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PNN Vendor Profile: Stentor plans compression offering to ease image viewing, transfer needs


Stentor plans compression offering to ease image viewing, transfer needsFirst product set to reach market in MarchA growing number of hospitals and medical centers are seeking to take advantage of the efficiency and workflow benefits of

Stentor plans compression offering to ease image viewing, transfer needsFirst product set to reach market in March

A growing number of hospitals and medical centers are seeking to take advantage of the efficiency and workflow benefits of enterprise-wide digital image distribution. This goal is not easily attained, however. Clinicians often demand to review images at the same resolution as radiologists do, and the bandwidth requirements for large image files pose thorny network problems.

Enter Stentor, a medical informatics company founded last year by two PACS industry veterans with the goal of overcoming these barriers and making low-cost enterprise-wide image distribution a commercial and clinical reality. Stentor has licensed proprietary wavelet compression-based technology developed at the University of Pittsburgh Radiology Informatics Lab (PNN 1/99) and turned it into a Web-based application that can be downloaded and installed on a hospital’s intranet. The company expects to have its first commercial product available to customers early next year.

“Our goal with this technology is to solve the problem of image distribution across the medical enterprise,” said Oran Muduroglu, Stentor president and chief executive officer. “Many large PACS sites are still printing film for distribution outside of the radiology department because sending images electronically is still too slow. And as images get larger and more of them need to be sent and retrieved, the servers get overloaded.”

Stentor was established in 1998 with $5 million in venture capital from Caduceus Capital Investment of Boston and Sanderling Biomedical Venture Capital of Menlo Park, CA. The University of Pittsburgh also holds an equity stake. The company boasts a strong management team as well.

In addition to Muduroglu, who was vice president of sales and marketing at Cemax-Icon for seven years, John Huffman, former medical marketing manager for Silicon Graphics and co-founder of the wavelet compression firm Aware, serves as chief technical officer. Rounding out the team is Dr. Paul Chang, director of radiology informatics at the University of Pittsburgh Medical Center and a well-known figure in the field of medical informatics. Chang is not a Stentor employee, but serves as the company’s executive clinical advisor.

Chang is also one of the developers of the iSyntax technology, originally dubbed “dynamic transfer syntax” (DTS). When UPMC was considering implementing a large-scale PACS network a few years ago, Chang and his colleagues realized early on that their $25 million budget would not be sufficient to meet the image viewing requirements of the medical center’s referring physicians, many of whom wanted the same image quality and resolution available in the hospital’s radiology department. Rather than deploying a huge network pipeline to handle the large data files and installing multiple $100,000 workstations throughout the hospital, Chang and his colleagues used Java and CORBA technology, along with DICOM libraries from Merge Technologies, to develop a new image-distribution model that allows near real-time delivery of electronic images via standard Ethernet lines to PCs anywhere in the hospital.

Wavelet-based image representationiSyntax combines a wavelet-based flexible representational data scheme with an interactive server/client communication protocol to facilitate rapid delivery of image data with arbitrary fidelity. Instead of using traditional compression algorithms or fetching techniques that may compromise image fidelity, iSyntax relies on “just in time” data delivery to provide various levels of image detail on demand and in a manner that fits the requirements of the user and the resources of the network and viewing workstation.

When an image request is made, iSyntax automatically retrieves and sends lower resolution versions of the images but allows users to identify specific regions they want to see in higher resolution. This obviates the need for high-bandwidth networks and high-powered workstations and reduces end-user costs without sacrificing image quality or acquisition times, according to the company.

“Using iSyntax, you can look at a 2K x 2.5K image within one second, and you can pan and zoom around the image in real-time, all without overwhelming the network,” Muduroglu said.

iSyntax was unveiled as a work-in-progress (still called DTS) during the 1998 RSNA meeting, where it received a summa cum laude award. Since being licensed to Stentor, the technology has undergone some reengineering to make it a more commercially viable product. The only installation at this time is at UPMC, which has served as the primary beta site. Stentor filed a 510(k) application with the Food and Drug Administration in August and expects to receive marketing clearance for iSyntax by November, prior to the RSNA meeting. A full commercial release is scheduled for March 1, 2000, following several more months of beta testing at up to 30 sites, including UPMC, Stanford University, and the University of California, Davis. The company has also filed six patents, which are pending.

Once FDA clearance is gained, Stentor plans to use a unique business model to distribute its products. The company will make the iSyntax technology available directly to customers through iSite, a client application service that self-installs, self-diagnoses, and is maintained via a real-time connection to Stentor’s Quality Engineering Center. iSite can be downloaded via the Internet, installed on a hospital’s internal intranet server, and used for one month on a trial basis, free of charge. Customers who decide to continue using it will then be billed on a per-use/per-image basis. As part of this service, Stentor is making a cost-distribution model available on its Web site so that CIOs and other prospective customers can determine their potential savings prior to installing the iSite system.

“Our goal is to offer close to an order of magnitude cost savings using this technology versus how they do it now,” Muduroglu said.

OEM relationships will also play a key role in Stentor’s production distribution plans. The company is talking to healthcare information systems vendors (primarily those already working with electronic patient records) and PACS companies that will attach the iSyntax technology to the back end of their systems to enhance image distribution. Stentor expects to announce these partnerships at the RSNA meeting in late November. The company also plans to demonstrate a full-field mammography viewing workstation enabled with iSyntax at the RSNA show.

Future prospectsUPMC’s and Stentor’s technology received much fanfare at its 1998 RSNA meeting debut, and is backed by some of the brighter minds in the industry. Aggressive pricing to attract end users, coupled with prominent OEM partnerships, will likely continue the firm’s momentum into 2000 and help secure a solid niche for it in the marketplace.


385 Oyster Point Blvd., Suite 8B
South San Francisco, CA 94080
fax: 650/866-4197


Key personnelOran Muduroglu, president
John Huffman, chief technical officer

Product lineiSyntax

Product distributionDirect and and OEM sales

OEM partnersPending

Key beta sitesUniversity of Pittsburgh Medical Center; Stanford University (pending); University of California, Davis (pending)

Strategic focusTo solve the problem of enterprise-wide image distribution using low-cost, Web-enabled technologies, wavelet compression techniques, and standard PCs to make any image available any place at any time.

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