Imagine if a simple blood test could detect recurrent cancer earlier, while also predicting a patient's prognosis, Cleveland Clinic physicians say. Or imagine if a device the size of two decks of cards could help a paraplegic breathe without a bulky ventilator. Or imagine if a machine could essentially keep harvested organs alive until they're transplanted in the recipient.

Now imagine that these innovations already exist, because they do, along with seven other emerging technologies that make up Cleveland Clinic's Top 10 Medical Innovations for 2009. The list of breakthrough devices and therapies was selected by a panel of Cleveland Clinic physicians and scientists and was unveiled during Cleveland Clinic's recent 2008 Medical Innovation Summit.

The innovations touch on avian influenza, electronic medical records, and various minimally invasive surgeries to treat uterine fibroids, to repair heart valves, and to remove organs through the body's natural orifices.

"Once again, we are seeing a diverse list of technologies that have the potential to make an enormous medical impact in the near future," said Michael Roizen, M.D., who chaired the Top 10 Medical Innovations List.

The Top 10 Medical Innovations for 2009:

10. Private Sector National Health Information Exchange: A comprehensive system of electronic health records that link consumers, general practitioners, specialists, hospitals, pharmacies, nursing homes, and insurance companies is in the process of being established. Primarily a private-sector effort, this computerized system has the potential to replace paper-based medical files with digitized records of patients' complete medical history.

9. Doppler-Guided Uterine Artery Occlusion: Fibroid tumors occur in upwards of 40% of women older than 35, triggering pelvic pain, pregnancy complications, and heavy bleeding. There is a new, non-invasive approach to treat fibroids called Doppler-guided uterine artery occlusion, or DUAO.

8. Integration of Diffusion Tensor Imaging (Tractography): Diffusion tensor imaging (DTI) is the new technology that allows neuroscientists to non-invasively probe the long-neglected half of the brain called white matter, with its densely packed collection of intertwining insulated projections of neurons that join all four of the brain's lobes, allowing them to communicate with each other.

7. LESS and NOTES Applications: LESS (laparoendoscopic single-site surgery) takes laparoscopic surgery to an entirely new level by reducing the process to a small cut in the belly button. NOTES (natural orifice transluminal endoscopic surgery) bypasses normal laparoscopic incisions altogether. Instead, the surgeon gets to an appendix, prostate, kidney, or gallbladder through one of the body's natural cavities, such as the mouth, vagina, or colon.

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