# Presentation: 577059

## Title: Information Guided Therapy Resources

**Laurence P. Clarke Ph.D.**
**Branch Chief**
**Imaging Technology Development**
**Image Guided Therapy**
**NCI: Biomedical Imaging Program, USA**

## Biomedical Imaging Program(BIP)

**Diagnostic**
**Imaging**
**Branch**

**Molecular**
**Imaging**
**Branch**

**Image-guided**
**Therapy**
**Branch**

**Imaging**
**Technology **
**Development**
**Branch**

**Division of Cancer Treatment and Diagnosis**
**(DCTD)**

**Cancer**
**Diagnosis**
**Program**
**(CDP)**

**Develop-**
**mental**
**Therapeutics**
**Program**
**(DTP)**

**Cancer**
**Therapy**
**Evaluation**
**Program**
**(CTEP)**

**Radiation**
**Research**
**Program**
**(RRP)**

**NCI**

##  Branches: ITDB and IGT

**Support basic research, technology development, integration, and feasibility testing for novel imaging sensors and contrast materials.**
**Develop initiatives to facilitate partnerships with academia/ industry/ SBIR/STTR.**
**Develop of centers of excellence, imaging networks and research resources to promote translational research.**
**Promote programs:(NIH inter-institute and inter-agency programs within the USA) and international.**

## NCI:Types of New Initiatives (1998-01)

**Research Centers of Excellence (Molecular Imaging)**
**Small Animal Resource Centers (Molecular Imaging)**
**National Distributed Research Resources**
**      ****Research Interface Software ( Ultrasound).**
**      ****Image Databases for Software Evaluation (Lung CT).**
**      ****Platform Independent Imaging Methods (MRI).**
**NCI/NIBIB: New funding mechanisms tailored for Imaging Technology Development, including IGT/IGS.**
**   **

## Slide 5

## NCI/NIBIB: Novel Imaging Technologies

- <date/time>

**NCI/NIBIB: Novel Imaging Technologies**

**Aim:**** Support high risk/high gain imaging technologies, such as molecular imaging, including proof of feasibility studies as opposed to hypothesis based research. **
**Goal****: Full support for the development and/or  integration of novel technologies with  traditional imaging methods with specific deliverables at the end of the funding period.**
**Areas:**
**Early cancer detection/ other disease processes.**
**Large screening applications/ other disease.**
**Imaging for diagnosis, staging, therapy.**
**Image guided biopsy and novel forms of therapy. **

## PAR: Novel Imaging Technologies

**NCI/NCRR: Phased Innovation Award (R21/R33).**** Specifically designed for technology development, with provision of academic/ industry partnerships.**
**Combined R21/R33 or R33 alone:**** R21: Feasibility study. R33: Technology development / feasibility.**
**    ****Parallel SBIR/STTR: Similar scope and timetable.**
**NCI Review:**** Reviewers: Academia and Industry and small business. **
**Applications****: 1****st**** Round 40; 4 funded, 2****nd**** Round 70**
**Future:**** Multiple Prototypes: SB Joint Ventures.**

## Cars 2000: Panel ReportChallenges and Opportunities in Computer –Assisted Interventions.

**Laurence P. Clarke **
**Richard D. Bucholtz **
**Henry Fuchs **
**Ron Kikinis**
**Richard A. Robb**
**Ramin Shahidi**
**Michael Vannier**

## Visualization Standards

**In order to make 3D imaging more reliable and**
**widely used, the following protocols are **
**recommended to be developed:**
**Standards for 3D image Acquisition.**
**Standards in visualization parameters to categorize various types of tissues in 3D models.**
**Standards for interpretation of 3D images.**

## Validation Standards

**In order to make the validation process more **
**compatible across platforms, recommend protocols: **
**Breaking down “ overall systems error”in a given system to its basic components. **
**Protocols wherein all basic errors components can be tested and measured using the same criteria.**
**Initiating open dialogue between centers for communication and sharing validation results. **

## Automatic Segmentation

**Need for involvement of non traditional **
**disciplines and approaches:**
**Attract new investigators ( Computer scientists, mathematicians and pattern recognition experts).**
**Identify and distribute international requirements for image segmentation verses diagnostic requirements for the scientific community.**
**Specific segmentation research for IGT, such as  interactive methods as necessary to enhance reliability.**

## Real Time Visualization

**Need for implementation techniques for real **
**time image rendering:**
**Real time volumetric data deformation techniques.**
**Fast 3-D visualization of inter-operatively-acquired data, such as US images.**
**Mechanisms for intuitive presentations of 3D information during ongoing surgical procedures, such as augmented reality**

## Data Correlation

**Need to address one of the large sources of error, **
**namely tissue deformity that occurs between per-**
**operative and tissue intervention using methods **
**such as:**
**2D/3D registration (e.g. intra-operative X-ray or endoscopic data registration with CT/MRI).**
**Identifying and development of quantifiable methods for the prediction and interpolation of tissue deformation during therapeutic procedures.**
**Development of novel algorithms for more robust registration methods.**

## Tracking techniques

**Significant improvement is necessary for tracking **
**of surgical tools in a stereotactic space, and thus **
**the following is recommended:**
**Design of novel instruments for tracking with emphasis on miniaturized systems using NANO/MEMS fabrication technology.**
**Investigation of the effects of tissue types on such systems.**
**Computer controlled effectors and interface standards, in a flexible plug and play format**

## Machine and Human Interface

**There is a need to focus on the human operation of computer **
**assisted systems and develop more advanced systems:**
**Smart tools that can conduct intra-operative anatomical/ functional imaging and access trajectory of the surgical path.**
**Smart displays that minimize the surgeons need to coordinate eye hand movements and enhance target recognition.**
**Customized human/computer interfaces for sterile environments ( I.e. eliminate keyboards/mouse)**
**Robotically activated devices for scaling macroscopic and microscopic movements.**

## New Clinical Applications for Emerging Technologies

**Systems need to be evaluated based on cost**
**increase verses potential health benefit and thus the**
**following is recommended:**
**Set the gold standard for assessing the impact of specific technologies on medicine.**
**Measure the benefits and drawbacks for different IGT technologies.**
**Create a training programs for IGT technologies for next generation of physicians.**

##  NCI BIP WebPage

** ****URL = www.nci.nih.gov/dip/**
**Email Newsletter : Monthly Updates: js95x@nih.gov**
**Contact: lclarke@mail.nih.gov**