Technology Development of Image-Guided Interventions: Phase I (R21) RFA-EB-06-003

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NIBIB Perspective on Image-Guided Interventions
Research
John W. Haller, Ph.D.Acting Director, Division
of Applied Science and Technology National
Institute of Biomedical Imaging and
Bioengineering October 19, 2006
NATIONAL INSTITUTES OF HEALTH U.S.
DEPARTMENT OF HEALTH HUMAN SERVICES
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Outline of Talk

• Definition of Image-Guided Interventions
• What lead to the RFA for IGI?
• Open Source Technologies
• Open Architecture
• Open Interface
• Future Directions

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Definition of Image-Guided Interventions

• All image-guided interventions require
• a source of images
• real-time display linked to the intervention
  patient
• target definition in the context of real 3D space
  of the patient

as distinguished from virtual image space.
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Image-Guided Interventions

• Images used DURING intervention
• Preoperative or intraoperative images are used
  during a procedure to guide physician to a target
• Both images AND intervention must be involved
• Image-guided Interventions include
• Minimally invasive surgery
• Image-guided Biopsy
• Radiation Treatment
• Image-guided radiofrequency ablation
• Cryoablation
• Endoscopic interventions
• Other image-guided therapies

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Recommendations from the 2002 2004 IGI
Workshops

• A technical working group is needed to develop
  standardized system interfaces.
• Collaborations between academia and industry
  should be facilitated.
• Exploit grid computing and informatics
  infrastructure
• Heterogeneous data integration/fusion.
• Platform technologies for IGI systems should be
  seamlessly integrated for a wide range of
  clinical applications

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Federal Agency RetreatJanuary 2006

• Standards for IGI
• Standards for IGI include not only informatics
  standards, but also standards for IGI imaging and
  interventional devices.
• Standards for IGI could facilitate the
  integration of imaging and data systems
• Establish standards for data acquisition,
  storage, communication, software,
  interoperability of systems.
• IGI standards will enable interoperability and
  plug-and-play capability.

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Concept for Image-Guided Interventions Initiative

• Disruptive technologies
• Minimally invasive IGI technologies that replace
  current technologies
• Two-phase, 8 yr. initiative, 40M Total Cost
• Phase I 3 yr Development/feasibility studies,
• 300K Direct Costs Per Year
• Phase II 4-5 years in duration
• 750K direct costs per year
• Five new IGI Centers (Cooperative Agreements)
• Goal-directed, problem solving

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Technology Development of Image-Guided
Interventions Phase I (R21) RFA-EB-06-003

• Receipt Date October 23, 2006
• Project period of up to three years
• Direct costs up to 300,000 per year.
• 5,000,000 per year NIBIB set aside
• Goal is to produce disruptive technologies to
  replace current treatments with minimally
  invasive, image-guided interventions.

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Technology Development of Image-Guided
Interventions Open SourceRFA-EB-06-003

• Reviewers will be instructed to evaluate the
  software dissemination plan
• 1. The software should be freely available .
• 2. the software should be transferable such
  that another individual or team can continue
  development
• 3. should include the ability of researchers to
  modify the source code and to share modifications
  
• 4. Commercialization should be permissible.

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Technology Development of Image-Guided
Interventions RFA-EB-06-003

• STANDARDS
• The software should adhere to community-based
• standards
• OPEN ARCHITECTURE
• open-architecture whose specifications are made
  public (i.e. the interface to other systems
  should be non-proprietary).
• open architecture will allow for the future
  integration and inter-operation of new IGI
  components

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Technology Development of Image-Guided
Interventions RFA-EB-06-003

• DATA SHARING
• data sharing plans will be considered by
  Program staff when making recommendations about
  funding

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Hardware/System Access

• Open technologies
• vs.
• Open architectures
• vs.
• Open interfaces
• vs.
• Closed/Proprietary systems

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Open Source Technology

• Cholera Treatment Device Device for improved set
  up, operation and monitoring of intravenous drip
  infusion systems, the only treatment for severe
  cases of cholera.

WIRED Issue 11.11 November 2003
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Open Architecture
Intervention Device (e.g., Surgical
Work- station or Robot)

• Open architecture allows users to see inside
  the architecture without proprietary constraints.
  
• All or parts of the architecture are published.

Open-Source Software

• i.e., accessibility to a machine by any other
  machine or software.

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Open Interface
An API that does not require royalties for access
and usage is called "open."
Open Interface (API)
An application programming interface (API) is the
interface that a computer system, library or
application provides in order to allow requests
for services to be made of it by other computer
programs, and/or to allow data to be exchanged
between them.
http//en.wikipedia.org/wiki/API
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Open Interface
Intervention Device (e.g., Robot)
DaVinci Robot
Tracking Device
Open Interface (API)
An API that does not require royalties for access
and usage is called "open."
Open-Source Software
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Disclaimer

• The follow slides do not represent the views of
  the NIBIB, NIH or Major League Baseball.

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We need another quantum jump of imaging in
medicine. I envision that in 30 to 40 years there
will be no open surgerythere will be only
image-guided microsurgery. -Elias Zerhouni,
MD January 2003
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Future IGI Activities

• Encourage the use of open source software and
  open architectures
• Reduce health disparities both domestically and
  globally through new and affordable IGI
  technologies.
• Establish working group for IGI standards?
• Develop a Demonstration Project?

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Open Interface Demonstration Projects?
DaVinci Robot
JHU Robot
Open Interface (API)
Medtronic Stealthstation
Brainlab
Open-Source Software
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Reductio ad absurdum?
DaVinci Robot
JHU Robot
Philips Scanner
Siemens Scanner
GE Scanner
API Open Interface
Medtronic Stealthstation
Brainlab
ITK
Analyze
Image Databases
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Summary

• Continuum of hardware/system access

Open-source Technology
Open Architecture
Open Interface
Closed Proprietary

• Suggested action items
• Establish working group for IGI standards
• Develop a Demonstration Project

• What role can NIH play to promote
• open architectures/open interfaces?

hallerj_at_mail.nih.gov