**Exhibit 10.18**

 

**AMENDMENTNO.****3 TO**

**MARKETING AND DISTRIBUTION AGREEMENT**

**DATED MARCH 30, 2007 BETWEEN**

**VITAL IMAGES, INC. AND TOSHIBA MEDICAL SYSTEMS CORPORATION**

 

**THIS AMENDMENT NO.****3 (the “Amendment”)** ismade as of March, 2008 by and between Vital Images, Inc., a Minnesota corporation having its principalplace of business at 5850 Opus Parkway, Suite 300, Minnetonka, Minnesota55343 USA (“Vital Images”)  and Toshiba Medical Systems Corporation havingits place of business at 1385, Shimoishigami, Otawara-Shi, Tochigi 324-8550,Japan (“Toshiba”).

 

ThisAmendment modifies the Marketing and Distribution Agreement dated March 30,2007 between the parties. Under this Amendment, the following items in theAgreement are modified as set forth below:

 

1.             Exhibit E: The pricing forlicenses of and maintenance for the # Products set forth in Exhibit E tothe Marketing and Distribution Agreement are revisedas set forth in Exhibit E to this Amendment. All other provisions of Exhibit Eattached to the Marketing and Distribution Agreement, and Amendments 1 and 2thereof, remain unchanged.

 

2.             This Amendment shall take effect asof March, 2008.

 

3.             Except as amended hereby, theAgreement shall remain in full force and effect in accordance with its originalterms. The amended portions of the Agreement shall be read, wherever reasonableto do so, to be consistent with the portions not so amended; provided that theamended portions shall be deemed to control and any conflict shall be resolvedin favor of such amended portions.

 

**IN WITNESS WHEREOF,** the parties have caused thisAgreement to be executed by their duly authorized representatives below.

 
| VITAL IMAGES, INC. |                      | TOSHIBA MEDICAL SYSTEMS   CORPORATION |
|--------------------|---------------------------|---------------------------------------|
|               |                      |                                  |
|               |                      |                                  |
| By                 | /s/ Susan A. Wood         |                                  | By |  /s/Satoshi Kimura |
|               |                      |                                  |   |   |   |
|               |                      |                                  |   |   |   |
| Name               | Susan A. Wood             |                                  | Name | Satoshi Kimura |
|               |                      |                                  |
|               |                      |                                  |
| Title              | Executive Vice President, |                                  | Title | X-ray System  Division General Manager |
|               |                      | Product Marketing  and Development    |   |   |
|                    |                           |                                       |  |  |  |  |  |  |  |  |  |  |  |

 

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**# Confidential Treatment has beenrequested, the portion indicated has been redacted and the redacted portion hasbeen separately filed with the Securities and Exchange Commission.**

 

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**EXHIBIT E**

**PRODUCT PRICE LIST**

 

***Exhibit E****of the**Agreement is modified bychanging the pricing for the Product set forth below andadding the following packages:***

** **
| **License** | ** ** | **U.S. (current)** | ** ** | **U.S. (new)** | ** ** | **Non-U.S.   (current)** | ** ** | **Non-U.S. (new)** | ** ** |
|-------------|------------|-------------------------|------------|---------------------|------------|-------------------------------|------------|-------------------------|------------|
| # *         |       | $                       | #          |                | $          | #                             |       | $                       | #          |   | $ | # |   |
|             |            |                         |            |                     |            |                               |            |                         |            |  |  |  |  |

 

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**when and if available*

 

**ADDITIONALSOFTWARE PACKAGE PRICING**

 
| ** **                                                                 | ** ** | **Pricing for New Customers** | ** ** |
|----------------------------------------------------------------------------|------------|----------------------------------------------|------------|
| **Package**                                                                | ** ** | **U.S.A.   (2008)**                     | ** ** | **Non-U.S.A.   (2008)** | ** ** |
| ***Angio XA Basic Package***                                               |       | $                                            | #          |   | $ | # |   |
| ·      *Vitrea**â*                 |       |                                         |       |   |   |
| ·      *# **                            |       |                                         |       |   |   |
| ***Angio XA CT Package*********                                            |       | $                                            | #          |   | $ | # |   |
| ·      *Vitrea**â*****             |       |                                         |       |   |   |
| ·      *# **                            |       |                                         |       |   |   |
| ·      *CT Perfusion option*****        |       |                                         |       |   |   |
| ·      *Peripheral Vessel Probe option* |       |                                         |       |   |   |

 

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**when and if available*

 
| ** **                                                                  | ** ** | **Pricing for Existing Customers off   Maintenance**** | ** ** |
|-----------------------------------------------------------------------------|------------|---------------------------------------------------------------------------------|------------|
| **Package**                                                                 | ** ** | **U.S.A.   (2008)**                                                        | ** ** | **Non-U.S.A.   (2008)** | ** ** |
| ***Angio XA Basic Package***                                                |       | $                                                                               | #          |   | $ | # |   |
| ·      *Vitrea**â*******            |       |                                                                            |       |   |   |
| ·      *# **                             |       |                                                                            |       |   |   |
| ***Angio XA CT Package***                                                   |       | $                                                                               | #          |   | $ | # |   |
| ·      *Vitrea**â*******            |       |                                                                            |       |   |   |
| ·      *# **                             |       |                                                                            |       |   |   |
| ·      *CT  Perfusion option*****        |       |                                                                            |       |   |   |
| ·      *Peripheral  Vessel Probe option* |       |                                                                            |       |   |   |

* *

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**when and if available*

 

***Existing Customers on Maintenance willreceive the products when and if they are made available*

 

**# Confidential Treatment has beenrequested, the portion indicated has been redacted and the redacted portion hasbeen separately filed with the Securities and Exchange Commission.**

 

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