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Biotech / Medical : IMAT - ultrafast tomography for coronary artery disease -- Ignore unavailable to you. Want to Upgrade?

To: Brian Moloney who wrote (2308)	4/3/1998 9:09:00 PM
From: robert scheb	Read Replies (2) \| Respond to of 3725

Brian Last year I ask someone on this thread when the patent on this stock was up. Do you know when it does or remember reading anything about this? Anyone?????? Scheb

To: Brian Moloney who wrote (2308)	4/3/1998 9:31:00 PM
From: ENOTS	Respond to of 3725

Interview with Dr. Fishman.... Edited Transcript of April 21, 97 Conference InteliHealth/Johns Hopkins Forum Three Dimensional Imaging or Bringing the Movies to Medicine with guest Elliot K. Fishman, M.D. InteliHealth: Welcome. I have now closed the floor and we are ready to start our conference on: THREE DIMENSIONAL IMAGING or BRINGING THE MOVIES TO MEDICINE. Our guest tonight is Dr. Elliot K. Fishman, a professor of radiology and oncology at Johns Hopkins University School of Medicine and Hospital in Baltimore, Maryland. Dr. Fishman has been involved in medical research and clinical care using 3-D imaging for the past 12 years. His initial work included involvement with Lucas Films and Pixar. The medical applications Dr. Fishman works on replace invasive procedures such as angiography with noninvasive studies such as CT scans. (Computed tomography (CT) is the creation of video images from x-rays.) These techniques hold the promise of decreasing the cost of care while improving the quality of care for the patient. Dr. Fishman has also been involved in several unique projects such as the imaging of the Peruvian Ice Maiden featured in the June 1996 and January 1997 issues of the National Geographic Magazine. ------------------------------------------------------------ InteliHealth: Welcome, Dr. Fishman. ------------------------------------------------------------ Dr. Elliot Fishman: Hi and welcome. Medical imaging is an exciting application of computer technology and has tremendous potential for patient care and management. ------------------------------------------------------------ InteliHealth: Thank you, Dr. Fishman, for joining us tonight! ------------------------------------------------------------ Question: I've just heard about Ultrafast CT. What is it exactly, and is it available to the public? ------------------------------------------------------------ Dr. Elliot Fishman: Ultrafast CT or electron beam CT is a newer form of CT scanning that available at select sites across the US. It takes images in 100 msec and has potential applications in the heart especially for coronary artery evaluation. Routine CT even with newer techniques typically take 0.75sec which is still too slow to freeze cardiac motion. The main disadvantage with ultrafast CT is its fixed costs which are 2-3x that of regular CT. Future scanners will merge standard spiral CT and ultrafast techniques at a more affordable price and will provide many of the cardiac and vascular applications. ------------------------------------------------------------ InteliHealth: Dr. Fishman, is this only used in advanced research? ------------------------------------------------------------ Dr. Elliot Fishman: One application that is becoming popular is to quantify coronary artery calcification. This may prove to be a good non-invasive technique for the early detection of coronary disease--even before the patient has symptoms. ------------------------------------------------------------ Question: is it a substitute for angiography? ------------------------------------------------------------ Dr. Elliot Fishman: That's the potential. With 3D CT we can replace many of the classic angiographic applications including evaluation of the aorta, carotid arteries, renal arteries and mesenteric arteries. We can do this today and at Hopkins are doing daily as an outpatient procedure. 3D CT is non-invasive and is 25-30% the cost of an angiogram in most cases. The patient study time is only 5-10 minutes and is always an outpatient procedure. Our results and that from other institutions show that 3D CT angiography (3D CTA) is equal to classic angiography in accuracy. It seems to be a win-win. I believe that 70-80% of classic angiography can be replaced. ------------------------------------------------------------ Question: Are these techniques only use for diagnostic purpose? ------------------------------------------------------------ Dr. Elliot Fishman: At the present time most applications are for pre-operative planning or patient management in general. Future applications include the merging of imaging and robotics for image guided procedures guided in 3D space. Some preliminary work in this area is being done for example in neuro- radiology. Other preliminary work is in the liver. I believe robotic guidance with imaging will be important--telemedicine is a great future potential. ------------------------------------------------------------ InteliHealth asks: How did you first get involved with the Peruvian Ice Maiden Project? ------------------------------------------------------------ Dr. Elliot Fishman: The folks at National Geographic called me based on our prior CT and 3D imaging work which was fairly well known. They wanted to know if we could non-invasively find out more about the Peruvian Ice Maiden. Everyone felt this might be a unique opportunity based on her excellent physical condition. The project took a while to get started because of the necessary arrangements with the Peruvian government -- they wanted to make sure that the condition of the mummy would not be harmed by the travels to Baltimore and Johns Hopkins. ------------------------------------------------------------ InteliHealth asks: Did you do any special imaging on her, something that you couldn't normally do with a regular patient? ------------------------------------------------------------ Dr. Elliot Fishman: Not really except we typically do not scan a patient from head to toe as we did in her case. Otherwise we used a similar protocol that we might use 40-60 times a day. InteliHealth: What are the possible side effects if a living human being went through this imaging 40-60 times a day? Dr. Elliot Fishman: The typical radiation dose with our newer scanners is low, and poses no patient risks. We routinely maintain our systems with daily quality insurance to make sure everything is in proper working order. Medical x-rays are of little risk when used correctly. ------------------------------------------------------------ Question: What was it like working with Lucas Arts and Pixar? ------------------------------------------------------------ Dr. Elliot Fishman: It was very exciting. Lucasfilms assembled a superstar team of computer graphic experts including Ed Catamul, Alvy Ray Smith, Pat Hanrahan, Bob Drebin, et al. Their work was legendary and continues to be whether at Silicon graphics (Drebin), Stanford (Hanrahan), Microsoft (Smith) or Pixar (Catamul). Pixar, who's CEO is Steve Jobs, moved from computer hardware/software more toward end products like Toy Story. It just seems that medicine and the movies keep meeting.. From a balance sheet perspective the movies tend to be more profitable than medicine. Only in the movies can you make a billion dollars from a single product (i.e. Toy Story). However it is amazing how the same technologies impact both applications . ------------------------------------------------------------ InteliHealth: Yes, but the movies don't save lives the way modern medicine does! ------------------------------------------------------------ Dr. Elliot Fishman: That is absolutely correct. Fortunately medicine can benefit from technologies developed for non-medical applications. The synergy is exciting and will be even more important in the future. ------------------------------------------------------------ InteliHealth: Can you share any specific predictions as to where this futuristic technology will take us? ------------------------------------------------------------ Dr. Elliot Fishman: The ability to transfer information from a remote site for consultation will become more important. The use of web-based technology will become critical and will prove revolutionary. Medicine will not be limited by physical or geographic limitations. Experts can be consulted at a distance. In the future remote surgery will also be performed with image guidance from 3D data sets. A battlefield injury could be treated by a physician a 1000 miles away for example. This sounds like Star-Trek type stuff but it will happen in our lifetime.--I predict within 10 years for sure. ------------------------------------------------------------ Question: Where can I find your images? on this forum? ------------------------------------------------------------ Dr. Elliot Fishman: We can make them available if people would like select images to study. ------------------------------------------------------------ InteliHealth: As soon as we get the images from Dr. Fishman, we'll be posting them in the Library... ------------------------------------------------------------ Dr. Elliot Fishman: We can provide select images as well as Quicktime videos. The images are initially generated on an SGI Onyx workstation using up to nearly 700 1mm slices of the Maiden. ------------------------------------------------------------ Question: Do you ever anticipate a time when you can actually pursue a "real time" surgical procedure using your imaging techniques, or have you already done so? ------------------------------------------------------------ Dr. Elliot Fishman: This is actually being done in several sites in the US at the present time. The biggest challenge is the integration of the computer and imaging into the operating room. The computers obviously need to be very fast to refresh the data views in near real time. This is obviously a very computer intensive task. I believe that the procedure that will use real time imaging first will involve MRI and such applications as biopsy of small tumors or for ablation of tumors as with cryosurgery will be the leading edge. ------------------------------------------------------------ Question: What are some of the kinds of computers that are used , like mainframes or PC's? ------------------------------------------------------------ Dr. Elliot Fishman: We typical use work stations such as Silicon Graphics Onyx and Infinite Reality systems. Other systems from Sun Microsystems or HP can also be used. Potentially Pentium Plus multiprocessor systems can also be used . The good news is that the cost of the needed hardware is dropping. ------------------------------------------------------------ Question: How do you determine the age of the Peruvian Maiden and with what precision? ------------------------------------------------------------ Dr. Elliot Fishman: We studied her bone age (i.e. look at the hands and wrists) and can be very accurate. The time she lived is based on a number of other facts including the time of the Inca empire. If anyone has any questions after the sessions I can be reach at Dr. Elliot Fishman: my e-mail is elliot@boingo.med.jhu.edu ------------------------------------------------------------ Question: Were you surprised by anything you found in imaging the Ice Maiden? ------------------------------------------------------------ Dr. Elliot Fishman: Yes. We were surprised by the skull and orbital fractures which were never suspected prior to the CT scanning. ------------------------------------------------------------ InteliHealth: I think I read somewhere that the assumption was that the maiden suffocated to death? That was the thinking before the scanning took place, correct? ------------------------------------------------------------ Dr. Elliot Fishman: In fact this changed the opinion as to her cause of death from poisoning to a skull fracture with intracranial bleeding. The initial thought was poisoning. This was proven to be incorrect. ------------------------------------------------------------ InteliHealth: Dr. Fishman will be leaving us shortly. Please take this time now to ask a question if you haven't already done so! Thank you Dr. Fishman for being so patient! ------------------------------------------------------------ Dr. Elliot Fishman: My pleasure. Thanks for all the great questions. Perhaps we can do this again in the near future. ------------------------------------------------------------ Question: Do you mean that the Ice Maiden was brutally killed? ------------------------------------------------------------ Dr. Elliot Fishman: It would seem that her fracture was the result of a violent blow by a club or stick. Many of the images showing the fracture and the brain injury can be seen in the January 1997 issue of National Geographic. ------------------------------------------------------------ Question: Dr. Fishman are you involved in any contemporary forensics investigations, or do you limit your work to subjects of archaeological interest? ------------------------------------------------------------ Dr. Elliot Fishman: We have looked at other mummies as well as some animals from the National Aquarium.We are always interested in studies that can be helpful in advancing knowledge or in helping solve problems. ------------------------------------------------------------ Question: Just a comment, I think the technology is very exciting! ------------------------------------------------------------ InteliHealth: OK, with this, we'll be ending tonight's conference and a hearty thank you to Dr. Elliot Fishman for joining us tonight! [Top] [ Back to 3-D Imaging ] c1996-1998 Inteli-Health, Inc. All rights reserved. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen

To: Brian Moloney who wrote (2308)	4/3/1998 9:39:00 PM
From: ENOTS	Read Replies (2) \| Respond to of 3725

Dr. What is " Acute Rest Technetium 99m tetrofosmin myocardial perfusion" ? Thanks..

To: Brian Moloney who wrote (2308)	4/4/1998 12:10:00 PM
From: stock bull	Read Replies (1) \| Respond to of 3725

<<No, I don't know anything about it, but this is why I don't mortgage my house to buy a jillion shares. My concern is that someone else will develop some great piece of technology that can replace the ultrafast CT before it has a chance to dominate the marketplace. >> Brian, never were truer words spoken. More money has been lost by those people who try to make a killing in a single stock. As far as technology is concerned, watch out, there's always someone out there who is trying to knock you off the hill. There are very few companies who can remain as the "king of the hill"... not many Microsoft, Intel and Cisco Systems around. If Imatron continues to move up next week, we may now be showing some institutional interest in the stock. If this week's move is based on recent news and the Tom Brokaw (sp ?) news segment, then I suspect we will see the stock move down. I can see where it's not easy to get wide acceptance of a new technology in the medical field. Guess this has its good and bad points. Stock Bull