Medical Imaging for

Decision Support, Diagnostics,

Research & Education

8 Opportunities for tech entrepreneurs and

investors

Prepared for HealthStartup.eu 6 on medical imaging for decision support & diagnostics.

November 19, Heidelberg http://healthstartup.eu/2013/06/hsu6call/

Why Should You Care?

Trend 1: A massive increase in the volume and

complexity of imaging data

Trend 2: The promise of eHealth (sharing medical

images within the healthcare system)

Trend 3: Increasing demand for solutions that reduce

costs and increase efficiency

Trend 4: The rise of patient empowerment

A massive

increase in the

volume &

complexity of

imaging data

1

Imaging technology is

advancing rapidly, leading to

ever more modalities

Radiography

MRI

Nuclear medicine

Fiduciary Markers (SPECT, PET)

Ultrasound

Tomography

Thermography

Photoacoustic imaging

Echocardiography

Consumer networked photography (smartphones)

All of which

generates data,

lots of data to

archive &

manage

1 Exabyte = 1 billion gigabytes Frost & Sullivant predicts that diagnostic imaging

alone will generate 1 exabyte of data by 2016,

creating a huge data archiving burden for

hospitals

But data is food for

software

Which enables interdiscisplinary

research in:

• Medical image visualisation

• Computer aided diagnosis

• Computer aided surgical planning

• Computer aided intervention

• Molecular imaging

(image courtesy Nagoya University Diagnostic

Medical Imaging Lab)

The promise of

eHealth (sharing

medical images

within healthcare

system)

2

Efficiency: avoiding repitition of medical

imaging

Safety: caregivers have immediate

access to their patient’s earlier medical

images

Outcomes: caregivers can work together,

sharing info & expertise, to decide best

treatment

The eHealth promise?

1

3

2

But the silos need to

be unlocked

“Most of the vast stores of imaging data remain

locked in silos—contained within proprietary

schema erected by different PACS

manufacturers. ...much of the medical imaging

data may not be easily shared across a single

enterprise, much less across different provider

networks and regions.”

- Frost & Sullivan White Paper

Increasing demand

for solutions that

reduce cost and

improve efficiency

3

$19 billion

4-5% CAGR)

Global market for medical imaging devices

continues to grow (InMedica), driven by rising

demand for healthcare (ageing populations +

emerging markets)

But the downturn is forcing most buyers to reduce

spending on high-end imaging devices. Also, emerging

markets are keen on more affordable solutions. Creating

pockets of growth in point of care ultrasound, mobile x-ray

& multimodality devices

Siemens introduces

a more affordable,

wired-detector

version of its high-

end Mobilett Mira

mobile digital X-ray

system

MedPAC recommends utilisation factor of 90% for medical

equipment costing over $1 million

How to achieve that without negative consequences for

patients?

$1,000,000 –

$10,000,000 Price range of an MRI

machine

The rise of patient

empowerment 4

Most patients want direct access to their

radiology images and reports.

(J. Am. Coll. Radiology, April 2012)

Given the above trends, here’s

8 opportunities

for tech entrepreneurs & investors

Analyse imaging

data for Computer-

Aided-Diagnosis,

therapy planning,

and therapy

assistance

1

Alma IT systems

develops medical

imaging software

for diagnostic and

therapy planning

purposes, that is

integrated with

main PACS, RIS &

HIS systems.

www.alma3d.com

Virtual Proteins develops 3D visualisation and augmented

reality applications, for therapy planning and research

purposes

www.virtualproteins.com

The Nagoya University

Medical Image Processing

Lab develops solutions for

medical image visualisation,

computer aided diagnosis

and computer assisted

interventions

Right-above:

Endoscope

insertion assistance

system

Left: Virtual

unfolded view of

the stomach Right-below: Automatic

detection of colonic

polyps from CT images

http://www.med.nagoya-u.ac.jp/english01/6489/6600/Diagnostic-Medical-Image-Processing.html

German company Mint

Medical develops

image processing

methods to improve

medical diagnosis,

therapy planning and

computer-assisted

therapy

http://www.mint-medical.de/

Quantifying,

analysing &

visualising

imaging data for

research purposes

2

Belgian company IcoMetrix offers advanced image

processing for quantitative analysis of biomedical

images (which is useful for for research purposes)

http://www.icometrix.com/

The Applied Medical

Informatics working

group at ExMI

(Experimental

Molecular Imaging)

lab (Uni.

Hosp.Aachen)

develops methods to

quantitatively analyze

clinical and

preclinical image

data. One aim is to

automate certain

analytical steps. http://exmi.rwth-aachen.de/

da-cons offers data

analysis and

visualisation services

pertaining to 3D

microscopy and 3D

cell biology. Handling

large 3D, 4D or 5D

imaging data files that

can be up to several

terabytes or even

petabytes in size

requires immense

computational power

http://www.da-

cons.de/en/welcome

Process imaging

data for efficient

recording, storage,

networking &

mobile/web-based

visualisation

3

Belgian company

Telemis was founded as

a medical imaging

software company

(expertise in image

compression and

networking) and ended

up competing as an

independent PACS

vendor.

http://www.telemis.com

Read our interview with the CEO here: http://healthstartup.eu/2012/06/14-lessons-for-

health-startups-from-a-successful-health-tech-entrepreneur/

eSaturnus is a Belgian

company with roots in

the universities in

Leuven and Oxford. The

company developed a

user-friendly medical

image recorder (to

review cases, for patient

communication, for

education) and a

networked visualisation

solution that serves as a

control platform for

surgeons.

www.esaturnus.com

Dixit Solutions in Italy built a web-based image and

diagnosis exchange network, called WIDEN,

designed specifically for clinical trial purposes

http://www.dixitsolutions.com/

Calgary

Scientific

developed a

medical

image

viewer for

mobile and

tablets, with

clinical

workflow

tools .

www.calgaryscientific.com

Jack Imaging is a web-based platform for sharing

medical images

https://beta.jackimaging.com/

Create searchable

imaging databases

for decision

support,

collaboration, &

education

4

Diagnologic is

a search

engine of

200,000+

radiological

images,

designed to

help clinicians

make

diagnostic

decisions

www.diagnologic.com

VisualDX is a

database of

medical photos

(100,000+ peer-

reviewed images)

for diagnostic

purposes. It is

web-based and

easy to integrate in

point-of-care

www.visualdx.com

German

company

Averbis

developed a

tool for data

mining

radiological

diagnostic

reports &

images

www.averbis.de

Khresmoi developed a multi-lingual, multi-modal

search and access system for biomedical information

and documents. It can be used for analyzing and

indexing multi-dimensional (2D, 3D, 4D) medical

images

www.khesmoi.eu

Create imaging

interfaces & tools

for patient

education

5

3D4Medical creates anatomy

apps for educational purposes www.3d4medical.com

Vitalrecon processes imaging data at high spatial

resolution to create detailed 2D, 3D & 4D

visualisations for educational and research

purposes www.vitalrecon.com

A German research

team developed the

‘Magic Mirror’, an

Augmented Reality

system (using Microsoft

Kinect) that allows a

user to virtually look

inside the own body, by

standing in front of a

magic mirror.

http://campar.cs.tum.edu/files/mirracle/index.htm

Develop low-cost

imaging devices &

solutions for

primary care and

consumers

6

MobiSante

developed a

smartphone-

based

ultrasound

imaging

system

http://www.mobisante.com/

Skin Analytics lets

people keep track

of their moles

using their

smartphone. The

software helps

detect changes in

the structure and

colour of moles.

www.skin-analytics.com

3Derm is

developing a

solution that

enables primary

care givers to take

3D images of skin

moles and upload

them to a web-

based platform for

remote consults

http://3derm.com/pitch.html

Film & broadcast

medical practice

for educational &

research purposes

7

Medinbox

develops

solutions for

recording and

broadcasting

surgery (from

multiple

angles +

technical

feeds)

http://www.medinbox.com/

Use image-

recognition &

movement

detection

technology to

develop novel user

interfaces for

healthcare

8

TedCas

developed

aseptic

Natural User

Interfaces

based on

Microsoft

Kinect

www.tedcas.com

Slovenia-based Adora developed an

interactive (and contact-free) physician’s

assistant enabling presentation of patient's

information before and during surgical

procedures www.adora-med.com

Consider

7

potential

challenges

3

1 Clinical validation

It is necessary

It takes time

It is expensive

How will you fund it?

Who will you partner with (startup

+ university + large tech/pharma)?

2 Integration

How will you make it easy,

convenient & secure for clinicians

to take part?

Work with clinicians & providers,

integrate with their systems and

interfaces.

3 Business model

Who will pay?

Healthcare providers

Patients

Established PACS/medical devices

Health insurance

Public health/government

Europe’s networking

conference for digital

health innovators.

Conference topic: Imaging

for decision support and

improving diagnosis

Join us in Heidelberg on

November 19

http://healthstartup.eu/2013/06/hsu6call/