Philips’ Astonish debuted at the 2003 RSNA meeting laden with hubris. Designed for the pending era of molecular imaging, the work-in-progress software was out of step with its time.
Philips' Astonish debuted at the 2003 RSNA meeting laden with hubris. Designed for the pending era of molecular imaging, the work-in-progress software was out of step with its time.
Astonish had been designed to image targeted agents that would create hot spots in the body. It was commercially released when precious few such agents were available and none were in widespread use. With no appreciation of the context for which the software was created, the imaging community categorized it for what it could do at the time--recover resolution and suppress noise--and it blended into a class of other products bearing hyperbolic names and performing mundane functions.
Next year, however, Astonish might find its light.
Little-known Cell Point, a biopharmaceutical company with big dreams, expects to complete later this year clinical trials of a new kind of radiotracer platform called ECDG (ethylenedicysteine-deoxyglucose). The new radiotracer could be a boon for gamma cameras, especially high-performance SPECT/CTs (DI SCAN, 2/20/07, Cell Point, Philips bet on next generation of radiotracers).
How Astonish was created is a story of collaboration between an innovator and an industry mainstay whose shared vision of the future led them to aim ahead of the marketplace. What Astonish will do when the rest of nuclear medicine catches up, how it will be sold, and who will sell it are questions that reflect the nature of the industry itself.
Astonish grew from a joint effort between Philips and Cell Point to develop customized software for the interpretation of ECDG images. Fifty-five percent of its development was supported by Cell Point and 45% by Philips.
The software incorporates algorithms that optimize the images produced using ECDG. These algorithms would be the basis for diagnoses and treatments based on imaging hot spots created by the uptake of ECDG rather than the absence of radioisotope, referred to as cold spots, as is now prevalent in nuclear medicine. But the challenge is greater than just this change.
The algorithms would have to take into account different scatter and energy characteristics for the different isotopes that might be attached to ECDG, such as technetium and indium. They would also have to calculate attenuation corrections for different body segments, the brain versus the chest or pelvis.
Philips would have liked to sell the product for its true capabilities, but marketing Astonish solely for molecular imaging would have been like selling snow boots in summer. No matter how good the boots, nobody is going to buy them. So Philips looked for another angle, settling on the side benefits of the Astonish algorithms: workflow enhancements that speed image quality.
"We created Astonish for molecular imaging, but what we found was that using this software increased accuracy, which meant fewer counts were needed statistically to prove that something was abnormal," said Cell Point president Dr. F. David Rollo. "We found Astonish allowed correct diagnosis in five minutes rather than 15 minutes (of data acquisition). That translated into workflow issues, particularly in cardiac imaging."
Now, as ECDG closes in on the marketplace, Rollo expects the joint effort that he negotiated with Cell Point when he was Philips' chief medical officer will start paying off for both companies. Almost five years after starting the development that led to Astonish, the software has been clinically validated, according to Rollo.
"We have been able to prove that the combination of diagnostic CT with SPECT and unique software gives accurate diagnosis," he said.
To be commercially successful, however, Philips and Cell Point must get the rest of the imaging industry to buy into the radiotracer and the technology to image it. How this will happen has to do partly with the "keeping up with the Joneses" mentality that marks the imaging industry, as demonstrated by the independent development of high-performance SPECT/CTs by both GE and Siemens.
Philips and Cell Point hope to boost the development of SPECT/CT by these vendors by licensing Astonish for visualizing ECDG. This might happen in one of two ways.
In consideration of the joint funding behind the development of Astonish, Philips owns the intellectual property associated with the final software package, and Cell Point owns the IP associated with the agent. Their agreement allows Philips to market Astonish optimized for use on its Precedence SPECT/CT scanners and to license the software to other vendors for use on their scanners under their own brand names. Cell Point has the right to license elements of the software related specifically to ECDG.
In this way, Philips and Cell Point hope to provide the "chip" that will unleash the potential of molecular imaging, Rollo said, by making generally available the software needed to interpret ECDG images, in the same way Intel processors power PCs.
"It took us five years to develop and validate the clinical software, so rather than having the other companies start all over again and wait five years to get their products ready, it makes sense to cross-license the technology to these other companies," Rollo said.
The plan could bear fruit soon. Rollo expects the radiotracer platform to be on the U.S. market in mid-2008.
Tomorrow: the game plan for making ECDG the next FDG.