Medical Imaging

More health for every penny

By Kenneth Stoltz
January 29, 2007

The MI Lab has a paradoxical vision: to spur innovation that will result in additional workplaces in Norwegian industry and fewer workplaces in the Norwegian health service.

 

Illustrasjonsbilde/FOTO

Introduction
Medical imaging is a rapidly growing industry with a significant international market potential. In 2003, annual sales of medical imaging systems amounted to EUR 14.5 billion, with imaging tools and contrast agents amounting to an additional EUR 4 billion. The market for medical devices is at present expected to grow in value by approximately 9% per annum. In 2004, the number of patient imaging procedures was 1.3 billion worldwide and is growing faster than the value of equipment sales.

The MI Lab at NTNU has been established to become the leading institution in research and commercial exploitation of medical technology within ultrasound and MR in an international health market that demands cost-effective solutions. Trondheim has a number of preconditions that should help it reach this goal. The medical technology cluster has achieved international recognition for its research in imaging tools such as ultrasound and MRI (Magnetic Resonance Imaging). There is also the proximity to the users at St. Olav’s Hospital. Another advantage is close partners such as GE Vingmed Ultrasound, Medistim, Mison, and FAST.

”That is the tongue-in-cheek version,” emphasizes Research Centre Director Olav Haraldseth. It is all about developing MR and ultrasound technology that results in more treated patients per employee – or more health for every penny.

Illustrasjonsbilde/FOTO Four main goals
The group behind the Medical Imaging Laboratory for Innovative Future Healthcare has agreed upon four main goals. With innovative technology and the adoption of this technology in clinical practice, these goals involve:

  • For the patients: improved quality of life
  • For the health service: cost-effective solutions
  • For industry: new, improved and more products and areas of application
  • For society: reduced increase in the costs related to health and healthcare

The research-based integration between the MI Lab and the users at St. Olav’s University Hospital in Trondheim is the key to success. Internationally, such a tight bond is rarely seen in medical imaging environments in other industrial countries, which represents a considerable advantage for Norwegian industry.

A global market
Even more important than the domestic market, is the MI Lab’s intentions in international cooperation. Corporate partners have been successful on the global market, and NTNU’s research groups have an extensive network of partners at university hospitals around the world. This is an important channel for disseminating knowledge about the potential for innovative technologies and new clinical practice. For the medical imaging industry, this means a marketing display window which will help to gain access to the global market.

“The MI Lab will create research ideas and innovation both within and outside the business areas of our corporate partners,” says Olav Haraldseth.

”In cases where innovation outside our partners’ areas of interest has industrial potential, the MI Lab will also actively initiate new spin-offs. If new products prove to promote cost-effective health solutions for large patient groups, the market potential is enormous,” he adds.

Illustrasjonsbilde/FOTO The new stethoscope
MR and ultrasound stand out as the two main types of imaging for the future health service. The reason is their ability to provide images of soft tissues, the blood stream, organ functions, and physiology. The MR and ultrasound technologies are promising for the new fields of functional and molecular imaging.

A unique advantage of MRI is the superior quality of anatomic information. New, advanced MR methods provide diagnostic information about organ functions, physiology, metabolism, and molecular activity.

Ultrasound is often referred to as ”the new stethoscope”, and has a major advantage of real-time imaging, portable equipment, and low costs. Researchers at what is now the Department for Circulation and Imaging at NTNU started investigating the possibilities of medical ultrasound applications 30 years ago. They developed Doppler blood stream equipment and used ultrasound technology for non-invasive diagnoses of heart function and heart valve diseases.

Tailoring
New knowledge about individual genetic variations within pathology is growing in importance when choosing the most efficient treatment for each patient. This knowledge lies behind the development of the philosophy of personalized medication, i.e. individually tailored treatment based on detailed biological information about the patients and their total clinical picture. However, this research field is still very new and has a great need for new methods as well as broader empirical background information.

Beyond state-of-the-art technology
“The MI Lab will conduct research and innovation at top international level with particular emphasis on the following four areas,” says Professor Olav Haraldseth:

  • Ultrasound technology innovation
    Real-time 3D ultrasound imaging of high quality has recently been established. However, the use is still limited by image resolution and image noise and artefacts. There are also has technical limitations for use with ultrasound contrast agents in the new and important areas of functional and molecular imaging.
     
  • Medical imaging applications for non-expert users
    Within MR and ultrasound there is a wide variety of new and advanced clinical methods that are of great benefit for primary diagnosis, for monitoring of disease development (‘watchful waiting’), and for the follow-up of drug treatment in chronic diseases. However, presently these methods depend on expert users and can mainly be performed in specialized departments in large hospitals. The limitations for more widespread use for non-expert medical doctors in smaller hospitals and com¬munity-based medicine are both in the acquisition of images of sufficient quality, and in the inter¬pretation of the results with sufficient precision.
     
  • Image-guided minimally invasive surgery
    Image-guided minimally invasive surgery is gaining increased popularity as an alternative that causes less tissue traumatization and quicker rehabilitation for the patients. However, presently the use is limited by lack of imaging technology adapted to the operation theatre and by increased risk of some intra- and post-operative complications that are avoided in open surgery.
  • Image-based information to support medical decision making
    New knowledge about individual variations in genomics and disease pathology and its importance for choice of the most efficient treatment has caused the development of the ‘personalised medi¬cine’ philosophy. That is individually ‘tailor-to-fit’ treatment, based on more complete biological information about the patient and his/her disease entity through integration of knowledge of indi¬vidual disease phenotype with knowledge of individual genetic expressions.

However, this field of research is in its infancy and in great need of development of new methods and integrated diag¬nostic protocols covering in-vivo phenotyping from medical imaging and genetic expression based on image-guided sampling of representative biopsies. There is also a general need for scientific evaluation of the benefit for patient outcome.

Building on decades of knowledge
”We have a wide span and ambitious goals both for our research and innovation. But with our excellent partners, we are realistic,” claims Haraldseth. And the partners the MI Lab has attracted from the industrial side are influential and acknowledged. Three of which, GE Vingmed Ultrasound, Mison, and Fast, were awarded the top awards from the European Information Society Technology for their products, in 1995, 2002, and 2004 respectively.

Another asset is over 30 years of research history behind the realization of the MI Lab as a Centre of Research-based Innovation. One of the most significant pioneers, Professor Bjørn Angelsen, is still on the team.

Research Centre Director and prime mover Olav Haraldseth also has extensive experience: He was the first physician in Norway to take a doctorate in MR, with the title NMR spectroscopy of cerebral ischemia and reperfusion in rat. In 1998, after six years as a researcher at SINTEF where he focused on new MR contrast agents in cooperation with Nycomed Imaging, he became a professor of medicine at NTNU. Haraldseth has been at NTNU since, and is also dean of research at the Faculty of Medicine and research director at the Clinic for Imaging at St. Olav’s University Hospital, as well as the director of the CRI.

Professor Haraldseth also heads the regional department of the National Competence Centre for Functional MR. At the same time he heads the regional department of FUGE technology platform in Molecular Imaging (MIC Trondheim), and is invited in 2006 by the European Science Foundation (ESF) to lead their work on developing a Science Policy Briefing in Medical Imaging.

Go to MI Lab's website

FACTS ABOUT MI Lab

Medical Imaging Laboratory for Innovative Future Healthcare
The Centre does work in medical imaging that forms the basis for cost-effective health services in order to strengthen Norwegian industry in this area. Activities include ultrasound and MR, and the main areas are the development of ultrasound technology, advanced user-friendly ultrasound and MR equipment and methods for non-expert users, image-guided minimally invasive surgery, and other biological information to help doctors reach decisions quickly in order to give the best possible treatment.

Host institution:
Norwegian University of Science and Technology (NTNU)

Research Centre Director:
Professor Olav Haraldseth, Department of Circulation and Imaging, NTNU

Board:
Kjell Arne Ingebrigtsen (Chair)
Arne Grip (Corporate partner)
Bjørn Olstad (Corporate partner)
Dagfinn Sætre (Corporate partner)
Sturla Eik-Nes (Centre user partner)
Stig Slørdahl (Host institution)
Ursula Sonnewald (Host institution)

Partners:
Corporate partners: GE Vingmed Ultrasound, FAST, Medistim, Mison, Odetect, Nordic NeuroLab, Cortechs Labs., MedTech Trondheim

User partners:
St. Olav’s Hospital, Central Norway Regional Health Authority

Other partner:
SINTEF

Total budget:
NOK 40 million per annum for 8 years. (EUR 4.8 million/USD 5.9 million)

In total, NOK 320 million. (EUR 38 million/USD 47 million)

Staff:
Man-years corresponding to 10 doctoral and 10 post-doc positions every year over eight years. The number of staff from partners is not yet established.

Contact:
Email: olav.haraldseth@ntnu.no

Postal adress:
MI Lab
Department of Circulation and Imaging
Faculty of Medicine
NTNU
NO-7491 Trondheim, Norway

Centre for Research-based Innovation (CRI):

The establishment of the Centres for Research-based Innovation (CRI) emphasizes Norway’s long-term prioritizing of R&D for the business sector. In 2006, a total of 14 Centres were established, including the Medical Imaging Laboratory for Innovative Future Healthcare. The main objective for the Centres for Research-based Innovation is to enhance the capability of the business sector to innovate by focusing on long-term research based on forging close alliances between research-intensive enterprises and prominent research groups. (In the long run this basic research will also benefit small and middle-sized enterprises that lack their own research departments.) The total budget for the 14 CRIs will amount to NOK 2 billion over the next eight years. Here the contribution from the Research Council of Norway is NOK 1 billion. The host institution and partners contribute NOK 500 million each.