NIBIB Perspective on Image-Guided Interventions Research

John W. Haller, Ph.D.Acting Director, Division of Applied Science and TechnologyNational Institute of Biomedical Imaging and Bioengineering

October 19, 2006

NATIONAL INSTITUTES OF HEALTH U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES

Outline of Talk

• Definition of Image-Guided Interventions

• What lead to the RFA for IGI?

• Open Source Technologies

• Open Architecture

• Open Interface

• Future Directions

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.

Image courtesy of F. Jolesz

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

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…

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.

Federal Agency RetreatJanuary 2006

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

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.

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.

Technology Development of Image-Guided Interventions: Open Source

RFA-EB-06-003

• STANDARDSThe 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…

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 …

Technology Development of Image-Guided Interventions

RFA-EB-06-003

Hardware/System Access

• Open technologiesvs.

• Open architectures

vs.

• Open interfaces

vs.

• Closed/Proprietary systems

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

Open Architecture

Open-Source

Software

• Open architecture allows users to see inside the architecture without proprietary constraints.

• All or parts of the architecture are published.

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

Intervention Device

(e.g., Surgical Work-

station or Robot)

Open Interface

(API)

Open Interface

An API that does not require royalties for access and usage is called "open."

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

DaVinci Robot

Open Interface

(API)

Open-Source

Software

Open InterfaceIntervention

Device(e.g., Robot)

Tracking Device

An API that does not require royalties for access and usage is called "open."

Disclaimer

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

We need another quantum jump of imaging in medicine. I envision that in 30 to 40 years there will be no open surgery…there will be only image-guided microsurgery.

-Elias Zerhouni, MDJanuary 2003

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?

DaVinci

Robot

JHU

Robot

Open Interface(API)

Open-Source

Software

Open InterfaceDemonstration

Projects?

MedtronicStealthstation

Brainlab

DaVinciRobot

JHURobot

API Open Interface

ITK Analyze

Brainlab

Medtronic Stealthstation

Image Databases

SiemensScanner

GEScanner

Reductio ad absurdum?

PhilipsScanner

Summary

• Continuum of hardware/system access

hallerj@mail.nih.gov

Open-sourceTechnology

Open Architecture

Open Interface

ClosedProprietary

• Suggested action items

1.Establish working group for IGI standards

2.Develop a Demonstration Project

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