Innovations: Making 3-D medical imaging a reality

EchoPixel likes to compare its 3-D imaging technology to cutting through a loaf of bread. Medical diagnostic tools like MRIs and CT scans can create flat, two-dimensional pictures—or single slices—of information. But what if you wanted to cut into the loaf from a different angle to get more detailed cross sections?

Mountain View, Calif.-based EchoPixel allows users to create a 3-D image from patient-imaging data and then manipulate it—to remove tumors, dissect tissues or measure veins. The technology can take the guesswork out of surgical planning by allowing physicians to get a more accurate and precise view of patient anatomy.

“It's changing the way doctors use images,” said Sergio Aguirre, EchoPixel's founder and chief technology officer. “It really helps doctors not think about the data. They can focus on the clinical issues.”

With machine learning, the software records the way a clinician interacts with the images, allowing another doctor to follow the same steps and methodology. The software is designed to work on different types of hardware, including wearable devices such as Google Glass, so it can even be set up in an operating room.

“We're bridging the radiology and surgery gap, and that is a very powerful thing for the marketplace and for us,” said Ron Schilling, EchoPixel's CEO.

The company says its technology is getting traction in a number of applications. One use is virtual colonoscopies, a less-invasive way to screen for colon cancer that's yet to be demonstrated to be as effective as the traditional procedure. EchoPixel says its technology has 98% sensitivity in identifying lesions less than 6 millimeters in length, which is the key threshold for concern.

Aguirre said EchoPixel's imaging can mitigate false positives in virtual colon cancer screenings by allowing doctors to “grab” and virtually remove tissue on the screen to determine if it looks like a polyp or perhaps only residue from the colonoscopy prep solution.

Another application the company touts is in pediatric cardiology, where surgeons perform delicate and complex procedures to correct congenital heart defects such as tetralogy of Fallot. “They were (previously) basically drawing on a piece of paper, and that was the surgical plan they were taking into the OR,” Aguirre said.

But 3-D imaging allows surgeons to do a run-through on a life-size patient replica, reducing the guesswork in interpreting images. That, in turn, has reduced surgical time from about four hours to as little as 90 minutes, which means less time under anesthesia and less cost to the hospital.

“These kinds of operations are very hard to do with 2-D views,” Aguirre said. “Ultimately, the doctor is looking at 2-D images and trying to reconstruct that in his mind. What (our technology) means is that less-experienced doctors can perform at the same level as experienced doctors. It levels the playing field.”

EchoPixel's True 3D software also has applications in interventional cardiology and neuroradiology. Take Boston Scientific Corp.'s Watchman device for atrial fibrillation, a heart implant that's inserted through a catheter. Doctors try an average of 2.7 devices per patient in order to find the right fit, Aguirre said, at a total average cost of $20,000. And each placement attempt also carries the risk of perforation.

At Penn State College of Medicine, EchoPixel's technology is being used as an educational tool for teaching anatomy to doctors in training. Most first-year medical students learn anatomy through dissecting a human body, but cadavers are expensive and can't be preserved for future reference.

So when third- and fourth-year students take electives in specialties like orthopedics, Penn State uses EchoPixel. Students can dissect a real knee—albeit a virtual representation of one—to learn about bone tumors and skiing injuries.

“This gives us a lot more flexibility,” said Dr. Timothy Mosher, who chairs Penn State's radiology department. “The 3-D images also give you the haptic feedback. It's not often as a radiologist that I'm feeling the image.”

EchoPixel received clearance from the Food and Drug Administration in January 2015 for general diagnosis and surgical planning, and it is pursuing similar approval in Europe.

The company is located in the Fogarty Institute for Innovation, on the campus of El Camino Hospital. Dr. Thomas Fogarty, inventor of the balloon catheter, is an investor. Other investors in the venture-backed company include Russia-based Runa Capital; Aurus, a Chilean investment firm; and Harris & Harris Group of New York. The company has raised $5.8 million and has shipped more than 25 systems.

“There's a lot of enthusiasm for this technology because it's gotten to the point where it's a reality,” Mosher said. “The technology has now improved to the point over the past couple of years where it's real enough.”