In future, hardly any other development will leave its marks as strongly on modern industrial societies as demographic change, which will lead to a strong increase in age-related diseases (for example cardiovascular diseases, cancer and neurodegenerative diseases). Modern medicine is based on the quantitative measurement of both physiological quantities and cellular and molecular processes. In the human body, these quantities are closely interconnected and very important for an improved diagnosis of a disease and for well-founded therapeutic decisions. Furthermore, quantitative measurement procedures play a key role in the detection, for different patients, of changes in the individual measurement values of a patient due to a therapy. This tendency of an evidence-based and personalized medicine has positive effects on the world-wide growth market of "medical engineering". PTB supports industry especially in the fields of laboratory medicine, imaging and environmental technology.
About 70 % of all medical diagnostic decisions are based on results of laboratory medicine which is mainly based on the quantitative analysis of body fluids. Thereby, the concentration of biomolecules, among other things, is determined which can be used as diagnostic markers, e.g. for the diagnosis of cardiovascular diseases or a virological or bacterial handicap. This requires the secure identification of relevant molecules and their exact quantification. Procedures used in clinical practice must have been validated by means of primary procedures. Currently, these are generally based on mass spectroscopy which can be used for smaller molecules with molar masses up to 1000 g/mol. However, many important diagnostic markers are macromolecules with molar masses up to several million g/mol. Routine procedures to analyze these markers often do not provide concordant results. The urgently required traceability of those measurands requires completely new strategies for primary procedures. Here, solutions will be developed on the basis of biotechnological and optical-analytical measurement procedures.
Measurements of cell concentrations – the most prominent example is the "complete blood count" – are very frequent analyses in laboratory medicine. They are particularly important for therapeutic decisions and checks. New approaches in laboratory medical diagnostics require improved methods of identification and counting of rare cell types in smaller sample quantities. Here, the development of reference procedures and their validation by means of round robin tests are required.
New quantitative measurement and analysis procedures in the field of in-vivo imaging by means of ultrasound, X-ray and magnetic resonance (MR) are developed to support the diagnosis by means of image contrasts. The measurements of physiological parameters, such as local blood circulation, oxygen supply and metabolism, is of high importance here. In addition, imaging will be increasingly combined with local spectroscopic measurements and electrophysiological examinations. The aim is to be able to measure functional effects with higher accuracy and sensitivity.
During the last few years, multi-modal systems (e.g. PET-CT, PET-MR) have increasingly found their way into the daily routine of hospitals. Therefore, combined measurement and reconstruction procedures will become more and more important, as new iterative reconstruction algorithms often have a greater influence on the measurement accuracy than the actual measurement procedures themselves. New reconstruction procedures are already being used for dose reduction in surgery-accompanying X-ray imaging and in computer tomography which require new approaches to be developed for the individual dose determination. The combination of therapeutic procedures with imaging diagnostics is also a current tendency in medical engineering. This allows both image-guided therapy and direct local therapy checking. For the combination of radiation therapies including MR imaging, there is a great need for reference phantoms and new dosimetry procedures which allow the therapy dose to be precisely determined in the high MR magnetic fields or even simultaneously for MR diagnostics. A long-term objective of these developments is a reliable measurement of the biological effectiveness of a radiation therapy with simultaneous MR imaging, e.g. of a radiated tumor and of the surrounding healthy tissue.
Nanoparticles are of increasing importance for medical diagnostics and pharmaceutical applications. Magnetic nanoparticles are already a fixed component in laboratory diagnostics, e.g. for cell characterization. In future, they will be used as a marking compound in MR imaging or as a contrast agent in magnetic particle imaging. They also permit new approaches in cancer therapy. The diagnostic quality and the therapeutical effect, in particular, depend on the magnetic properties of the nanoparticles used. Their pharmaceutical kinetic behavior will, however, be strongly determined by the shape, the size and the electric charge. Methods adapted to these applications of magnetic, electric and dimensional characterization of magnetic nanoparticles are therefore required for the assessment of both the effectiveness and patient safety.
Hearing protection will become an increasingly important task to ensure the quality of life in an ageing society. An incompatible noise exposition at workplaces or in the private living environment is to be avoided. New procedures for the determination of the perceptible strain due to infrasound and ultrasound, i.e. at frequencies below and above the typical human hearing range, are of high importance for the understanding of detection mechanisms and the evaluation of possible negative environmental influences on health.