Imagine you’re a surgeon steeling yourself to operate on a child’s defective heart. In the future, doctors like you might be able to do a fail-safe trial run by snipping through a 3D image of the patient’s faulty cardiac anatomy while it floats in mid-air above a desktop.
That’s the ultimate goal for Mountain View, CA-based EchoPixel, a software startup that assembles data from 2D diagnostic scans and projects a three-dimensional map of an afflicted organ as a virtual reality image in open space.
EchoPixel, founded in 2012, has already been selling its interactive 3D representations of the human body for the purpose of health and medical education. But the company announced today it has received FDA clearance to provide the system to doctors and medical centers for the first steps in clinical use.
EchoPixel’s True3D Viewer was approved as a tool to help doctors diagnose illnesses and prepare plans for surgical treatment. Sergio Aguirre, the company’s founder and CTO, says the technology can help make the most of the hundreds of two-dimensional MRI and CT scans often provided to physicians in each surgical patient’s case.
“Scanners can provide such highly detailed information,” Aguirre says. But those 2D scans each show only a single thin cross-section of a heart or kidney or lung, like a series of slices of a fruitcake. Surgeons look at each slice individually, and then try to reconstruct in their minds what the solid organ would look like if it were re-assembled, with the target vein or tumor snaking a complex path through the tissue.
As part of the current surgical planning process, those many 2D scans may only add up to information overload for the physician, Aguirre says.
“Doctors are so pressured to produce results so fast, that they will skip images to go through cases at sufficient speed,” Aguirre says. “It’s an opportunity to lose clinically significant information.”
In addition to re-assembling the hundreds of scans into a 3D image, EchoPixel’s software allows doctors to zoom in on a specific segment of the virtual anatomical model, Aguirre says. This move is familiar to anyone who has ever outlined a square section of an interactive online street map and expanded it to fill the screen and reveal more detail.
The doctor outlines a cube rather than a square, to expand a key section of a diseased organ and better profit from the increased resolution of medical imaging technology. For example, the doctor could examine in detail the margins of a tumor, and the extent of tumor growth toward a nearby blood vessel, Aguirre says.
Doctors planning brain surgery could use the True3D Viewer to display all components of the patient’s head, from the skin layer, to the bony skull, the brain, and the blood vessels intertwined within it, Aguirre says. Users of the software can change its parameters to focus on the layer of most interest. For example, they could make the bone layer transparent and reveal the soft tissues of the brain beneath it.
As EchoPixel developed the software, it worked with doctors at Stanford and UCSF as they interpreted CT and MRI scans and drew up surgical plans for patients. These plans, a collaboration between the radiologist and surgeon, often include two-dimensional drawings, Aguirre says. Eventually, an EchoPixel virtual image may be used in the operating room for the surgeon’s reference instead of a flat drawing, he says.
In early trials at university medical centers, EchoPixel saw signs that the technology helped doctors interpret scans more quickly and operate more efficiently, Aguirre says.
EchoPixel raised a $3.8 million seed round in 2012, and the following year moved into the Fogarty Institute for Innovation, a Mountain View, CA incubator for medical device developers founded by Dr. Thomas Fogarty, the noted inventor of the balloon catheter. Fogarty is an investor in EchoPixel through a private fund.
EchoPixel’s software is currently used on the stereoscopic display system of Sunnyvale, CA-based zSpace, which is also developing its technology for use in corporate training, science education and university research. A demonstration by zSpace using EchoPixel’s software helped EchoPixel land a contract for its use in medical education with Taiwan-based Foxconn, EchoPixel CEO Ron Schilling says.
EchoPixel has also worked in partnership with Siemens and Philips, big manufacturers of medical imaging equipment. Those companies have contributed to three-way partnerships with university medical centers where EchoPixel’s technology is being tested, Schilling says.
The big imaging companies don’t seem to be venturing into virtualization technologies themselves, Schilling says. “They’d rather leave it to small companies and then acquire them,” he says.
EchoPixel’s system already includes virtual instruments for use in practice surgeries, but the field opens vast opportunities for refinements and new technologies. Currently, users can make incisions in any direction to reveal deeper levels of data about a patient’s anatomy, Aguirre says. But the system can’t represent everything, such as the flow of blood after an incision, or the different levels of resistance as the surgeon cuts through different types of tissue. However, with EchoPixel’s current virtual instruments, users get an early version of tactile feedback as they reach a new tissue layer, Aguirre says.
“If you hit something, the tool vibrates a little,” Aguirre says.
EchoPixel plans to refine the virtual instruments and its software to create a more exact simulation of real surgery, Aguirre says.
“We will be working on haptic feedback for surgical rehearsal to give doctors a feeling for the force required for bone, skin and vessels,” Aguirre says.
