Grim Gjønnes, Head of Sales & Marketing, Ceetron AS.
Back when studying engineering at university around 30 years ago, I, like many engineering students, had big dreams about solving key societal problems with brilliant technological inventions. Like many engineering students I was hit hard by reality when I started to work in large industrial corporations. Some days ago, when talking to Dr. Thomas Langø, Chief Scientist at the Medical Technology research group at SINTEF, I had a sense of fulfillment when he talked about a joint project for building an image-guided flexible lung catheter platform. Here is what he said: “By our new visual navigation technology, the success rate for a lung biopsy in the outer airways can be increased from around 20% to close to 80%.” Such success rate translates into reduced health care costs, faster diagnosis, correct treatment earlier, increased survival rates, and reduced emotional strain on the patients and their relatives.
Coming from 3D visualization for CAE (FEA, CFD, and FSI) space, as Head S&M in Ceetron, it was particularly fulfilling to have this feeling of contributing to the medical field. I started to ponder why and how we (or the field of 3D visualization for CAE) could contribute meaningfully in a field dominated by the behemoths of medical technology, like GE Healthcare, Philips, Siemens, and Medtronic. Medical visualization is also an established and thriving academic field of its own, dating roughly back to 1978 when Sunguroff and Greenberg published their work on the visualization of 3D surfaces from CT data for diagnosis and radio-therapy planning system. (For a good, but a tad old overview of the field of medical 3D visualization, see for example C. P. Botha et al. about“From individual to population: Challenges in Medical Visualization”, https://arxiv.org/pdf/1206.1148.pdf.)
I decided to explore the issue of relevance of Ceetron / 3D visualization in CAE to the field of medical visualization in more depth, with good input from partners and friends. This blog post summarizes my findings.
Methodologically, I decided to base my blog on structured conversations with some participants in our Mariana  project, including SINTEF (Trondheim, Norway), St. Olavs Hospital (Trondheim, Norway), and NTNU (Trondheim, Norway). However, I complemented such structured conversations with informal discussions with representatives from other leading European academic and industrial entities in the areas of medical devices, medical visualization, and digital dentistry. I also complemented it with experiences from various software development projects for medical applications (see screen shot to right of Fraxinus Cloud Viewer as an example).
Before I do that, I should probably briefly present SINTEF and Ceetron. SINTEF’s Medical Technology research group is part of the SINTEF group. SINTEF is the largest independent research organization in Scandinavia. It is a broadly based, multidisciplinary research institute with international top-level expertise in technology, medicine and the social sciences. The Medical Technology research group at SINTEF is also part of the Norwegian National Advisory Unit for Ultrasound and Image-Guided Therapy (www.usigt.org), Lung being one of the main clinical fields of this unit and collaboration (St. Olavs, NTNU, and SINTEF). Ceetron is a leading provider of 3D visualization technology for FEA and CFD. The joint project Mariana is about creating an advanced image-guided flexible catheter platform with immediate application to diagnosis and treatment of lung cancer. It was recently ranked as #1 project proposal of 363 eligible Eurostars applications.
Going back to the objective of this blog post (why and how a product vendor in CAE space could contribute to the innovation processes in the medical field), here are my findings:
Finding 1: Cloudification and thin web apps. The cloudification of engineering apps and sharing of data across departments and devices have been an ongoing trend in CAE for many years. Most or all major providers of CAE software (including ANSYS, DS Simulia, and Autodesk) have mature or semi-mature cloud-based offerings. It is fair to say that the major companies in the medical field have been less innovative in this field. Security has been a major concern; on the other hand, a simulation engineer creating new car models in BMW has similar or possibly stricter security requirements.
Finding 2: Surface models / topological models. In CAE, we have always focused on surface models (with tessellated surfaces) rather than 2D intensity plots or volumetric models based on sensor data, which are commonly used in the medical field. For planning, simulation, and navigation purposes surface models offers a much more effective visual format. (Going back to Botha et al.’s article, it is interesting that they identified what they call topological methods as one of “the medical visualization research challenges that [they] foresee for the coming decade”.)
Finding 3: Service-oriented architectures for heterogenous IT environments. Traditional medical applications, whether for desktop or for dedicated devices, have traditionally been massive monolithic applications written in C++, with application-specific databases. The trend in CAE is towards service-oriented architectures, may be based on a microservices architectural style, and built on sharing of data between applications. (Again. Botha et al. make the important, but today somewhat trivial observation (again as part of their section on research challenges) that “Mobile devices, in particular the APPLE products IPAD and IPHONE, are extremely popular among medical doctors and indeed solve some serious problems of desktop devices in routine clinical use.”)
Finding 4: New and open innovation models. The Mariana project is an example of an open innovation model, combining universities, hospitals, research organizations, and industry, from inside an outside the medical space. Its objective is to create ‘more accurate, more effective and less expensive management of early stage lung cancer’. It sounds like disruptive innovation (though there is a semantic issue regarding the use of the term ‘disruptive innovation’ in the sense of Clayton Christensen, see https://hbr.org/2015/12/what-is-disruptive-innovation). Contrast that with the in-house R&D conducted by GE Healthcare, Siemens, or Philips: closed innovation models, proprietary IP, and massive R&D labs.
Before concluding this blog post, I decided to talk with Håkon Olav Leira, Attending Physician at St. Olavs Hospital and post doc at NTNU. Here was his perspective: “I think we will see significant diffusion of technology from the field of CAE (FEA, CFD, and FSI) to the medical field. My research interests are related to the use of advanced visualization technology in medicine, segmented models from medical images such as CT, MR, PET and ultrasound, and time-varying data (ultrasound combined with tracking technology); key challenges in the medical field as well as in CAE.”
Tor Helge Hansen, CEO, Ceetron AS
I also decided to talk with our CEO, Tor Helge Hansen. Here is what he said about Ceetron’s strategy in the medtech area: He said: “Ceetron endeavors to establish a #1 position in 3D visualization of tessellated surfaces for medical applications. The Mariana project and other R&D projects with leading academic and industrial entities are important building stones for the realization of this objective. However, we are a product company and have started on the work of establishing an aggressive product road map in this field. Ceetron Cloud Medviewer is first one out, scheduled for release Q1 2018.”
Going back to the introduction in this blog post, I hope it has given you some insight into how I and my colleagues in Ceetron feel about our technology contributions to the medical field, and why this keen sense of personal engineering fulfillment.
Whether you represent a provider of medical technology or are conducting leading-edge academic research in the medical field, I encourage you to contact us for discussions about how our technology can contribute to the realization of your R&D objectives. My email address is provided below.
Thanks to our partner at SINTEF, NTNU, and St. Olavs Hospital, for their contributions to this blog post.
Grim Gjønnes, Dr. Ing.
 Caveat: I am coming from the field of 3D visualization for CAE, and have limited understanding of the academic field of medical visualization. I do not pretend that this is the most relevant overview article of the field of medical visualization; I came across it when browsing through the annals of MIT Technology Review when doing research for this blog post.
 Mariana project: Image-guided catheter navigation in the outer airways. EUROSTARS project 2017 – 2020. Consortium: Ceetron AS, SINTEF, University College Cork, Smart Electronics Ltd, DEAM BV, Delft University of Technology.
 The Trondheim area in Central Norway is considered one of the top medical ultrasound clusters in the world, with several prominent institutions and companies, the most important ones being the Norwegian University of Science and Technology (NTNU) with more than 25,000 students, SINTEF with more than 2,000 employees, and St. Olavs Hospital, Trondheim University Hospital, with more than 8,000 employees.