Vital Images adds expertise for market debut of 3-D workstation

Firm hopes to make 3-D a routine clinical tool

Is 3-D image processing finally ready to make the transition fromR&D laboratory toy to everyday clinical tool? If so, VitalImages hopes to be one of the companies leading the way. The Fairfield,IA, software developer has begun shipping VoxelView, a 3-D workstationthat received 510(k) clearance in December (SCAN 12/13/95).

Vital Images and VoxelView made their Radiological Societyof North America debuts at last year's meeting. VoxelView runson any Silicon Graphics workstation and employs proprietary volume-renderingalgorithms for 3-D visualization. By processing data acquiredwith CT or MRI scanners, the workstation is capable of providing3-D views of any structure in the body, according to the company.

At the RSNA meeting, Vital Images representatives gave boothvisitors wild computer-generated fly-throughs up a patient's noseand in and around the nasal passages. At one point, the virtualskull displayed on the workstation split apart, enabling the viewerto be launched high above the 3-D volume. The point of view tilteddown to reveal the skull's divided hemispheres and the cerebralcortex before the viewer dove back into the anatomy to searchagain for anomalies in the tortuous nasal structures.

The company also presented colon fly-throughs developed incooperation with Dr. Geoffrey Rubin, Dr. Brook Jeffrey, and Dr.Sandy Napel of the radiology department at Stanford University.These could be used to develop virtual colonoscopy applicationsto identify polyps without the need for a colonoscope.

In this approach to virtual colonoscopy, the viewer is providedan external view of vasculature and bone before flying throughthe colon itself. The radiologist chooses a slice view throughthe object and then clicks at any point on any slice to identifythe pixel and direction that establishes the field of view. Severalsuch "key frames" are identified along the route bythe user before the computer fills in the gaps automatically tocreate the impression of continuous flight.

Vital Images' software is also being used by Dr. David Viningof the Bowman Gray School of Medicine in Winston-Salem, NC, aspart of his virtual colonoscopy work (SCAN 7/19/95). Vining hasdeveloped his own visualization technique that employs the 3-Dvolume-editing functions of VoxelView.

Vital Images also displayed 3-D renderings of functional MRIdata at the RSNA meeting. This multichannel rendering techniqueallows anatomic CT and functional MRI data sets to be fused anddisplayed on a single image. The demonstration was assembled byDr. Kamil Ugurbil of the University of Minnesota.

Preparing for launch. Vital Images has been expanding its salesand marketing capabilities to promote and sell VoxelView, andhas assembled an executive team to shepherd the commercial introductionof the product.

The company was founded in 1988 by Vincent Argiro, a neurobiologistat Maharishi International University in Fairfield, IA. Argirodevised the first prototype of VoxelView in 1987 using experiencegained from developing 3-D visualization software for laser-scanningconfocal microscopes used for neurobiological applications.

Vital Images initially targeted the confocal microscope marketfor the technology, then expanded to the oil and gas industryin 1990, marketing a product for three years for oil and gas explorationpurposes. It sold the rights to this program last year to CogniSeisDevelopment.

Vital Images early on recognized the potential of its productfor medical imaging applications, and last year began shiftingresources to pursue the healthcare market.

The company was acquired in May 1994 by Bio-Vascular, a St.Paul, MN, surgical instrument company. Bio-Vascular manufacturessurgical implants based on soft-tissue patching material, andbelieved there could be synergy between VoxelView and Bio-Vascularproducts in surgical planning applications. Vital Images now employsabout 25 workers.

As Food and Drug Administration 510(k) clearance for VoxelViewapproached last fall, Vital Images began assembling the managementteam required for a commercial launch. Andrew Weiss was appointedpresident, with Argiro reassigned as executive vice presidentand chief technical officer. Weiss was formerly global vice presidentof sales and marketing at Marquette Electronics in Milwaukee.

Vital Images rounded out its management team last month whenit appointed Interspec veteran David Davis to lead its sales andmarketing effort.

VoxelView has clinical applications in three broad classes,according to Weiss. The software is demonstrating value in diagnosticworkups, surgical planning and real-time surgical guidance, hesaid. It may also be useful in radiation therapy planning andfollow-up.

The company has 85 medical imaging research sites. Its closestinvestigational relationships in medical imaging are with Dr.Linda Gray, a neuroradiologist, and Alan Johnson, a physicistresponsible for technology development, both of whom work in theradiology department at Duke University in Durham, NC. Other importantcollaborators include Stanford and the Mallinckrodt Institutein St. Louis.

The Gray-Johnson team has pioneered applications of VoxelViewto identify aneurysms in the circle of Willis. The software createsa 3-D view, then allows the physician to navigate inside the volumeby rotating to different views, so pathology can be examined fromany angle.

"You can potentially replace x-ray angiography with thistechnique because it is so easy to understand views of the anatomyand spatial relationships between an aneurysm and the vasculature,"Weiss said.

Vital Images is also working with Imatron to develop 3-D renderingtechniques using the company's ultrafast CT data to create noninvasivecoronary angiograms. The investigational technique, featured atImatron's RSNA booth, characterizes coronary calcifications andstenosis with or without contrast.

Since the show, virtually every major CT and MRI manufacturerhas expressed interest in collaborating with Vital Images, accordingto Weiss; however, only one formal deal is in place. That mid-1995agreement is with Precision Therapy International, a North MiamiBeach, FL, firm that uses VoxelView in its computerized radiationoncology planning system.

Vital Images believes that its software, along with fallingprices for workstations, could overcome the obstacles that havehindered routine use of 3-D imaging in the past, according toWeiss.

"The traditional hit on 3-D is that it creates prettypictures, but it's too slow and lacks image quality," Weisssaid. "Using volume rendering, our pictures are not justpretty, they are diagnostically significant."