More than 100 years ago, the discovery of X-ray revolutionized medical care by opening a window into the human body. Today biomedical photonics—the application of light in medicine and biology—promises to be equally groundbreaking. At the forefront of the revolution is Anita Mahadevan-Jansen, the School of Engineering’s Orrin H. Ingram Professor of Engineering.
“Medical photonics is the use of light to diagnose, monitor and treat disease,” she says. “I work on diagnosing and treatment.”
As director of optical diagnostics research in the Biomedical Photonics Laboratories at Vanderbilt, Mahadevan-Jansen develops technologies that can be used in clinical care. The professor, who joined the School of Engineering in 1997, has received numerous awards and patents on her devices and has pioneered techniques in laser spectroscopy, the interaction of matter with light.
One of her main interests is optical guidance in surgery. Surgeons use her laser spectroscopy techniques during delicate brain surgery—when mistakes can be catastrophic—to better distinguish between healthy and diseased tissue.
Her optical techniques are also used in breast cancer surgery. Following lumpectomies—in which surgeons remove only the cancerous tumor instead of the entire breast—it can take several days for laboratory tests to discover if all the cancerous tissue has been removed. Often, the patient must return for further surgery. Mahadevan-Jansen’s techniques are currently being used to discriminate between the lump’s healthy and cancerous tissue so that all of the diseased tissue can be removed in a single operation.
Shedding Light on Cancer
An acknowledged leader in biomedical phonics, she always has several research projects under way or in development. “I’m excited about all my projects,” she says. However, she’s particularly enthusiastic about two new undertakings: developing a simple and effective method of finding the parathyroid glands during thyroid surgery and diagnosing cervical cancer in ethnically diverse women.
“Four years ago I gave a talk at Vanderbilt’s School of Medicine about using light to detect brain tumors or breast tumor margins,” she remembers. A few days later, surgical resident Lisa White, MD’06, showed up at Mahadevan-Jansen’s office to ask about methods to detect the parathyroid glands during thyroid surgery.
Up to 19 percent of the time when surgeons remove diseased thyroid glands, damage also occurs to the parathyroids, four organs the size of rice grains located at the back of the throat. Such damage can have lifelong negative effects on patients’ health because the parathyroid glands control calcium concentrations in bones, intestines and kidneys.
Working together to image these tiny glands with near-infrared light, the biomedical engineering professor and the surgical resident discovered that the parathyroid glows with a natural fluorescence 10 times stronger than fluorescence from thyroid tissue. The fluorescence is so strong that a simple detector can reveal it, allowing surgeons to see the location of the parathyroid and avoid it. Vanderbilt has recently received an international patent on a detection device and licensed it to a private company for manufacturing.
“This kind of collaborative discovery could only happen in a place like Vanderbilt,” Mahadevan-Jansen says. “There is a close and open relationship between engineering and medicine here.”
Saving Women’s Lives
Another research area she’s pursuing is using light to detect cervical cancer. Cervical cancer is one of the most preventable of all cancers, and yet the disease kills thousands of women in the United States each year. In sub-Saharan Africa, however, hundreds of thousands of women die from cervical cancer annually, in part because of the lack of early detection and access to health care.
“In Zambia alone, 1 in 5 women die from cervical cancer each year,” Mahadevan-Jansen says. “I wanted to take the techniques we’ve developed and use them there.”
But before that could happen, certain questions had to be answered. Through her research on mostly Caucasian women at Vanderbilt University Medical Center, Mahadevan-Jansen found that laser spectroscopy could detect pre-cancerous changes in the cervix 94 percent of the time. But she needed to know if those findings would hold up in ethnically diverse women. Partnering with physicians from Nashville’s Meharry Medical College, she tested the method with African American women and found that race did not change the results. Since then, she has received funding from the National Institutes of Health (NIH) to continue her research in this area.
Power of Collaboration
Mahadevan-Jansen’s work often reaches beyond campus. An interdisciplinary Vanderbilt team that includes Mahadevan-Jansen; her husband, Duco Jansen, professor of biomedical engineering; and neurosurgeon Dr. Peter Konrad is working with researchers from Southern Methodist University and other institutions to develop prosthetic arms and legs that work naturally through a two-way optical link with the peripheral nervous system. Supported by a grant from the Department of Defense, the researchers are attempting to use beams of light to stimulate and control bundles of nerve cells, allowing amputees to control and feel the movement of prosthetic limbs.
Mahadevan-Jansen also collaborates with physicians from the medical center on projects as diverse as using optical methods to detect deadly melanoma, identify the quality of bone health, and determine when mothers are having pre-term labor. Such collaboration often results in products to improve patient care.
“The physicians at Vanderbilt Medical Center are always happy to work with us,” she says. “And the next thing you know, our research has the potential to become a (commercial) product. If it weren’t for the relationship between engineering and medicine at Vanderbilt, that wouldn’t happen.”