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At the 13th EFR Congress in April 2014, Prof. Dr. Karin Mittmann was awarded the Hörhager Poster Prize for her presentation "Laparoscopic fluorescence imaging following endoscopic colorectal tattooing using a persistent near-infrared marker".

This year's European Congress of the Federation for Colorectal Surgery was dedicated to paradigm-changing innovations in colorectal surgery. The Hörhager Poster Award was presented in Vienna by Prof. Dr. med. Irene Kührer, Co-President of the EFR, for the pioneering collaboration between the EUREGIO BioMedtech Center at Münster University of Applied Sciences, the University Medical Center Schleswig-Holstein, Lübeck site, and the Asklepios Clinic, Hamburg-Barmbek.

Colorectal cnacer is recognized as a priority in cancer control and care by European Union. Therfore the European Fereation for coloRectal cancer was founded in 2003 to bring all scientist together who are involved in this disease to share their knowledge and to inforce networking betewwn the different professions.

The EFR-Congress this year also adressed state-of-the-art multidisciplinary management of colorectal cancer. The optimal method to diagnose and teat this common cancer required a multidisciplinary approach.

Improved cancer detection along the entire value chain: The INTERREG project "InMediValue" at Münster University of Applied Sciences developed three innovations together with seven project partners from Germany and the Netherlands. In three interlinked sub-projects, the consortium worked on a pain-reduced examination procedure for breast cancer, a technology with artificial intelligence (AI) that detects tumours on X-ray images and a new type of marker that makes it possible to detect affected tissue during minimally invasive operations.

"We are very satisfied with the results and are delighted to have completed the project with an outstanding output," says project manager Prof Dr Karin Mittmann from the EUREGIO BioMedtech Center (EBC) at Münster University of Applied Sciences. It was particularly important to the initiator of "InMediValue" to involve all disciplines concerned: "Partners from the engineering and natural sciences, from medical technology companies and from clinical practice worked together on the project. This enabled us to ensure that the innovative findings could also be put into practice and we received direct feedback from the clinicians who tested the technology in studies so that it could be used on patients in the future," says Mittmann. Over the course of the project, the consortium has applied for a patent, tested the technologies in four clinical trials and already published four international publications.

The first innovation starts with breast cancer screening. The Institute of Clinical Radiology at Münster University Hospital (UKM) and the medical technology companies Holland Innovative BV and Sigma Screening BV have developed a special compression plate to increase the quality and participation rate of mammography. "During mammography, the breast tissue has to be compressed in order to take X-ray images of it. This procedure is sometimes perceived as painful by women. The developed plate determines the pressure and adjusts it individually," explains Mittmann. In addition, 3D images were taken in several planes, enabling a more precise diagnosis.

In the second sub-project, the UKM and the medical technology company ScreenPoint Medical BV developed an AI-based technology that analyses the 3D images from the mammography. To do this, the program learned to recognise so-called suspicious areas - tissue in which tumours are suspected. The AI can also distinguish the smallest calcium deposits in breast tissue from tumours. The programme can significantly reduce the number of false positive findings. It provides valuable information for radiologists and thus supports the diagnostic process.

"Our third innovation is a multimodal imaging marker: a liquid that is injected near the tumour before the operation," says Mittmann. This marker combines two properties that have never been combined before. It contains tiny magnetic particles and fluoresces in the near infrared range. This makes it easy to find the suspect tissue during minimally invasive surgery - using a fluorescent laparoscope for the fluorescent ingredients or a hand probe for the magnetic particles. "Both methods have their strengths, which we have now combined," explains the project manager. "The optical method provides a precise image through several layers of tissue. Magnetic detection can locate regional lymph nodes during surgery, which can be used to determine whether the tumour has already spread." The EBC worked on this sub-project together with the biotechnology company Cysal GmbH from Münster and the TechMed Centre at the University of Twente.

Mittmann summarises: "I have to express great praise for the entire consortium. Despite corona, we have achieved all the milestones with the project extension and much more besides."
On the subject: The cross-border, interdisciplinary project "InMediValue", short for "Innovation in medical imaging value chains", with a duration of four years, was funded with more than 2.3 million euros in the INTERREG V programme. More than 20 people are involved across borders, working for the companies Screenpoint Medical BV from Nijmegen, Sigmascreening BV from Enschede, Holland Innovative BV from Enschede, Cysal GmbH from Münster, TAFH Münster GmbH and the Institute of Clinical Radiology at Münster University Hospital (UKM), the TechMed Centre at the University of Twente in Enschede and the project management at the EUREGIO BioMedtech Center at Münster University of Applied Sciences in Steinfurt.

Innovations for medical imaging: This is what the German-Dutch project "InMediValue" is all about, in which our university collaborates with representatives of the Institute of Clinical Radiology (IKR) at Münster University Hospital (UKM), the University of Twente and industrial partners from the Netherlands and NRW.

In concrete terms, a total of three projects are being worked on: Subproject 1 deals with the optimisation of breast compression in mammography - the interdisciplinary team aims to improve the comfort of screening mammography and at the same time increase the quality of settings and images. Subproject 2 focuses on the use of artificial intelligence in the early detection of breast cancer, while subproject 3 develops novel markers and their detection to better identify tissue changes in the body. The "InMediValue" project partners discussed the status of the respective subprojects at the UKM.

The basic aim of the INTERREG project is to develop modern techniques around medical imaging for concrete use in hospitals and medical practices. In the end, women in particular should benefit from improved diagnostics and early cancer detection.

Dr. Helmut Ahrens gives a course on sterile work in the operating theatre at the FH Münster

"Unsterile, out!" and "Remember the altar boy!" were the two favourite sentences of Dr. Helmut Ahrens, who gave a further education à la Edutrainment - Education, Training, Entertainment - at the University of Applied Sciences Münster. Interactively, amusingly and highly instructive, the doctor at the Clinic for General Orthopaedics and Tumor Orthopaedics of the University Hospital Münster transformed the seminar room into an operating room and the 40 participating students of Biomedical Engineering into surgical assistants - in full uniform with smock, mouthguard and hood.

The top priority in the operating theatre is and remains: The environment and all persons must be sterile. Anyone who does not comply with this rule will be fired. The students learned, among other things, that for the operating theatre they have to rub disinfectant not only on their hands but also on their forearms. Under UV light, they could check how well they had done. And afterwards they were not allowed to bring their hands below the belt. "A little tip: Folding your hands like an altar boy is a bit more comfortable than just holding them up, it gets really tiring at some point," said Ahrens. Also a must: the greatest possible distance of at least 50 centimetres from objects and other people. If you have to get past somebody, you first look for close shoulder contact and then choose the back-to-back method: you roll yourself past them, so to speak, around the person - because the gowns in the operating theatre are closed at the back, and thus the backs are the zones that are least sterile.

Ahrens also had answers to the questions essential for the operating theatre. How does a long beard disappear under a mask? "Most of my colleagues put a pigtail in their mouths." With or without socks in the OR? "I like to go into my shoes without socks on and let the blood dry up and run down if something goes wrong at the operating table." What if I sneeze during surgery? "You walk back away from the patient as soon as possible and then sneeze all over him. The germs will either hang in your mouth guard or be shot off to the left and right sides." And why is everyone wearing green in the operating room? "If you look into an open abdominal cavity full of red blood for three hours and then look somewhere else, you'll see spots everywhere on light surfaces, you'll go crazy." The green intercepts this effect of the eye.

The winner of numerous teaching awards demonstrated an operation on an ankle joint to the course participants. He also explained to them the signs of ascending fainting, so that the future medical technicians could still leave the room in time. At the end, everyone in full surgical clothing was given gloves to put on. And don't forget: "If you shine as a student with ignorance, you will be exposed in the operating theatre.

Ahrens had come to the Steinfurt campus of Münster University of Applied Sciences for the first time with his advanced training course on sterile working "Sterile remains sterile even if it falls to the floor - Why there is no 3-second rule in the operating theatre" at the invitation of Prof. Dr. Karin Mittmann and her team from the Department of Physical Engineering. "Both bloody first-year students and master's students who are already in their final dissertation were enthusiastic about training sterile handling in the operating theatre", says Prof. Mittmann.

Trends in the medical industry, informative demonstrations and excellent opportunities to test the latest equipment systems live, the participants did not miss out on the excursion.

Top topic fluorescence and laparoscopy:

We informed ourselves in detail about the latest developments in laparoscopy, such as NIR fluorescence detection, and tested them hands-on. The students were impressed by the opportunity to discuss detailed questions with the developers and to compare the image quality of the videos from different manufacturers. We also tested the latest developments for 3D imaging of the laparoscopic surgical field. Some of the equipment systems that have not yet been CE-certified have already been presented to us in detail. The companies were very happy to take advantage of the students' interest to encourage them to submit unsolicited applications.

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We were able to test live very good software and hardware components that enable the surgeon to create a detailed and rotatable three-dimensional representation of an organ for planning the procedure. The participants were particularly enthusiastic when Prof. Mittmann introduced you directly to one of the company's employees who joined this highly innovative company 10 years ago after completing his master's degree in biomedical engineering at Münster University of Applied Sciences.

Conclusion:

Thanks to the commitment of the EUREGIO BioMedtech Center team, a highly informative and free excursion to MEDICA, the world's largest medical trade fair, was made possible. Students take the enthusiasm and motivation for medical research and development with them, the best prerequisite for the planned applications in innovative companies and institutes! Translated with www.DeepL.com/Translator (free version)

• Establishment of a spheroid-based cell culture system for exposure studies
  
  
• Comparison of image and signal evaluation analysis for the identification of fluorescent objects in NIR fluorescence laparoscopy
  
  
• Creation of phantoms as model system suitable for near infrared (NIR) laparoscopy
  
  
• Synthesis of superparamagnetic iron oxide nanoparticles in a polymethyl methacrylate matrix