The bright Future of Diagnostic Imaging
The bright Future of Diagnostic Imaging
The bright Future of Diagnostic Imaging
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<strong>The</strong> <strong>bright</strong> <strong>Future</strong> <strong>of</strong><br />
<strong>Diagnostic</strong> <strong>Imaging</strong><br />
Paul Smit<br />
Senior Vice President Medical Systems
Overview<br />
Medical Systems<br />
• <strong>The</strong> role <strong>of</strong> <strong>Imaging</strong> in healthcare<br />
• State <strong>of</strong> the art<br />
• Philips’ position<br />
• New developments<br />
2
Role <strong>of</strong> imaging in healthcare<br />
<strong>Diagnostic</strong><br />
<strong>Imaging</strong><br />
Medical Systems<br />
Tests<br />
Treatment<br />
(<strong>Imaging</strong>)<br />
Acute<br />
Care<br />
System<br />
Symptoms<br />
Follow up<br />
(<strong>Imaging</strong>)<br />
Cured<br />
or chronic<br />
3
Role <strong>of</strong> <strong>Diagnostic</strong> <strong>Imaging</strong> in<br />
Healthcare<br />
• Determine nature, location and size <strong>of</strong> disease in<br />
patients with symptoms<br />
• Guide interventions<br />
• Monitor the progress <strong>of</strong> treatment<br />
Medical Systems<br />
4
Market for <strong>Imaging</strong> has shown<br />
consistent growth<br />
Growth is driven by new applications, increasing accuracy and increasing speed<br />
>1 Billion <strong>Imaging</strong><br />
Procedures/Year<br />
worldwide<br />
(source: Medtech Insight)<br />
On average, 2 out <strong>of</strong><br />
every 5 Patient Visits<br />
involve an imaging<br />
procedure in USA<br />
(source: SG-2)<br />
Medical Systems<br />
€bln<br />
16<br />
14<br />
12<br />
10<br />
8<br />
6<br />
4<br />
2<br />
0<br />
Ultrasound<br />
Nuclear<br />
Medicine<br />
CT<br />
MRI<br />
1950 1960 1970 1980 1990 2000<br />
5
Medical Technology creates proven<br />
benefits<br />
• “New technologies <strong>of</strong>ten bring health<br />
improvements and productivity benefits.”<br />
• “Around 70% <strong>of</strong> the survival improvement in<br />
heart attack mortality is a result <strong>of</strong> changes in<br />
technology.”<br />
Medical Systems<br />
Source: Technology Benefits based on Study by Cutler and McClellan<br />
6
….which translates into a healthier population<br />
Medical Systems<br />
Heart Disease<br />
Cancer<br />
Heart Disease<br />
Cancer<br />
80<br />
75<br />
70<br />
65<br />
US Life Expectancy at Birth<br />
1950-2000<br />
1950 1960 1970 1980 1990 2000<br />
Source: NCHS<br />
7
Overview<br />
Medical Systems<br />
• <strong>The</strong> role <strong>of</strong> <strong>Imaging</strong> in healthcare<br />
• State <strong>of</strong> the art<br />
• Philips’ position<br />
• New developments<br />
8
CardioVascular X-Ray<br />
Average price: € 1 mln<br />
• Diagnosis <strong>of</strong> bloodvessels<br />
– Heart<br />
– Brain<br />
– Body<br />
• Guides treatments <strong>of</strong> the<br />
cardiovascular system<br />
– Clot removal , e.g. dottering<br />
– Stent placement<br />
– Aneurysms repair<br />
– Arythmia repair<br />
Medical Systems<br />
9
Philips’ continuous improvements in<br />
Cardiovascular X-Ray<br />
Medical Systems<br />
Detail visible 0.001 mm 3<br />
Measurement time 35 s<br />
250x<br />
finer details<br />
1999 2003<br />
0.000,004 mm 3<br />
5 s<br />
10
Repairing arteries in the brain<br />
Medical<br />
Paul Smit<br />
Systems<br />
2003-09-25<br />
Zooming allows the cardiologist to enlarge the microscopic<br />
images to the desired size<br />
11 11
Philips’ continuous improvements in<br />
Computed Tomography, CT<br />
Average price € 0.4 – 1 mln<br />
• Diagnosis <strong>of</strong> anatomy,<br />
all body parts<br />
• Workhorse <strong>of</strong> Radiology<br />
• Continuously faster and<br />
more accurate<br />
Medical Systems<br />
12
Diagnosing lung cancer<br />
• Courtesy <strong>of</strong> Wiemker et al. Medica Mundi 2003<br />
Detail visible >5 mm<br />
Measurement time 222 s<br />
Medical Systems<br />
1998 2003<br />
35x faster in 5 years<br />
2 mm<br />
6.4 s<br />
seconds<br />
250<br />
200<br />
150<br />
100<br />
50<br />
0<br />
1999 2000 2001 2002 2003<br />
13
Philips’ continuous improvements in MRI<br />
Average price : € 0.6 - 3 mln<br />
• Diagnosis <strong>of</strong> anatomy,<br />
most body parts<br />
• Unique in imaging s<strong>of</strong>t<br />
tissue, such as the brain<br />
and nervous system<br />
• Continuously faster and<br />
more accurate 12 seconds<br />
Medical Systems<br />
14
Analyzing the brain<br />
Detail visible 1 mm 2<br />
Scanning time 90 s<br />
Medical Systems<br />
15x<br />
faster<br />
1998 2003<br />
0.06 mm 2<br />
8 s<br />
15
Philips’ continuous improvements<br />
in Ultrasound<br />
Average price : € 50 – 300 k<br />
• Most cost-efficient imaging technology<br />
• Wide array <strong>of</strong> applications,<br />
incl. cardiovascular<br />
• Anatomy <strong>of</strong> many parts <strong>of</strong> the body<br />
• Obstetrics/Gynecology<br />
Medical<br />
Paul Smit<br />
Systems<br />
2003-09-25<br />
16 16
Live 3-Dimensional Ultrasound<br />
Medical Systems<br />
Signal / noise 5<br />
Procedure time 20 min.<br />
1998 2003<br />
25<br />
5 min.<br />
17
Nuclear Medicine<br />
Average price : € 0.4 - 2 mln<br />
• Most sensitive technology<br />
• Gold standard to assess heart infarction<br />
• Gold standard to detect primary cancer<br />
and metastases<br />
• Increasingly used for brain (infarction)<br />
Medical Systems<br />
18
Philips’ trackrecord <strong>of</strong> continuous<br />
improvements in Nuclear Medicine<br />
• GEMINI: worlds first and only<br />
“open” Positron Emission<br />
Tomography (PET) – CT<br />
• 3D registration <strong>of</strong> PET and<br />
CT data<br />
• Two scans for the price <strong>of</strong> one<br />
• Much better localization and<br />
identification <strong>of</strong> disease<br />
• Improved Radiation treatments<br />
Medical Systems<br />
19
And reduced the cost per patient<br />
• Greater than 50% reduction in<br />
scanning time<br />
– 60 minute scans reduced to less<br />
than 30 minutes<br />
– Enhanced image quality<br />
– True clinical flexibility<br />
Medical Systems<br />
20
…Continuous improvement in Performance,<br />
drives usage and creates new procedures<br />
• X-Ray: repair <strong>of</strong> brain vessels<br />
• CT: screening for lung cancer,<br />
cardiac CT, virtual colonoscopy<br />
• MR: whole body cardiovascular<br />
scans, cardiac MR, orthopedics<br />
• US: Biopsy guidance,<br />
mammography<br />
• CT-PET: cancer localization and<br />
staging, monitoring <strong>of</strong> cancer<br />
treatment<br />
Medical Systems<br />
21
… No wonder <strong>Imaging</strong> Systems are<br />
widely recognized for their impact<br />
• MR and CT are considered the most important<br />
innovations in healthcare <strong>of</strong> the last 20 years<br />
Medical Systems<br />
Fuchs &, Sox Health Affairs 2001<br />
22
….Which drive continuous growth in <strong>Imaging</strong><br />
Threefold increase in this decade:<br />
- Aging population<br />
- New cancer, Cardio Vascular and Neuro applications<br />
- Growth <strong>of</strong> Image guided interventions<br />
- Molecular <strong>Imaging</strong> Development <strong>Imaging</strong> Procedures (World)<br />
Medical<br />
Paul Smit<br />
Systems<br />
2003-09-25<br />
Procedures (million)<br />
2800<br />
2400<br />
2000<br />
1600<br />
1200<br />
800<br />
400<br />
0<br />
+5%<br />
+7%<br />
+13%<br />
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010<br />
Source: SG-2, Philips<br />
23 23
Overview<br />
Medical Systems<br />
• <strong>The</strong> role <strong>of</strong> <strong>Imaging</strong> in healthcare<br />
• State <strong>of</strong> the art<br />
• Philips’ position<br />
• New developments<br />
24
Philips is leading in many imaging areas<br />
Medical Systems<br />
# 1 in Cardiovascular X-Ray X Ray<br />
# 1 in digital X-Ray X Ray and digital Ultrasound in Cardiovascular Ultrasound<br />
# 1 in Nuclear Medicine<br />
# 1 to market with 16 slice CT<br />
# 1 in high-field high field MR<br />
# 1 in oncology simulation and planning<br />
25
Technology leadership:<br />
Re-use <strong>of</strong> Unique technology from Philips Research<br />
Medical Systems<br />
Xres TM<br />
extreme resolution<br />
From MRI To Ultrasound<br />
To X-Ray<br />
26
Clinical Leadership through collaborative<br />
research: Virtual Colonoscopy with CT<br />
Orthogonal<br />
reformats<br />
Front<br />
view<br />
Lesion<br />
marker<br />
Medical Systems<br />
Left<br />
Up<br />
Down<br />
Right<br />
Overview<br />
Rear<br />
view<br />
Lesion<br />
Annotation<br />
& Reporting<br />
27
Clinical Leadership through collaborative<br />
research: Virtual Colonoscopy with CT<br />
Medical Systems<br />
28
Clinical Leadership through collaborative<br />
Research: Stunning details with MR<br />
• Fast and very sharp images<br />
Medical Systems<br />
High Resolution: 0.04 mm 3<br />
29
Clinical Leadership through<br />
collaborative research : Ultrasound<br />
More accurate US images can change the way patients are treated<br />
Medical Systems<br />
30
Overview<br />
Medical Systems<br />
• <strong>The</strong> role <strong>of</strong> <strong>Imaging</strong> in healthcare<br />
• State <strong>of</strong> the art<br />
• Philips’ position<br />
• New developments<br />
31
Fusing MRI and X-Ray for<br />
targeted drug delivery<br />
Medical Systems<br />
32
XMR-guided targeted drug delivery<br />
(FeRx in HCC)<br />
Medical Systems<br />
Courtesy: UCSF<br />
33
Molecular <strong>Imaging</strong><br />
• Images the cells at work<br />
inside the living body<br />
• Allows earlier detection<br />
and characterization <strong>of</strong><br />
disease<br />
• Early assessment <strong>of</strong><br />
treatment<br />
Medical Systems<br />
34
Molecular <strong>Imaging</strong>: the key ingredients<br />
Medical Systems<br />
Targeting Bio-molecule<br />
Contrast Element, e.g Gd<br />
<strong>Imaging</strong> Modalities Targeted Contrast Agents<br />
35
Speeding up time-to-market <strong>of</strong> new<br />
imaging procedures<br />
Medical Systems<br />
Pre clinical CT<br />
Pre clinical PET<br />
36
Clinical areas<br />
• Oncology<br />
• Cardiology<br />
• Neurodegenerative<br />
diseases <strong>of</strong> the<br />
brain<br />
Medical Systems<br />
Courtesy: S. Wickline et al. Washington<br />
University, St Louis, USA<br />
37
MR: Seeing the tumor grow<br />
• As new micro arteries are developing....<br />
Medical Systems<br />
38
Summarizing<br />
• <strong>Imaging</strong> has made a big impact on healthcare<br />
over the last decades<br />
• Continuous Technology development for better<br />
and faster diagnosis while lowering costs<br />
• <strong>Future</strong> is <strong>bright</strong> as true Molecular <strong>Imaging</strong> is<br />
coming in sight<br />
Medical Systems<br />
39
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