About
Brian T Crouch is a professor affiliated with Duke University whose work focuses on biomedical engineering with a particular emphasis on global health. He co-authored the textbook "Biomedical Engineering for Global Health," published by Cambridge University Press in November 2024. This work explores the fundamentals of biomedical engineering technologies through the lens of global cancer inequities, connecting engineering principles to real-world global health scenarios. The textbook introduces major technological advances in cancer care, discusses how new technologies can address health inequities worldwide, and demonstrates the adoption of novel medical technologies in clinical practice. Designed for students from diverse backgrounds, the book includes modular chapters, ethical discussions, supplementary lab modules, and extensive end-of-chapter problems to solidify understanding. Through this publication, Professor Crouch contributes to equipping students with critical technical and ethical knowledge necessary to excel in biomedical engineering for global health.
Research topics
- Medicine
- Internal medicine
- Pathology
- Biochemistry
- Psychiatry
- Chemistry
- Biotechnology
- Clinical psychology
- Biology
- Cancer research
Selected publications
Scientific Reports · 2025-12-20
articleOpen accessIntracervical injections directly deliver therapies into the cervix. We previously explored ethyl cellulose (EC)-ethanol intracervical injections as a treatment for cervical dysplasia in low- and middle-income countries. Here we: (1) compared swine and human cervices to assess swine as a model for intracervical injections, and (2) evaluated two speculum-compatible injectors: a custom single needle injector and an extender injector, assembled from off-the-shelf components, to determine what parameters produced optimal distribution. Mechanical properties of swine and human cervices were compared. Swine cervices were injected with EC-ethanol iohexol using both injectors. Distribution and leakage volumes in tissue were visualized with microCT and quantified with 3D Slicer. Mechanical testing showed swine and human cervical tissue yielded comparable storage and loss moduli (p > 0.05). Ex vivo studies showed injections ≥ 10 mm deep and < 2 mL significantly reduced backflow and crack formation for both injectors. Additionally, the extender injector produced significantly less crack formation than the single needle injector. These findings indicate swine cervices are a clinically relevant model for intracervical injection studies. The extender device when inserted ≥ 10 mm and delivering < 2 mL of EC-ethanol achieved the most consistent results across intracervical delivery protocols.
Multi-probe Metabolic Fluorescence Microscopy Captures Poor Tumor Immunogenicity
2025-01-01
articleVisualizing complex tumor-immune metabolic interactions is imperative to understanding cancer progression. Cocultures of 4T1 tumor cells and CD8+ T cells were imaged for glucose uptake and mitochondrial metabolism. Results point to poor immunogenic tumor phenotype.
Research Square · 2025-10-22 · 1 citations
preprintOpen accessAnnals of Biomedical Engineering · 2025-07-21 · 3 citations
articleOpen accessPURPOSE: Current treatments for cervical neoplasia are often inaccessible in low- and middle-income countries (LMICs), which contributes to high cervical cancer mortality. We previously developed a low-cost ablative therapy using ethanol mixed with ethyl cellulose (EC) to a form an ethanol-retaining gel that reduces injection leakage. To optimize delivery of EC-ethanol into the cervix, we developed and compared three speculum-compatible injectors that each address clinical challenges: 1) a single needle injector, which contained an adjustable depth stop to control the depth of injection, 2) a multi needle injector, which injected three locations in the cervix simultaneously, and 3) an extender injector, which included a needle extender. METHODS: The variability in EC-ethanol injections was evaluated through bench top and ex vivo swine testing. Usability testing was performed by gynecology (GYN) providers who used each device in a custom pelvic model. RESULTS: Both the extender and single needle devices led to consistent ejection volumes in benchtop tests with no variability between injections. All devices achieved spherical depots with minimal leakage in ex vivo tests. In usability testing, 65% of GYN providers preferred the extender device, which achieved significantly shorter injection times in the custom pelvic model compared to other injectors. CONCLUSION: While all devices met clinical constraints, the extender device was preferred by clinicians and achieved repeatable injection distributions. This work presents a clinically informed low-cost intracervical delivery method for LMICs. Future work will include validating performance in clinical trials and assessing feasibility in clinical settings to advance global cervical neoplasia treatment.
International Journal of Gynecological Cancer · 2024-10-01
articleBiomedical Engineering for Global Health
Cambridge University Press eBooks · 2024-11-21
bookSenior authorExplore the fundamentals of biomedical engineering technologies with this thought-provoking introduction, framed around modern-day global cancer inequities. Connecting engineering principles to real-world global health scenarios, this textbook introduces major technological advances in cancer care through the lens of global health inequity, discusses how promising new technologies can address this inequity, and demonstrates how novel medical technologies are adopted for real-world clinical use. It includes modular chapters designed to enable a flexible pathway through material, for students from a wide range of backgrounds; boxed discussion of contemporary issues in engineering for global health, encouraging students to explore ethical questions related to science and society; supplementary lab modules for hands-on experience in translating engineering principles into healthcare solutions; and over 200 end-of-chapter problems, targeting multiple learning outcomes to solidify student understanding. This introduction is designed to equip students with all the critical, technical, and ethical knowledge they need to excel.
International Journal of Gynecological Cancer · 2024-10-01
articlePolymers · 2024-04-05 · 1 citations
articleOpen accessEthyl cellulose-ethanol (ECE) is emerging as a promising formulation for ablative injections, with more controllable injection distributions than those from traditional liquid ethanol. This study evaluates the influence of salient injection parameters on forces needed for infusion, depot volume, retention, and shape in a large animal model relevant to human applications. Experiments were conducted to investigate how infusion volume (0.5 mL to 2.5 mL), ECE concentration (6% or 12%), needle gauge (22 G or 27 G), and infusion rate (10 mL/h) impacted the force of infusion into air using a load cell. These parameters, with the addition of manual infusion, were investigated to elucidate their influence on depot volume, retention, and shape (aspect ratio), measured using CT imaging, in an ex vivo swine liver model. Force during injection increased significantly for 12% compared to 6% ECE and for 27 G needles compared to 22 G. Force variability increased with higher ECE concentration and smaller needle diameter. As infusion volume increased, 12% ECE achieved superior depot volume compared to 6% ECE. For all infusion volumes, 12% ECE achieved superior retention compared to 6% ECE. Needle gauge and infusion rate had little influence on the observed depot volume or retention; however, the smaller needles resulted in higher variability in depot shape for 12% ECE. These results help us understand the multivariate nature of injection performance, informing injection protocol designs for ablations using gel ethanol and infusion, with volumes relevant to human applications.
Biophotonics discovery. · 2024-07-17 · 2 citations
articleOpen accessSignificanceEmerging evidence that aggressive breast tumors rely on various substrates including lipids and glucose to proliferate and recur necessitates the development of tools to track multiple metabolic and vascular endpoints concurrently in vivo.AimOur quantitative spectroscopy technique provides time-matched measurements of the three major axes of breast cancer metabolism as well as tissue vascular properties in vivo.ApproachWe leverage exogenous fluorophores to quantify oxidative phosphorylation, glucose uptake, and fatty acid oxidation, and endogenous contrast for measurements of hemoglobin and oxygen saturation. An inverse Monte Carlo algorithm corrects for aberrations resulting from tissue optical properties, allowing the unmixing of spectrally overlapping fluorophores.ResultsImplementation of our inverse Monte Carlo resulted in a linear relationship of fluorophore intensity with concentration (R2<0.99) in tissue-mimicking phantom validation studies. We next sequenced fluorophore delivery to faithfully recapitulate independent measurement of each fluorophore. The ratio of Bodipy FL C16/2-NBDG administered to a single animal is not different from that in paired animals receiving individual fluorophores (p=n.s.). Clustering of five variables was effective in distinguishing tumor from mammary tissue (sensitivity = 0.75, specificity = 0.83, and accuracy = 0.79).ConclusionsOur system can measure major axes of metabolism and associated vascular endpoints, allowing for future study of tumor metabolic flexibility.
Development of a multi-scale imaging tool to quantify in vivo metabolic heterogeneity
2024-03-13
articleWe developed an approach to quantify intra-tumoral metabolic heterogeneity of in vivo tumor models by leveraging a computationally designed multi-scale microscope and a suite of exogenous fluorescent contrast agents to provide functional and structural information.
Frequent coauthors
- 62 shared
Nirmala Ramanujam
Duke University
- 18 shared
Megan C. Madonna
Duke University
- 15 shared
Caigang Zhu
University of Kentucky
- 13 shared
Amy F. Martinez
Vanderbilt University Medical Center
- 13 shared
Corrine A. Nief
- 12 shared
Jenna L. Mueller
University of Maryland, College Park
- 11 shared
Erika Chelales
Duke University
- 10 shared
Enakshi D. Sunassee
Duke University
Education
- 2018
Ph.D., Biomedical Engineering
Duke University
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