specialist knowledge. In fact, it was found that AI-powered models produce more accurate diagnoses in some areas than others – for example, they are particularly efficient in diagnosing dermatological conditions, but far less accurate when identifying gastroenterological issues. As more is learnt about the trained capabilities of these fast-evolving technologies, it is likely that patients will become more comfortable with their use, but completely autonomous diagnostic tools are unlikely to be accepted.

Familiarity should encourage public acceptance in time, and as the costs associated with developing advanced robotic systems fall, they will inevitably become more prevalent. Research by ARK Invest suggests that the average price of an industrial robot halved in the decade to 2022, and further significant price reductions have been forecast. For developers, this potential for growth means there is a strong commercial motivation to patent their innovations and, in doing so, secure a 20-year period of exclusivity to profit from their commercialisation in key global markets.

When preparing patent applications for AI-powered and robotic innovations, particularly those that bring together both technologies, it is important to extract all the valuable intellectual property (IP). This can be achieved by seeking patent protection for the constituent technologies, whilst also flagging that they can be used together. For developers seeking patent protection for AI models, it is sometimes wrongly assumed that software isn’t patentable despite the UK Intellectual Patent Office (UKIPO) and the European Patent Office (EPO) making it clear that it can meet the eligibility criteria. 

At a time when advanced technologies such as AI, data analytics and robotics are converging, medtech innovators must ensure they know where opportunities exist and what the market is ready to accept. When it comes to AI-powered robotic diagnostic and surgical solutions, early-stage projects have shown them to be accurate and reliable in some areas, but their suitability for widespread clinical use is still being evaluated. From an IP perspective, investing to build a robust patent portfolio in this area now could generate significant value in the future.

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This transcript has been edited for clarity. 

Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I’m Dr F. Perry Wilson from the Yale School of Medicine.

I am 45 years old. And I have been 45 years old for 8 months now. And I’m a doctor. A doctor who prides himself on being up to date on medical guidelines, practices, and evidence. And you know what I have not done yet? Not even made an attempt to do yet? Scheduled my screening colonoscopy. 

Let me be clear, this is not out of some high-minded concern for overdiagnosis or the issue of false positives in screening exams. This is pure, unadulterated, laziness. Or perhaps, if I’m being generous, I simply have too many other things going on in my life to take the 20 minutes to get this thing scheduled.

I probably should, because the rate of colorectal cancer among people ages 45-49 has been going up steadily since at least the mid-90s and dramatically over the last few years. We need to figure out what’s going on.

We’re going to dig into the rising incidence of so-called “early onset” colon cancer in a minute, but let me point out that, in recognition of the changing demographics of the disease, the United States Preventive Services Task Force (yes, that same USPSTF that may soon be fired en masse by RFK Jr) changed their recommended starting screening age from 50 to 45 years of age in 2021.

With a stroke of a pen, 45 million Americans were suddenly eligible for colon cancer screening, typically through colonoscopy or a fecal immunochemical test: that’s the one you do at home that lets you know if there is microscopic blood in your stool. 

And now, 4 years later, we can look back and see the effect that change in screening criteria had. In fact, appearing this week in JAMA, we have a trio of papers looking at the issue of early-onset colorectal cancer from a few different angles: How to get younger people like me to screen, how much younger people like me are screening, and how much new colon cancer we are detecting.

Let’s start with the screening numbers. In Trends in Colorectal Cancer Screening in US Adults Aged 45 to 49 Years, Jessica Star at the American Cancer Society and colleagues used a nationally-representative health survey to look at screening across various age groups and over time. 

The primary results are here.

You can see that screening is pretty rare among 40–44-year-olds and hasn’t changed much over time. That seems right; guidelines currently suggest to start screening at 45, not 40.

Moving into my age group, you see a dramatic increase from about 20% screening in 2019 and 2021 to 35% screening in 2023. 

This is about a 60% relative increase in baseline screening rates. It’s not perfect, of course. People like me who haven’t gotten around to screening yet are still in the majority, but it shows how guideline changes can move the needle on this stuff. Of course, it’s worth noting that the Affordable Care Act (Obamacare) mandates that insurers cover any screening test recommended by the USPSTF. Paying for screening also increases screening.

One concern people had about the change in guidelines was that all this new screening in younger people would crowd out screening in older people. The data, fortunately, doesn’t show this. Screening rates were high and stable in the over 50 crowd over the past 5 years. 

If you’re a believer in screening, you probably want to know how to improve rates among younger people like me. In another article in this week’s JAMA, researchers led by Artin Galoosian at UCLA report out results from a randomized trial that tried four different strategies to increase the screening rate in people aged 45-49.

A bit more than 20,000 individuals were randomized. A quarter of them were invited, via an online patient portal, to use the fecal immunochemical test (FIT) for screening. Another quarter were invited to do a screening colonoscopy. A quarter were invited to do either; they could choose which they preferred. And, finally, a quarter were simply mailed a FIT. 

Of the people invited to do FIT testing, 18% got some kind of screening, mostly colonoscopy.

Of those invited to colonoscopy, 15% were screened. Of those given the choice between the two, 18% picked one or the other. But in those who just had the test show up in the mail, 28% completed screening. This is pretty powerful data. It confirms a fundamental principle of behavioral economics: People will do something if you make it easy for them.

Anecdotally, if I opened the mail tomorrow and a FIT test was in there, I’m pretty sure I would do it. Since that isn’t standard of care (yet), I need to call my PCP (who I haven’t seen in like 5 years) and go through the rigamarole. But I’ll do it. I will. I think.

Now, I opened this commentary by mentioning that all of this research is driven by the simple observation that colorectal cancer rates are increasing in young people. A third paper in JAMA this week, Colorectal Cancer Incidence in US Adults After Recommendations for Earlier Screening, from Elizabeth Schafer and colleagues at the American Cancer Society, tracks those rates for us from 2006 on using the SEER database.

There are some really interesting findings here. Let me start with this picture, the rate of any colon cancer diagnosis in individuals aged 45-49. You see a steady uptick, about 1% per year from 2006 on, and then a dramatic increase (about 12%) in the past few years.

That’s a scary graph. But I’ll de-scare it a bit for you. Here is the graph for local colorectal cancer over that time period. These are early cancers that have not yet spread.

It looks very similar. In fact, according to the paper, nearly all of that accelerated increase in the past few years is driven by early, local cancers. That is a strong signal that it is the increased screening that is leading to increased diagnosis, as opposed to some new environmental or other exposure. And, since early cancers are more treatable, we can potentially argue that this increase is actually a good thing. Better to detect now than later.

But the rise in [colorectal cancer] in young people is not all due to screening. Here is the graph showing the rate of colorectal cancer with distant metastases over time. 

You see a steady increase — no big inflection that we can attribute to more screening. Nor would you expect there to be, as screening is really optimized to catch early cancers, not metastatic ones.

Bottom line: If you hear headlines about a startling rise in colorectal cancer in young people, realize that there is nuance here. Yes, there has been a dramatic rise in the last few years, mostly because we are catching early cancers through screening. But there has also been a slower rise over a much longer time period. Over decades.

Which leaves the question of… why? Why is colon cancer affecting younger and younger people over time? What has changed in our lives during the past 30 years? There is no smoking gun, but there are an awful lot of possibilities. I think the obesity epidemic is a big one here, and it will be interesting to see if these curves flatten in the GLP-1 era. But there are other possibilities: microbiome changes, ultraprocessed foods, even microplastics. It will take a bit more detailed epidemiology to get to the bottom of the increased risk in younger people. But, given the data, well, I should probably call my PCP and get that damn colonoscopy scheduled.

F. Perry Wilson, MD, MSCE, is an associate professor of medicine and public health and director of Yale’s Clinical and Translational Research Accelerator. His science communication work can be found in the Huffington Post, on NPR, and here on Medscape. He posts at @fperrywilsonand his book, How Medicine Works and When It Doesn’t, is available now.

Cornell food scientists have created a natural blue food dye made of algae protein that could replace petroleum-based artificial food colorants with a stable, adaptable option.

The research published July 24 in the journal Food Hydrocolloids.

Phycocyanin (PC), a protein in algae, can be used as a vibrant blue food colorant, and can also replace synthetic emulsifiers, said Alireza Abbaspourrad, the Yongkeun Joh Associate Professor of Food Chemistry and Ingredient Technology in the Department of Food Science in the College of Agriculture and Life Sciences, and corresponding author of the research.

“Consumers don’t want artificial ingredients in their food,” said Qike Li, first author on the paper and a doctoral candidate in Abbaspourrad’s lab. “They want something healthier and more natural. Specifically, they want to see a ‘clean label,’ which is a major reason we have chosen to work to increase the functionality of phycocyanin as a colorant and emulsifier.”

On its own, this extract from algae is sensitive to heat during processing and light during storage. This lack of stability makes it challenging to integrate into food formulations, Li said.

Their goal was to dissect PC into its building blocks and create a more stable form. They used a denaturant to reorganize it from large and uneven polymers into smaller and more uniform components, which exhibit a higher emulsifying capacity, Li said. These uniform particles create emulsions, which present a vibrant natural blue color and enable the protection and delivery of nutrients in oil.

They then analyzed the results with a technique called small angle X-ray scattering (SAXS), used to see the structure of materials at the nanoscale.

“It’s like using a magnifying glass to see and understand changes in protein structure,” Abbaspourrad said. “Our aim is to increase the functionality of phycocyanin as a colorant, emulsifier and antioxidant, so that on the list of ingredients, it could replace multiple synthetic items.”

Removing artificial food colorings from commercial foods has become a bipartisan hot-button issue, with Red No. 3 banned and Blue No. 1, Blue No. 2, Green No. 3, Red No. 40, Yellow No. 5 and Yellow No. 6 on the chopping block in many state bills. U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. has announced an plan to phase out certain artificial food dyes from the nation’s food supply and medications.

And consumers are eager to see the artificial blue dyes removed from common cereals, fruit snacks, baked goods, ice cream and candies.

But the food industry has cautioned that natural substitutes are often less stable, less vibrant and more expensive. Natural blue dyes are especially hard to create because blue pigments are rare in nature. The color of the sky or the vibrant blue of a morpho butterfly’s wings is the result of how light is scattered or reflected rather than due to a blue pigment.

The crude protein extracts of spirulina, where PC is a key component, are increasingly being studied and incorporated into foods. It is used as the substitute for artificial blue coloring in M&Ms. But the Cornell team believes PC may have superior properties and utility.

Abbaspourrad said the cost associated with adoption of phycocyanin in place of artificial blue dyes is likely reasonable, considering its health benefits. Next steps include scaling it up with a food industry partner.

Funding for this research came from the U.S. Department of Agriculture.

Overview

The “WHO operational handbook on tuberculosis. Module 3: diagnosis” provides an implementation guidance on detection of TB infection, disease and drug resistance within a single reference document. It also provides updates to the diagnostic algorithms, in view of new recommendations on concurrent testing of respiratory and non-respiratory samples among adults and adolescents with HIV, children with HIV, and children without HIV or with unknown HIV status. Finally, it summarizes updates on diagnostic accuracy of the WHO recommended technologies, in view of the WHO TB Diagnostic guidelines updates as well as analysis of discordant results.

This document accompanies the “WHO consolidated guidelines on tuberculosis. Module 3: diagnosis”, which summarizes and updates the latest WHO recommendations on the detection of TB infection, disease, and drug resistance for Member States, technical partners, and other stakeholders. 

Thank you. Listen to this article using the player above. ✖

A research team at Kumamoto University has identified a genetic mechanism that enables the human T-cell leukemia virus type 1 (HTLV-1) to remain dormant and undetectable in the body. The findings, published in Nature Microbiology on May 13, 2025, highlight a viral silencer sequence that suppresses HTLV-1 gene expression and may offer insights for future therapies targeting retroviral infections.

HTLV-1 (Human T-cell leukemia virus type 1)

A retrovirus that infects T-cells and is associated with adult T-cell leukemia/lymphoma (ATL) and inflammatory disorders. It is endemic in some regions of Japan, the Caribbean, and parts of Africa.

HTLV-1 is a retrovirus that can cause adult T-cell leukemia/lymphoma (ATL), an aggressive cancer. While many infected individuals never show symptoms, some eventually develop leukemia or inflammatory diseases. The virus is able to persist in the body by entering a latent state, where its genes are largely inactive, reducing its visibility to the immune system.

Identifying a silencing mechanism within the virus

In this study, the researchers mapped the HTLV-1 genome and discovered a region that acts as a transcriptional silencer. This element was found to recruit the host’s own RUNX1 transcription factor complex, which blocks the expression of viral genes. In laboratory models, removal or mutation of this silencer sequence led to greater viral activity and increased immune system recognition.

RUNX1 transcription factor

A protein complex involved in gene regulation that plays a role in blood cell development and cancer. 

The study was led by Professor Yorifumi Satou of the Joint Research Center for Human Retrovirus at Kumamoto University. His team’s findings reveal a viral strategy for maintaining dormancy that is built into the genetic architecture of HTLV-1 itself.

Application to HIV latency and treatment

To test whether the silencer could affect other retroviruses, the researchers inserted the sequence into HIV-1, the virus that causes AIDS. When modified in this way, the HIV virus showed reduced replication and lower levels of host cell killing, suggesting a shift toward latency.

This finding indicates that the silencer mechanism discovered in HTLV-1 may be repurposed to develop new strategies for managing HIV and potentially other retroviruses. By promoting a controlled latent state, it may be possible to reduce the harmful effects of viral replication while enhancing the ability of therapies to target infected cells.

Implications for treatment in endemic regions

HTLV-1 infection is concentrated in certain areas, including parts of southwestern Japan, the Caribbean and Central Africa. The identification of a viral latency mechanism offers a clearer understanding of how the virus persists for decades and may help inform strategies to limit progression to leukemia or other conditions.

Reference: Sugata K, Rahman A, Niimura K, et al. Intragenic viral silencer element regulates HTLV-1 latency via RUNX complex recruitment. Nat Microbiol. 2025;10(6):1447-1462. doi: 10.1038/s41564-025-02006-7

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