Issue 35 – June 2009 Philips Research technology magazine

Password
Image-guided drug delivery
takes the next step

Hitting
the right spot
Creating a white-light LED for everyday use

The race
for white light
Navigating
the airways
Lung biopsy ‘navigator’ may help
doctors find their way
 The race
for white light
LEDs: they produce vibrant light in
thousands of colors, offer intriguing
design and lighting possibilities and
are more energy efficient than
traditional lighting. They’re not yet
an everyday standard, but a new
technology may just change that.

Page 12

Password is a technology magazine Editor-in-chief Contributors More information

published by Philips Research. Peter van den Hurk Stuart Cherry Philips Research
Philips Research, part of Royal Philips Karin Engelbrecht Communications Department
Electronics, has laboratories in three Managing editor Brandy Vaughan High Tech Campus 5 (MS04)
regions (Europe, Asia and North Brandy Vaughan 5656 AE Eindhoven, The Netherlands
America) where around 1,800 people Printer Tel. +31-40 27 46616
investigate promising options for innovation. Copy editor Print Competence Company Fax. +31-40 27 44947
Chris Boulle Email: research.communication@philips.com
Realization Subscriptions and further details
Centagon Production management on the articles in this edition Articles and images may be reproduced only
Veldhoven, The Netherlands Claudia van Roosmalen www.research.philips.com/password with permission from Philips Research.
www.centagon.com Moniek Hurkmans
© KONINKLIJKE PHILIPS
Design Distribution management ELECTRONICS N.V. 2009
Roland Kersten, Bart van Etten Nelleke Tops All rights reserved

2 Password June 2009

 Contents
Hitting 10 Did you know...
the right spot Interesting facts and figures
at your fingertips.
Cancer and cardiovascular disease are
two of the most deadly and difficult-to-
treat diseases. But new image-guided 16 Bringing new life
4 drug delivery techniques may one day
help change that by delivering treatment
right to the target spot.
to old ruins
In Mexico, the Mayan
archaeological site of Edznà
lights up after dark with
dynamic, colorful light displays
Smart medicine using Philips LEDs.
Nowadays, ‛smart’ technology is
all around us. Soon we may even 28 Did you know...
be taking smart pills as Philips’ new Interesting facts and figures
‛iPill’ takes intelligent drug delivery at your fingertips.

8
to the next level.

30 The personal side

of technology
As part of the Smart Kitchen Life
team, Jettie Hoonhout uses her
Navigating background in psychology and her

the airways love of food to make technology

more personal.
A new virtual GPS-like technology may
help doctors navigate the convoluted
system of airways during lung biopsies.

18
Emotional
technology
Modern life moves much faster than
ever before. In our few free moments,
we want to leave stress far behind.

23 New ‛emotional’ technology may help

us do just that.

Password June 2009 3

by Brandy Vaughan Images: Philips, Illustration: Centagon

4 Password June 2009

 Hitting
the right spot
Image-guided drug delivery. These four words could
one day revolutionize the way diseases like cancer
and cardiovascular disease are treated. For patients,
it could change lives: more effective treatment, lower
systemic toxicity and new drug possibilities.

Cancer and cardiovascular disease affect millions of people
around the world. They’re also two of the most deadly and
difficult-to-treat diseases. Currently, most treatments involve
powerful drugs that are distributed passively throughout
the body – all for a disease that may be limited to one spot.
Doctors are left without an efficient way to ensure the
treatment gets to where it’s needed most.
This ‛whole-body’ dosing also limits a doctor’s ability to ensure
the treatment is as effective as possible. Due to the inherently
toxic nature of treatments like chemotherapy, doctors have to
work within a tight margin – called the therapeutic window –
to make sure the amount of treatment given is enough to have
a positive effect while keeping side effects and toxicity to a
minimum. Usually, this means the doctor has to limit treatment
doses and spread them over a period of time. It’s definitely not
the powerful punch doctors – and patients – are hoping for.
Right on target
One solution is to deliver the treatment right to the target
spot. Right now, the best way to do this is through injectable
drug-loaded ‛carrier’ particles, which already exist for the
treatment of some diseases, such as breast cancer. But they
aren’t as effective as they could be.
The current generation of carriers localizes treatment but
only in a passive manner, with drugs released as a slow diffused
leakage over time. Ideally, there would be a better way to
control – or trigger – the release of drugs right at the disease
site.

Password June 2009 5

 Triggered release
With the goal of giving patients more benefit from potentially
life-saving treatment, Philips Research began to develop
localized drug-delivery techniques that aim to release
treatment locally using an external trigger, such as ultrasound
pulses or heat. The concept involves tracking the path of the
drug through the body and then triggering its release from
the carrier particles at the target spot – potentially making
the uptake of treatment into disease cells more controlled
and, therefore, more powerful.
“New options that involve externally triggered treatment at
the specific site of disease could really change patient care for
the better,” notes Klaus Tiemann, Professor of Cardiology at
the University of Münster, Germany.
This is because triggered local delivery means a higher
concentration of the drug reaches the disease site. This may
result in fewer side effects for patients and give doctors the
option of increasing dosage in an effort to hit the disease
harder straight away, possibly improving treatment efficacy.
Visual delivery
Not wanting to limit the possibilities, Philips is working on two
different image-guided delivery techniques that could one day
change the way these diseases are treated.
The first technique, developed for the treatment of cancer,
involves drug-loaded particles mostly made of phospholipids
– called liposomes. Typically just 100 to 200 nanometers in
diameter, liposomes are tiny enough to travel through small
capillaries in the vascular system and penetrate deep into
diseased tissue. After injection, the particles are tracked using
MRI and once they’re at the target site, a small amount of heat
is applied using ultrasound, causing the heat-sensitive particles
to release the treatment drugs on the spot.
Since damage can occur when tissue is overheated, MRI is ideal
because it can be used to monitor local temperature changes
in the body. “The physiological range of heating body tissue is
6 Password June 2009
very small,” explains Holger Gruell, project leader at
Philips Research. “You shouldn’t heat body tissue much
above 42°C. Beyond 44°C, you can do permanent damage.
So the heating effect that releases the drug must occur within
a certain temperature range, which requires a precise fine-
tuning of the particles. It’s a balance that we’re still working on.
But this is where the combination of ultrasound and MRI has
a big advantage because MRI can monitor the subtle
ultrasound-induced temperature changes very precisely.”
MRI is also capable of imaging soft tissues and organs, as well as
detecting the arrival of the drug-loaded particles at the disease
site using contrast agents.
A burst of bubbles
The other method for image-guided drug delivery
involves larger particles, up to two micrometers, often
called ‛microbubbles’, which can be adapted to rupture when
exposed to ultrasound pressure waves – or pulses. Philips
is exploring ways to fill these microbubbles, currently used as
contrast agents for ultrasound imaging, with treatment drugs
and use them to deliver precise doses exactly where needed
in the body. Ultrasound imaging would track the microbubbles
in the bloodstream and when they reach the target site, a high-
energy ultrasound pulse would shatter the microbubble shells
– releasing the drugs right at the disease site.
“When microbubbles are exposed to ultrasound pulses,
they rapidly expand and contract in size eventually causing
them to explode,” notes Marcel Bohmer, who’s responsible
for microbubble development at Philips Research. “But actually
one of the most exciting aspects of microbubble drug delivery
is the aftereffect of that bubble burst.”
Researchers have found that when microbubbles burst, the
explosion somehow pierces nearby cell membranes making
them more porous and, therefore, more susceptible to drugs.
This phenomenon is called sonoporation and could allow for
new treatment possibilities. In fact, there’s a whole range of
new drug therapies based on genetics and DNA that may

prove to be the most powerful and tolerable treatments
yet for diseases such as cancer and cardiovascular disease.
But there’s one main obstacle: getting the treatments into
the disease cells.
Sonoporation may just offer a solution. The controlled opening
of the cell membrane caused by the microbubbles may not
only increase the local drug concentration but also facilitate
the uptake of drugs that would never otherwise be able to
enter cells.
More
Particle particulars
Temperature-sensitive liposomes are formed by arranging
different lipids into a bi-layer about five nanometers thick,
which encircles a tiny reservoir that’s filled with highly
concentrated drug treatment. Liposomes have membranes
that closely resemble that of natural cells but are 50-100 times
smaller. When heated from 37°C to 42°C, the bi-layer develops
pores that readily release the drug. The research process also
involves fine-tuning the design and selection of lipid materials
to ensure a precise drug-release temperature.

There are still many rounds of testing and many issues to be

resolved before image-guided drug delivery hits the clinical
setting – no sooner than five to ten years from now. But it may
one day offer doctors more localized ammunition in the fight
against two of the deadliest diseases known to man.

Temperature-sensitive liposomes.

Microbubbles are currently used as contrast agents in

ultrasound imaging. They have a gas core and a shell consisting
of phospholipids, proteins or a biodegradable polymer. But

Novel techniques for drug delivery purposes, the more robust polymer shell is
preferred. These shells are formed around oil droplets containing
the treatment drugs. The oil is then partially removed and a
capsule with a polymer shell is the result. The oil acts as a liquid
The potential of image-guided drug delivery has not
reservoir for the drug, whereas the gas helps trigger its release
gone unnoticed. In fact, Philips is heading a €15.9 million
during the ultrasound application.
project focused on furthering the novel techniques.
The ‛Sonodrugs’ project, which is partially funded by the
European Union, draws on the expertise of 15 partners,
including medical centers and academic institutions from
throughout the EU.

The project will run for four years and work will focus
on a number of different areas, including the development
of new particles with the right size, structure, physical
High-resolution electron microscope images of microbubbles
behavior, half-life and bio-compatibility, as well as exploring
before and after drug release.
the bio-distribution and effectiveness of the drug-delivery
techniques in-vitro and in-vivo. For more information, go to www.research.philips.com/password

Password June 2009 7

by Brandy Vaughan Images: Philips
Smart medicine
Nowadays, everything seems to be smart: smart phones, smart cars,
smart toasters. And soon we may be taking smart pills.
Just slightly larger than a typical multivitamin, Philips’ new
intelligent pill (iPill) has the potential to take intelligent drug
delivery to the next level as the first pill that effectively combines
localized drug release with the ability to measure the internal
environment and communicate this information to the outside
world – without the need for large machines or wires.
Although iPill is designed to be swallowed like a regular pill
and travels normally through the digestive system, iPill is
definitely not your average pill. In fact, it’s not really a pill at all,
but more of a drug-filled capsule that uses the natural digestion
process to reach the intestines and then deliver treatment at a
iPill’s drug reservoir is filled with the right dose iPill is uploaded with the drug delivery location and
of treatment drugs, which can be adjusted to a the dispensing profile.
patient’s individual profile.
8 Password June 2009
specific spot. Once there, iPill has the technology onboard to
take internal measurements, such as temperature and acidity
levels, and wirelessly transmit the data via a transceiver to an
external unit, which the doctor can monitor.
This could be great news for patients suffering from hard-
to-treat and increasingly common intestinal disorders such
as Crohn’s disease and colitis, which are often treated with
systemic doses of steroids. With iPill doctors may one day
have the option of delivering the much-needed treatment
right to the problem spot. iPill may even be helpful in treating
colon cancer – which affects nearly one million people a year
iPill is swallowed normally and then travels through
the digestive tract to the stomach and on to the
small intestine.
worldwide – in the same manner by delivering chemotherapy
to the precise site of disease.
A matter of pH
So how exactly does iPill know where to initiate drug
release? Along with the drug treatment, iPill also houses
a microprocessor that controls an internal pump that triggers
drug release, which can be controlled remotely or via a
pre-planned schedule loaded onto the microprocessor.
Since specific areas in the intestinal tract have distinct pH
(a measure of acidity) profiles, iPill navigation is based on
measurements of small but distinct changes in acidity levels
to map its position within the digestive tract. Armed with
this pH information, as well as data on typical capsule transit
times, iPill can be programmed to determine its location with
good accuracy. And when greater precision is required,
MR or CT imaging could be used to fine-tune the location.
There may also be the potential to better personalize
treatment and give doctors more flexibility in terms of drug
dosage amounts. Because the iPill capsule comes empty,
it could be filled with a tailored dosage based on individual
Measuring just 11x26 mm, iPill incorporates a microprocessor, battery, pH
sensor, temperature sensor, wireless transceiver, fluid pump and drug reservoir.
iPill keeps in constant contact with a belt-worn control Based on transit time information and measured
unit. Changes in pH levels allow iPill to determine its pH levels, iPill knows when it has reached the
location in the digestive tract. Once pH rises steeply, target location and begins drug release.
iPill knows it has reached the small intestine.
patient characteristics. For instance, a patient that weighs just
50 kilograms often needs just half the dosage of a patient of
100 kilograms. But with normal pills the dosage amounts are
fixed often with only two or three available options.
“With iPill a doctor could take into account a patient’s specific
attributes and adjust the dosage accordingly, say for 60%
or 70% of a standard dose rather than the strict 50%, 100%
or 150% options,” explains Olaf Weiner, General Manager
of the iPill project at Philips Research.
Speedy and smart
iPill may also help speed up the lengthy and expensive new
drug development process, especially for orally delivered
treatments. Often to find a viable drug, pharmaceutical
companies have to test thousands of potential candidates
before one works. But since iPill has the potential to deliver
drugs to the target spot directly and in a controlled manner,
only a very small amount is needed for testing, which means
more molecules could be tested in less time.
“The combination of navigational feedback, electronically
controlled drug delivery and intestinal tract monitoring
promises to make iPill a valuable research tool for drug
development,” notes drug-delivery expert Karsten Cremer
of Switzerland-based Pharma Concepts. “In particular,
this technology could potentially improve drug candidate
profiling and selection, which could ultimately accelerate
the development of new drugs.”
Although iPill is still in the prototype phase, smart medicine
and more personalized treatment are clearly on the horizon.
For more information, go to www.research.philips.com/password
When the pH sharply decreases, iPill knows it has
entered the large intestine. As iPill is designed for
one-time use only, iPill then passes normally out
of the body.
Password June 2009 9
 Did you know...
400,000,000
in the dark While 80% of Indian villages have
at least one electricity line, just
44% of rural households have
access to electricity – leaving some
400 million Indian people without.

By the dozen
“Ideas are like rabbits. You get a couple
and learn how to handle them, and
pretty soon you have a dozen.”
John Steinbeck, American Pulitzer-prize winning author

Making the switch

If every home in the US replaced
just one conventional light bulb
with a compact fluorescent bulb,
the energy saved could light more
than three million homes for a year
lectricity
and would prevent the release
of greenhouse gas emissions
equivalent to that of 800,000 cars. First buzz
The English words ‛electric’ and ‛electricity’ are
first known to have appeared in print in 1646
in Thomas Browne’s Pseudodoxia Epidemica.

10 Password June 2009

10 million
a minute
 round 15 billion
A
cigarettes are sold daily
worldwide – nearly
10 million every minute.
Preventable
prognosis
Secondhand smoke kills 53,000 non-smoking Americans
yearly – making it the third leading cause of preventable
death in the US, after active smoking and alcohol abuse.

70% increase
The California Environmental
Protection Agency estimates that
secondhand smoke increases the risk
of breast cancer in younger, primarily
premenopausal women by 70%.

Secondhand risks
Non-smokers exposed to secondhand
smoke at home or work increase
their risk of developing heart disease by
25-30% and lung cancer by 20-30%.
In fact, experts estimate that 10-20%
of lung cancer cases occur in
non-smokers.

Password June 2009 11

 by Stuart Cherry Images: Stockexpert

The race
for white light
From red to yellow to violet, LEDs produce vibrant
light in all the colors of the rainbow. They’re also more
energy efficient than most other lighting options and offer
exciting new light and design possibilities. Still far from
being the new standard, LEDs are just now beginning
to enter the mainstream lighting market. And the new
Lumiramic* Phosphor technology could help pave the way.

12 Password June 2009

With their ability to produce vibrantly colored light across
the spectrum without using filters, LEDs are the next big
thing in the lighting and design world. They offer exciting
new illumination effects that just aren’t possible with other
light sources plus they use less energy. So with all this going
for them, why are LEDs still considered a niche product?
Part of the reason is because the one color LEDs have
struggled to produce consistently is white. And that’s exactly
the color most people want in their homes and offices.
“When solid-state lighting first began appearing in
architectural lighting applications, designers used it for things
like color-changing effects because it was new and different,”
explains Elizabeth Donoff, editor of Architectural Lighting,
North America’s leading lighting publication.
“It quickly became clear that lighting designers expected more
from LEDs and that the technology had to evolve beyond
just color if it was to be more widely accepted. That’s when
manufacturers began to concentrate on developing LEDs
in a white color range – ‛the race for white light’ began.”
Going white
LEDs can’t directly produce white light because they emit
light in a very narrow wavelength band. That’s perfect for
vibrant colors but not for white light, which contains all
the colors of the spectrum.
*Lumiramic is a trademark of Philips Lumileds.
One obvious way to create white-light LEDs is to package red,
green and blue LEDs into one product – often called an ‛RGB’
device. With the right control electronics, users can even vary
the light output to switch between colored light and white
light of different colors. However, different LEDs operate at
different voltages and currents, making tunable RGB products
difficult to manufacture and sensitive to operating conditions –
therefore not ideal for mainstream usage.
Another approach to white LED light is to use a phosphor
powder to change blue LED light to white. The phosphor is
embedded into a silicone coating, which converts some of the
blue light to yellow, and the mix of blue and yellow light give
off a color that our eyes then perceive as white. But the exact
shade of white light produced depends on the precise balance
of blue and yellow light – something that’s very difficult to
control. And ensuring a consistent shade of white from LED
to LED, even within the same product series, is a big challenge.
Into the bin
To solve this problem, manufacturers test all white LEDs and
divide them into ‛bins’ depending on the shade of white light
that a specific LED produces. Although it helps customers figure
out what they’re getting, the binning process still allows for a
much wider shade variance than the lighting industry is used to.
Password June 2009 13
 “Although LED manufacturers are paying more attention
to the binning process these days, there is still a sense of
the unknown when you receive a batch of LEDs. That’s very
frustrating for designers who are trying to specify a reliable
light source and fixture,” Donoff adds.
In multi-LED applications, color variations can be averaged
out by mixing and matching LEDs. However the light output of
individual LEDs is rising fast, and within five years, there should
be LEDs that produce as much light as a 100 watt incandescent
bulb. But this balancing out of colors with multiple LEDs is not
an option if only one is used, so the lighting industry needs
white LEDs with a more consistent color.
The promise of white
Now Philips Lumileds, the leader in high-power LEDs,
is rolling out a new phosphor technology called Lumiramic,
which promises just that. By replacing the phosphor-silicone
coating with a solid ceramic phosphor plate, Lumiramic
promises a more consistent color and more reliable supply
of white-light LEDs.
“By converting powder phosphors into a solid ceramic, we
can control the optical properties of the phosphor layer more
accurately,” explains Helmut Bechtel of the Philips Research
team that created the Lumiramic concept and technology.
That tight control, combined with new measurement techniques
developed by Philips Research, means the phosphor plate can
14 Password June 2009
be accurately classified before it’s combined with an LED.
As a result, the manufacturer can match individual plates and
LEDs to achieve a more consistent balance of blue and yellow
light, and hence a more consistent shade of white light.
Philips Lumileds has already used the Lumiramic technology
to reduce binning in its warm white LUXEON Rebel range –
the primary shade for home, office and hospitality lighting.
The technology will next be employed for cool white LEDs.
Lumiramic could also be used across the LED rainbow to make
other color LEDs more efficient at converting light. Also with
Lumiramic technology, multi-color products could be created
using just one type of LED, making their design easier and
overall efficiency higher.
A greener shade of white
Currently, lighting accounts for 30% of the average
domestic energy bill and 19% of the world’s electricity
consumption. It doesn’t need to be this way. LEDs solutions
use up to 90% less energy than a typical incandescent bulb
and are nearly three times more efficient than compact
fluorescents. When LEDs make the move into our homes
and offices, it will make a real difference in the planet’s
energy consumption and greatly reduce our carbon
emissions. For that, of course, we need a more consistent
color and supply of white-light LEDs – just what Lumiramic
can deliver. It’s a move that’s both aesthetically and
environmentally friendly.
 More A perfect match

For phosphor-based LEDs, producing a consistent shade of white

light requires precise control over the optical path the light takes
through the phosphor layer. A typical LED phosphor coating is
made by embedding phosphor powder into silicone or epoxy.
However, the embedding process doesn’t provide sufficient
control over the distribution of the powder grains limiting
control over the final color.

Lumiramic uses a well-known process called sintering to

Lumiramic phosphor plate
convert high-purity phosphor powders into a solid ceramic.
Philips Research developed novel techniques to control the
sintering process and fine-tune both the concentration of ions
that actually convert the light and the scattering of light in the
plate. This means the shade of white light produced can be
regulated by controlling the plate’s thickness.

Using extremely accurate machining processes borrowed from the

semiconductor industry, Lumiramic plates 100-150 micrometers
thick can be manufactured to within an accuracy of just one
micrometer. However, nanoscale issues mean the light converted
by different Lumiramic plates varies slightly. Not enough to
see, but enough to effect the careful balancing act needed for
consistent white light. Thus LEDs and plates have to be very
accurately matched.

True success Thin film chip Ceramic substrate

This accurate matching is possible in the Lumiramic approach
because the LEDs and phosphor plates are manufactured
separately and only combined in the final assembly phase.
Each can be pre-measured and, by matching Lumiramic plates
of the appropriate optical thickness to LEDs of the correct
wavelength, a stable supply of products with a consistent
white light output from device to device can be produced.

“The true success of the Lumiramic process is the accuracy with

which we can classify the plates. Nothing else available could deliver
that accuracy,” notes Frank Steranka, Head of Research
and Development at Philips Lumileds. “The team at Philips
For more information, go to www.research.philips.com/password
Research had to develop it from scratch.”

Password June 2009 15

 Bringing new life
to old ruins
The Mayan civilization is noted for its spectacular art
and monumental architecture. The historical site of Edzná,
in the Mexican state of Campeche, is no exception.
It takes beauty even a step further by combining remarkable
architecture with a newer form of art: dynamic, colorful
displays of light that bring new life to the ceremonial center
that flourished from 250 to 900 AD.
On weekend evenings, the temple is awash in millions of colors
during a multimedia spectacle called the ‛Light of the Itzáes’ -
made possible by Philips LED technologies.
16 Password June 2009
A team of lighting design specialists uses 127 Philips LED
ColorBlast(R) fixtures to create the dance of light. At the
beginning of the show, the temple is saturated in rich hues
of red, then blanketed in vibrant greens and blues.
And, importantly, the LEDs that bathe the site in color
do not radiate heat or UV rays, which could damage
the exterior over time.
The dynamic lighting spectacle that enhances the temple’s
natural beauty has now made Edzná a new icon for the
Maya culture.
Password June 2009 17
 by Brandy Vaughan Images: iStockPhoto

18 Password June 2009

Navigating
the airways
Lung cancer is a killer of massive proportions: 1.3 million
deaths a year worldwide – more than breast, prostate
and colorectal cancers combined. It’s also the most
common form of cancer today. To give patients the best
chance of survival, lung cancer must be caught early.
But this is not nearly as simple as it may seem.

As far as cancer goes, lung cancer is as bad as it gets with
one of the lowest survival rates around – 80% of all lung cancer
patients die within a year of diagnosis. The overall five-year
survival rate hovers between 10-15%. Why? Because it’s one
of the most difficult diseases to diagnose and treat. Lung cancer
needs to be diagnosed early, before the disease has a chance to
spread. With recent advances in imaging technology, suspicious
sites can be detected earlier than ever before. It’s reaching
these sites that now poses the biggest problem.
When a doctor suspects lung cancer, patients typically undergo
a chest CT scan to pinpoint possible tumors, and some are
then referred for a PET scan. Although imaging scans can give
doctors a pretty good idea if there are tumors present in the
lungs, the only way to confirm this is with a tissue biopsy.
During the biopsy, tissue samples of the suspicious masses
are taken to determine if lung cancer is present, and if so,
which stage it’s at and whether it’s localized or has spread –
important for gauging the best treatment approach. Lymph
nodes are also commonly sampled to determine if the cancer
has spread outside of the lungs. Biopsies are performed
regularly to test for cancer but when tough-to-maneuver areas
like the lungs are involved, things can get complicated quickly.
“With advanced imaging now available, earlier detection
of suspected lesions is driving the need to sample ever-
smaller peripheral lesions and lymph nodes, which is
not always straight-forward,” explains Rex C.W. Yung,
Director of Bronchology and Pulmonary Oncology at
the Johns Hopkins University.

Password June 2009 19

 Which way to go
One of the most popular ways to do a minimally invasive
biopsy is bronchoscopy, which involves moving through the
airways using a bronchoscope inserted into the patient’s mouth.
But as advanced imaging detects tiny, more peripheral masses,
doctors are having a harder time navigating the bronchoscope
through the convoluted system of airways that split and branch
off repeatedly – getting ever smaller. Plus, the bronchoscope
can only visualize a few centimeters ahead so it can be difficult
for bronchoscopists to judge where they are in the patchwork
of airways and how best to reach the target area.

“With the scan images, bronchoscopists usually have a

general idea of where they need to go once inside the lungs
but not necessarily how to get there,” explains Luis Gutiérrez,
healthcare researcher at Philips Research. “It’s like if you were
going to someone’s house for the first time and you know the
city it’s in and have the address, but without knowing how to get
there once arriving in the city, it’s going to be difficult to find it.

“From discussions with bronchoscopists we learned that

during lung biopsies, they are faced with many small airways
that split repeatedly and have to decide which route to take
many times over,” Gutiérrez adds. “Highly specialized doctors
can often find the best route, but for others it may
take many attempts and some may not get there at all.”

Locationally challenged
Because the procedure can be so challenging, the typical
diagnostic yield for lung biopsies of small lesions and lymph
nodes is anywhere from 30-70%, indicative of the challenge
of locating and sampling the small masses. Yet to really
improve patient survival rates, the yield needs to be closer
to the ideal of 100%.

With small-lesion biopsy yields so variable, sometimes doctors

don’t even want to put patients through the stress of the
procedure without a guarantee of success. “It’s a difficult call for
doctors whether or not to even biopsy if the lesion is small or
tough to access,” adds Yung. “Some patients are told to come
back for repeat CT scans and then for a biopsy when the lesion
is larger – not something a patient is keen to hear. It exposes the
patient to more scans and can delay diagnosis and treatment.”

20 Password June 2009

If only doctors had a better way to visualize or ‛map’ their way
during the biopsy, sampling yields could improve and patients
would clearly benefit. It was a challenge that inspired Philips
Research to come up with a better image-guided biopsy
technique – a biopsy ‛navigator’ of sorts.

Virtual navigation
During the biopsy, the navigator uses PET/CT images
to construct a 3D virtual model of the patient’s lungs and
target lesions to help doctors find their way within the
airways. It's a step up from the current technique that relies
on 2D images.

“It’s like a virtual GPS system with detailed visuals and

highly specialized ‛driving directions’ given in pulmonologist
terminology,” explains Guy Shechter, a healthcare researcher
at Philips Research. “It has been designed to give doctors a
good idea of where they are, but also where to go next to
reach the target lesion as quickly and easily as possible.
We’re hoping it will help improve biopsy yields so that smaller
lesions can be sampled earlier – giving patients a better chance
to fight the disease.”

Flying blind
With ‛blind’ biopsies – when target lesions are outside the
lung walls and therefore not visible with the bronchoscope
– it’s even more difficult to sample lesions. To overcome this
issue, the researchers have developed a way for the navigator
tool to process and combine CT and PET images to show
these outside lesions as well as the lymph nodes. “During
bronchoscopy, doctors often try to sample the lymph nodes as
well as the lesion to see if the cancer has spread,” explains Yung.
“Being able to perform biopsies on more than one site in one
procedure can reduce time and costs for multiple procedures.”

Another possible use still being researched is whether the

navigator can also help radiologists determine the best biopsy
method – bronchoscopy or percutaneous (the needle-through-
the-skin technique). When radiologists begin to analyze scan
images and spot a suspicious lesion, there are a number of
different aspects to look at when deciding if a biopsy is
feasible and then choosing between the different methods.
For instance, a lesion may be too small to sample in a biopsy
or too difficult to locate with a certain technique.

Password June 2009 21

 In cases that are unclear, the navigator tool can help by
presenting relevant past cases with similar characteristics
(from a large database) and reporting their eventual outcomes.
This smart retrieval process is based on image analysis that
identifies similar cases based on nearly 200 highly specific
physical characteristics compiled from multi-slice chest CT scans.
The information includes how the biopsy went, which method
was chosen, whether the patient tested positive for cancer, the
disease stage, as well as how the treatment went and
the eventual outcome. Additional information like this
could help doctors determine how to proceed.
Although the navigator prototype is currently reserved
for research studies, the potential benefit of a system like
this remains clear: earlier detection of lung cancer will give
patients the best chance of survival.

More
The navigation program displays current real-time bronchoscopic
images (left) and images from the virtual lung navigator model
(right) based on the CT images and the relevant PET/CT data,
which supports targeted placement of the bronchoscope.

Real-time bronchoscopic images. Virtual lung navigator model based on CT images

and relevant PET/CT data.

For more information, go to www.research.philips.com/password

22 Password June 2009

by Stuart Cherry Images: Getty Images, iStockphoto

Emotional
technology
Modern life seems to move so much faster than ever before.
Quality time - either alone or with loved ones - is getting
scarce as work and home pressures mount. Technology was
supposed to give us a better work-life balance, yet for many
it’s just led to a feeling of always being ‛on’. But there’s good
news: a new kind of technology might just help us put the
‛quality’ back into quality time.

Password June 2009 23

 In the time-crunch era we live in, those few ‛free’
moments we have are now highly prized. When they do
come, we want to relax quickly and leave stress far behind.
We want to enjoy our free time on a deeper, more intense
level. While it might be natural to think that more technology
is not the answer, the latest ideas to come out of ‛emotion
science’ may one day prove this theory wrong.
The concept involves developing technology that can gauge how
we’re feeling and then help us achieve a more relaxed state of
mind. But how can technology understand our emotions? And
how can something so intrinsically human be broken down into
something simple enough for machines to interpret?
In touch with emotions
The answer lies in a branch of science called psychophysiology,
which studies how our emotions and mental processes are
linked to physiological changes in our bodies – like a rapid
heartbeat, faster breathing or even perspiration. These
reactions evolved millions of years ago as part of our basic
‛fight or flight’ response – so they’re common to all of us.
Psychophysiologists have been investigating these physiological
changes since the 1970s. And they’ve developed a number
of different ways to explore our emotions. These include
monitoring changes in heart and breathing rate, measuring
the electrical conductance of skin to assess sweat levels and
using MRI to observe brain activity.
24 Password June 2009
“Psychophysiological signals can tell us a lot about how a
person is feeling,” says Margriet Sitskoorn, Professor of Clinical
Neuropsychology at Tilburg University in the Netherlands.
“And through sensory stimuli, we can influence these signals
and try to enhance the person’s mental or emotional state.
Besides short-term benefits, this could have long-term health
advantages. For instance, prolonged stress is harmful to the
brain and heart, so you can imagine a stress-warning system
that helps you relax when your stress levels are too high.”
Relaxing at home
Recognizing this quality-of-life issue, Philips Research is
exploring ways to bring the science of emotion into the
household domain through its Sensory Experiences program.
Imagine returning home after a long, tiring commute and your
stereo senses that you’re stressed and then plays your choice
of soothing music. Or the television automatically plays your
favorite funny movie to cheer you up. These are examples
of ways ‛emotion technology’ could eventually play a part in
helping us relax and, hopefully, improve our well-being.
For emotion-based devices to become a reality, physiological
measurements have to be made without disturbing the user.
In the lab, measurements often involve numerous sensors and
wires – sometimes requiring study participants to shave a part
of their skin or be smeared with gel to ensure a good electrical
sensor contact. But that’s clearly not feasible in our living rooms
or as part of the products we carry around with us.
So the Sensory Experiences team focuses on measurements
that can be made unobtrusively. They’ve developed state-of-
the-art dry sensors that can measure heart rate and heart rate
variation, respiration and skin conductance – all to accurately
gauge emotions and mental state. The team is also investigating
the use of embedded cameras to capture facial expressions.
A more personal experience
Then there is the challenge of interpreting those signals.
Lab-based scientists work in controlled conditions, taking
a baseline reading and using deviations from that to monitor
changes in emotion. But in a consumer product, the emotion-
sensing technology needs to work right out the box without
complicated set-up and calibration procedures – meaning
no baseline measurements.
To do this, Philips Research is developing smart algorithms
tailored to individuals rather than populations to correct
for the lack of controlled conditions. “Academic scientists
are interested in general trends and averages in the population.
At Philips, we’re more interested in how individual people react
so that we can improve the personal experience,” explains
Joyce Westerink, a senior researcher on the program.
Willem Jonker, Head of Lifestyle Experience Solutions at
Philips Research, adds: “Our aim with Sensory Experiences is
to achieve immersion and relaxation via a deep understanding
of the human mind. Over the past decade there has been
important progress within the academic world in the area
of brain research. And now is the right time to start
integrating this scientific evidence and knowledge into
commercial solutions.”
In the mood
On the emotion-influencing side, Philips Research is exploring
various stimuli. The use of sound and light to affect emotions
is well established. Most of us are familiar with the emotional
power of music. And the popular Philips Ambilight Television
has shown how light patterns can affect people’s emotional
response to onscreen action providing a more immersive
viewing experience.
Philips Research has also developed prototypes that use
light and music to help people learn how to relax more
efficiently. For example, the ‛Mood and Music Player’ varies
its music output to give users feedback on their excitement
levels and guide them through breathing exercises to reduce
stress. It can also help users concentrate on specific tasks.
Relaxation effects are possible using varying light patterns.
“It’s like having an electronic yoga teacher in your living
room or pocket,” says Hans van Gageldonk, the program’s
lead researcher.
While music and light are helping people relax, touch and
vibration can heighten our emotional responses, such as
the recently announced ‛Emotions Vest’.
Password June 2009 25
 It’s a jacket lined with vibration motors, like those in your
cell phone, that add a new level of immersion to movie
watching. The vibrations are synchronized with emotional
scenes in the movie to bring you closer to the characters’
onscreen experiences. It doesn’t imitate punches during fight
scenes but it can send real shivers down your spine during
scary ones. And when tension builds, the jacket mimics
a fast-beating heart.

Feeling the way ahead

The long-term goal is to develop consumer applications
that can both sense our emotions and deliver feedback that
will help us control them, although this ambitious aim is still
years away. But according to Fred Boekhorst, Head of the
Lifestyle program at Philips Research, the Sensory
Experiences technology is here to stay.

“As a company, one of our main priorities is improving

people’s health and well-being,” he notes. “To this end, we
expect the Sensory Experiences technology to find its way
into a number of applications – from consumer electronics
to sleep improvement solutions and even medical equipment
such as MRI scanners.”

And for those of us struggling to relax more and stress less,

the technology could be the light at the end of a very long,
tiring road.

More All about feelings

Although the study of emotions dates back many centuries,
psychologists have officially been studying them since the 1970s
and have since created a number of ‛emotion’ models. Perhaps
the most famous is the two-dimensional or ‛circumplex’ model,
developed by James Russell, which breaks emotions into two
components: ‛valence’, (how positive/negative an emotion is)
and ‛activation’ or ‛arousal’ (how excited we become). Identifying
emotions is then a case of determining activation and valence.
Of the two, activation is easier to measure. Many physiological
processes are directly linked to our arousal level, for example
our heart rate, breathing rate or perspiration levels (as measured
through the galvanic skin response). Measuring valence is more
complex. However, many scientists believe it can be done by
combining a number of measurements typically including skin
conductance, heart rate variability and expression recognition.

26 Password June 2009

 Activation
Tense Excited
Jittery Ebullient

Pinpointing specific emotions is still a distant dream but Upset Elated

Distressed Happy
the technology is moving in that direction. Westerink notes:
“We can already do some amazing things with the very
Displeasure Pleasure
little emotion information available.” Sad Serene
Gloomy Contented

Tired Placid
Lethargic Calm

For more information, go to www.research.philips.com/password Circumplex model

Deactivation

Password June 2009 27

 Did you know...
Rain or shine
Weather sites are the second most popular category
of websites, after email sites, visited by people who access
the Internet via their phone in the US.

25% by 2020
It’s estimated that emergency
department visits could grow 25%
to 20.2 million in the US by 2020.

DIY energy
Surprisingly, Kenya is the global leader in the number of
solar power systems installed per capita. More than 30,000
small household solar panels, each producing anywhere
from 10-100 watts, are sold in the country each year.

In 2008, Swiss teacher and adventurer Louis Palmer

completed the first round-the-world journey in
a fully solar-powered car. The 32,000-mile journey
began in Switzerland and took him through
38 countries over 17 months.

28 Password June 2009

Happy Danes
According to the world’s first ‛happiness’ map –
developed by psychologists at the University of
Leicester in the UK – Denmark has the happiest
residents, followed by Switzerland, Austria, Iceland
and the Bahamas. The US came in at number 23, the
UK at 41 and Burundi last at 178. Countries with good
access to healthcare and education came out on top.

Thrill of creativity
“Happiness is not in
the mere possession of money;
it lies in the joy of achievement,
in the thrill of creative effort.”
Franklin D. Roosevelt, the 32nd president of the United States

Feelings first
Coming in eighth in the same study
was the tiny kingdom of Bhutan,
whose former king coined the term
‛Gross National Happiness’ in reference
to the government’s top priority.

Mood over money

A BBC (British Broadcasting Corporation)
poll found that 81% of the British population
think their government should focus on making
people happier rather than wealthier.

Password June 2009 29

 by Brandy Vaughan Images: Zero40 studios
The personal side
of technology
Not many of us are fortunate enough to do something we
love everyday and get paid for it. But Jettie Hoonhout is.
As a senior scientist for the Smart Kitchen Life project at
Philips Research, Jettie Hoonhout combines her background
in psychology and her love of food with a passion for making
technology more personal and enjoyable. It’s the idea that
quality-of-life can actually be improved with the right kind of
technology that motivates her to do what she does everyday.
Here are the details.
Describe what you’re currently
working on.
I’m working on the Smart Kitchen Life
project, which explores ways to support
people with things pertaining to food,
such as food preparation, nutrition and
taste. One main focus is finding ways to
help people adopt and maintain healthier
lifestyles. There are many people who
would like to change their eating habits
for the better. Often, they’re worried
about their health, weight and/or fitness
levels – or that of family – but don’t know exactly how to make
these important changes. So in this project we combine the
latest insights in nutrition science and psychology (for example
how to increase people’s motivation and compliance)
30 Password June 2009
with a range of Philips technologies to develop products that
help people make healthier choices in their everyday lives.
How is your background in psychology helpful?
Before we can develop a new technology that involves food
or eating – something that people usually feel quite strongly
about – we have to interact with people to find out what
they want and would appreciate.
People naturally have a strong
emotional connection to food. Most
people love food – but not always
healthy food. So when trying to help
people adopt a healthier lifestyle, it can
be a sensitive area. We need to look at
research on changing habits and how
best to help motivate people to make
the changes on their own and feel good
about it – this is where my psychology
background comes into play.
My role also involves presenting product ideas and seeing how
people react to the product based on their family situation,
history, eating habits and preferences. Then we find ways to
improve the product or technology based on their feedback.
Why is it important to consider the human aspect
when developing technology?
Philips’ mission states that we aim to improve people’s lives
through meaningful products and technology. So we always
start with the question: how can this improve quality of life?
And to answer this we need to directly involve people who
may use the product. We need to understand them and their
lives, what drives them and what
makes sense to them.
The product could be absolutely
“To ensure a
brilliant from a technology technology best
perspective but, for most consumers,
that doesn’t matter. If it doesn’t meet fits people’s lives,
their needs and make their lives
better in some way, then it won’t be
it’s important
to consider the
a success. For instance, in the kitchen
people want to feel empowered so
it’s important that any technology
human aspect.”
or product we develop enhances
their experience, not complicates it. People also want to
stay involved in the process so we have to take that into
account as well. And since people usually have an emotional
connection to food and eating, it’s important to delve into
the psychological aspects to ensure the technology best fits
their lives. Just looking at it from a technology point-of-view
won’t work. The human aspect needs to be considered.
What motivates you to come to work every day?
It’s simple: I love what I do. I really enjoy working on projects
that explore how technology can help people do things in
a better and more enjoyable way,
especially when it involves something
that’s such a huge part of our daily
lives – food. And when I see how
excited people are about our project,
it inspires me.
I also love the creative energy that
surrounds the project. I strongly
believe in the power of synergy
when bringing together people with
different backgrounds – in most cases
one plus one equals much more than
two! And, of course, I love cooking and eating. Sorry if this
sounds like a sales pitch, but I really do have a great job!
For more information, go to www.research.philips.com/password
Password June 2009 31