<p> Trend of Information Coordination: New subtrend and its mechanism I.S.Sigalovsky Trend of Coordination, Medical imaging, Diagnostic imaging, Trends of Engineering System Evolution, TESE</p><p>Introduction The field of medical (diagnostic) imaging has gone through a number of tremendous transformations in the last few decades. This is especially true for ground-breaking brain imaging techniques such as functional Magnetic Resonance Imaging (fMRI) and others. Medical Imaging is inherently an extremely complex multi-disciplinary field because it combines knowledge from physics, mechanical engineering, electrical engineering, neuroscience, anatomy, signal and image processing as well as other disciplines. Because of their inherent complexity and multi-disciplinary nature, medical imaging systems are state-of-the-art machines that are typically developed in top academic institutions where TRIZ has not found its acceptance to date. Thus, TRIZ and TRIZ-based approaches have not been used to analyze/develop/forecast medical imaging systems. On the other hand, complexity of the field itself precludes clear systematic vision of what is happening with the field of medical imaging as a whole. This paper has two goals. The first goal is to describe and illustrate a new subtrend for the Trend of Coordination – coordination of information and describe a step-by-step mechanism of this subtrend. The second goal of this paper is to understand and predict the development of some medical imaging systems/applications through the lens of the Trends of Engineering System Evolution. This paper will primarily focus on application of TESE to MRI because of the author’s decade-long experience developing this technique. Methods Trends of Engineering Systems Evolution (TESE) are empirically derived directions of Engineering System development that describe the natural transitions of Engineering Systems from one state to another. A number of trends (at least eleven) have been described to date and they relate to one another through a hierarchical structure [1,2,3,4]. This paper will focus on the Trend of Coordination (Definition: As an Engineering System evolves, characteristics of the components of the Engineering System become more coordinated with each other and with the Supersystem). In particular, we will discuss a new subtrend and its mechanism – coordination of information. We will illustrate this new subtrend using example of medical imaging for surgery application. </p><p>Results Case Study 1: Medical Imaging and Surgery (Trend of Increasing Coordination) MRI has been playing an increasingly important role in surgery on humans, and in brain surgery, in particular. Brain surgery is considered the most challenging of operations because, to the naked eye, brain presents a jello-like homogeneous substance. One wrong cut and the patient will loose his/her ability to speak, move an arm or to see. At present, brain surgery is done on fully awake patients (there is no pain sensation because brain does not have pain receptors) who are asked to perform simple cognitive tasks, such as counting backward, during surgery. Ability or inability to perform such tasks gives surgeons an indication whether they are dissecting the intended part of the brain. Fundamentally, however, this method is unreliable, limited and inefficient (Step 1 in Figure 1). Step 4</p><p>Step 3</p><p>Step 2 Doctor is provided with simultaneous and co- localized image of the surgical zone Step 1</p><p>Doctor is provided with simultaneous but not co- future localized image of the surgical zone</p><p>Doctor is provided with images of the surgical zone prior to the operation today Doctor is not provided with any images Figure 1. Evolution of image-guided surgery Let us analyze the development of MRI-guided surgery through the lens of Trend of Increasing Coordination. Several decades ago, the chances of success for brain surgery were greatly improved with the appearance of imaging techniques such as X-Ray, CT-scan, PET and MRI. The doctor now had an ability to examine the internal structure of the patient’s brain before performing the surgery (Step 2 in Figure 1). This provided a tremendous advantage because brains of different people are very different and this is especially true for clinical cases with structural abnormalities (such as tumors). The next step in the image-guided surgery was to bring real-time imaging into the operating room (Step 3 in Figure 1). Now the doctor is not only able to track structural changes he/she introduces to the patient’s brain by making incisions, but also understand how surgical incisions impact functional abilities of patient. Even though this technology is still in its embryonic state, it has been used in selected cases in several hospitals. We predict that in the future, the labeled images of the brain structures and functions will be displayed on the patient’s head itself (Step 4 in Figure 1). These images will be taken in real time and show structural and functional changes associated with incisions that the doctor is making on the patient’s brain. Discussion At present, the Trend of Coordination has been described using four subtrends: coordination of shapes, rhythms, materials and actions [4]. We suggest that another subtrend of coordination exists - coordination of information. Let us look at the trend of image-guided surgery from the information stand-point. Step 1. Doctor performs surgery without of any information form MRI. Information available: (1) gross internal anatomy from anatomy textbook and previous experience on other patients, and (2) gross external anatomy visible upon dissection of the patient’s brain – No coordination. Step 2. Doctor performs surgery after looking at the patient’s MRI scans prior to surgery. Information available: (1) gross internal anatomy of patient from MRI (or other imaging modality) prior to surgery, (2) gross external anatomy visible upon dissection of the patient’s brain – coordination of information in source (i.e., both types of information come from the same source – patient). Step 3. Doctor performs surgery while looking at the patient’s MRI scans taken in real time during the surgery. Information available: (1) gross internal anatomy of patient from MRI (or other imaging modality) during surgery, (2) gross external anatomy visible upon dissection of the patient’s brain – coordination of information in source and time (both types of information come form the same source, patient, and are available at the same time, surgery). Step 4. Doctor performs surgery while looking at the patient’s MRI scans taken in real time and superimposed on the patient’s brain. Information available: (1) gross internal anatomy of patient from MRI (or other imaging modality) during surgery and co-localized to the patient’s brain, (2) gross external anatomy visible upon dissection of the patient’s brain – coordination of information in source, time and space. Of course, the subtrend of information coordination has to be demonstrated using many other examples from all types of technical systems to confirm its right to exist. A superficial analysis of technical systems that operate with information confirms that this trend holds for multiple types systems. Take, for example, route mapping process during traveling: Step 1. Traveler uses maps of the city he/she bought in the store (Step 1 in Figure 2). Step 2. Traveler uses maps of the specific route that he/she printed on the computer prior to traveling – coordination of information in source (Step 2 in Figure 2). Step 3. Traveler uses real-time maps of the specific route displayed on his/hers GPS device in the car while traveling (exists today) – coordination of information in source and time (Step 3 in Figure 2). Step 4. Traveler uses real-time maps of the specific route displayed on the route itself – coordination of information in source, time and space (Step 4 in Figure 2). Notice that this phase in the development of information systems has been appearing in multiple systems and has been referred to as “augmented reality”.</p><p>Step 4</p><p>Step 3</p><p>Step 2</p><p>Real-time map of a Step 1 specific route displayed on the route itself</p><p>Real-time map of a specific route future</p><p>Pre-printed map of a specific route today Pre-printed general map Figure 2. Subtrend of Information Coordination: route mapping for traveling</p><p>Conclusions This paper presented a new subtrend for the Trend of Coordination – coordination of information. It also suggested a mechanism by which information systems evolve according to this trend: coordination in source of information, coordination in time, and coordination in space (Figure 3). Here, we described how the trend of information coordination works using two examples from very different information systems: image-guided surgery and route mapping during traveling.</p><p>NO COORDINATION COORDINATION COORDINATION COORDINATION IN SOURCE IN TIME IN SPACE</p><p>Figure 3. Subtrend of Information Coordination: the mechanism</p><p>More extensive analysis is required to make a more definitive statement about the existence of the trend of information coordination as well as the mechanism by which it operates. This paper is the first step in this direction.</p><p>References 1. Altshuller G. Creatvity as an exact science. Gordon and Breach Science Publishers. 1984. ISBN 0-677-21230-5 2. Fey V. and Rivin E. Innovation on demand. Cambridge University Press. 2005. 3. Salamatov Y. 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