development for healthcare

Ákos Horváth

Senior Project ManagerImage ProcessingDepartment of X-Ray Systems

[email protected]

Innomed Medical Inc.

development for healthcare

www.innomed.hu

HungarianInnovationRoadshow

2013

London - Cambridge

Table of contents

• Short introduction of Innomed Medical’s development

• Main competences

• Product range

• Electrocardiographs

• Defibrillators

• Monitor systems

• Radiological devices

• PI-PACS

• PI-PACS Chest CAD

• Digital Tomosynthesis

• Quality assurance systems

• Premises

• Turnover

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ContentInnomed historyMain competencesProduct rangeElectrocardiographsDefibrillatorsMonitor systemsRadiological devicesPI-PACSPI-PACS Chest CADDigital TomosynthesisQuality assurance sys.PremisesTurnover

• Established in 1989 by ten R&D engineers

• First success with the ECG portfolio

• Domestic market leader in cardiology sector

since 1993

• Own developed x-ray generators since 1994

• Investment in new product lines: bedside

monitor development

• Acquisition of the Danish Artema defibrillator

factory in 2002

Nowadays:

• Dealers in more than 110 countries

• Over 135 employees

• 10 million Euro annual turnover

Innomed history

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• Developing medical devices

• Manufacturing

• Integrating x-ray systems

• Customised mobile screening units

• Marketing

• Participation in tender projects

• Turn-key hospital projects

Main competences

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Product rangeCardiology

Diagnostic ECGs:• ECG devices• Data base management sw• Holter ECGs• Stress test systems

Patient monitoringClinical defibrillators

Radiology• X-ray generators• Mobile X-ray unit• Integrating complete systems• Digital imaging system• PACS system• Chest CAD system

Veterinary

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• Wide range of devices

• Small, portable devices for GP’s

• Clinical versions

• Exercise system with threadmill or bicycle

ergometer

• Cardiological data management system

• Holter ECGs

Electrocardiographs


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Defibrillators

• Devices for clinical use

• Biphasic defibrillating waveform

• Cardioversion

• Semi automatic mode

• External pacemaker

• Measured parameters:

• 12channel ECG

• NIBP

• SPO2

• CO2


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Monitor systems

• Bedside monitor for intensive care unit

• Portable 7” lightweight monitor with

wide range of functionality

• Small wireless monitor for hospital and

home care

• Central monitor: monitoring and

controlling the network-connected

bedside monitors

• Wireless communication between the

measuring head and the monitor

• If needed stores all parameters for days


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Radiological devices

• High frequency X-ray generators • Complete digital X-ray systems• DR, CR systems

– Radiation protected cabin– High throughput, with low dose– User friendly software with PACS

integration– Built in chest X-RAY station - mobile

application

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Radiological devices

• MRX Tel

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• TOP-X DR TSm • TOP-X 100 MS

PI-PACS

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Early detection of lung cancer PI-PACS Chest CAD1 system on chest X-ray

Innomed Medical Inc. in cooperation with the largest technical and medical universities in Hungary:

• Budapest University of Technology and Economics and • Semmelweis University

developed the PI-PACS Chest CAD, a Computer Aided DetectionSystem for Chest X-Ray images, between 2008-2011.

Our goal was to develop a chest CAD system that helps a skilled pulmonologist or radiologist raise his/her sensitivity in lung disease detection especially tumorous ones.

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1CAD – Computer Aided Detection System that is a decision support system


PI-PACS Chest CAD

• Soft tissue analysing: – Bone shadow eliminating algorithms make the lung tissue visible

• The developed algorithms using artificial intelligence are the followings:– Find circular like dens areas– Find blurred and infiltrated areas

• The tool after a complex preprocessing uses three different filters:– Small circular shadows (5 - 35 mm)– Large circular shadows (35 - 75 mm)– Infiltrated areas of different sizes

• The findings of Chest CAD are shown for the pulmonologist. We use their suspected borderline as mark signs.

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PI-PACS Chest CAD

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Digital Tomosynthesis (DTS)

Chest radiography (CXR)

• Fundamental examination in lung imaging

• Short examination time• Easy accessability• Low cost • Low radiation dose

Disadvantages with CXR• Limited sensitivity and specificity for

many tasks

• Good enough sensitivity and specificity for Lung cancer

Disadvantages with CT

• High radiation doses

– Chest CT: E~5 mSv (low dose CT?)

– Chest x-ray (PA): E~10-20 µSv

• Complicated equipment

– Expensive examination

• For many hospitals: limited resource

– Delayed diagnostics

CT solves the problem

2D 3D


Extensive overlapping (2D)

Extremely low dose

No overlapping (3D)

Relatively high dose

CXR CT

Bridge the gap?


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• Modern version of conventional tomography

• A number of projections are acquired at a low dose - over a limited angular range - and used to reconstruct section images of the patient (=limited angle CT)



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J. T. Dobbins, H. P. McAdams: Chest tomosynthesis: Technical

principlesand clinical update in European

Journal of Radiology – 2009 pp. 244-251.

Image reconstruction

• Shift-and-add– Back projection

• Filtered backprojection– Fourier transform

– Ramp filter

– Low-pass filter

– Inverse Fourier transform

– Shift-and-add


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• Two main improvements from conventional tomography

– Reconstruction of arbitary number of slices from one acquisition

– Removal of surrounding anatomy

• Why today?

– Availability of suitable detectors (FPD)

– Computer power

– Radiation dose concerns

100 kHz-es nagyfrekvenciás technika alkalmazásaGVOP-3.1.1-2004-05-

0081

Sürgısségi életmentı rendszer, defi monitor fejlesztéseGVOP-3.3.3-05/3.-2006-

04-0105/3.0

Firtsave Automatizált Külsı Defi otthoni életmentı eszköz gyártási és ellenırzési eljárásának honosítása

GVOP-2.1.1-05/2.-2005-

09-0422/1.0

Digitális mellkasdiagnosztikaGVOP-3.3.3-2006-01-

0108

Multifunkcionális, felhasználó specifikus, környezetbarát, nagyfrekvenciás RTG generátorcsalád kifejlesztése a nanotechnológiai eredmények felhasználásval

GOP 1.3.1.2008-0073

RTG-önálló projekt

Állatgyógyászati betegırzı monitorKMOP1.1.1.07/1 2008-

0069 EKG-önálló projekt

Komplex mellkasdiagnosztikai Döntéshozó rendszerKMOP1.1.1.07/1 2008-

0035 RTG-önállóprojekt

Silvergate-112: Életvitelt segítı egészségügyi és szociális monitorozójelzırendszer

OM-00014/2008

EKG-konzorciumi tagként

Mobil röntgen készülékcsalád fejlsztéseKMOP1.1.1.09/1 2009-

0019

Új, nagy hatékonyságú, bifázisú hullámformával rendelkezı klinikai defibrillátor fejlesztése

GOP-1.1.1.-11-2012-

0001

Digitális tomoszintézis elvén mőködı alacsony rtgdózisú rétegfelvételi, radiológiai képalkotó eszköz és az arra épülı speciális mellkasdiagnosztikai döntéstámogató rendszer kifejlesztése

KMR_12-1-2012-0122


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Chest X-Ray


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• ISO 9001

• ISO 13485:2003

• CE marked products

• FDA, UL approved production

• FDA for our products:

under process

Quality assurance system



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Premises

Head office: Budapest

• Management

• Financial department

• Export and domestic sales

• Customer service

R & D department

• X-ray development

• ECG development

• Bedside monitor development

• Defibrillator development

• Training/guest centre:

Apartments, training hall, sauna, swimming poolwww.innomed.hu


Premises in Esztergom

Factory: Esztergom

Manufacturing

• X-ray generator• ECG devices• Defibrillators• Bedside monitoring system• Service support

Factory of Medicor

Diagnostics /member of

Innomed Group/

• Tilting tables

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Turnover in Million EUR

0

2

4

6

8

10

12

14

2009 2010 2011 2012

Turnover from DomesticSalesTurnover fromInternational SalesTotal


www.innomed.hu


2013

London - CambridgePresence in 119 countries


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Thank You for your attention!

Heal the world…

with Innomed!

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development for healthcare

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