Dr. Gupta and Robopsy Credit CIMIT as They Move Toward Commercialization
Sometimes a CIMIT moment can be expanded into a multi-year relationship.
Rajiv Gupta, MD, PhD, a radiologist at Massachusetts General Hospital, heads a small company called Robopsy that is preparing its device for commercialization.
In 2005 Dr. Gupta got involved in the CIMIT- MIT 2.75 engineering class, the program in which a doctor with a problem to be solved works with MIT students to get the job done.
With the help of MIT Professor Alex Slocum, PhD, the team developed a remotely controlled robot that aids in image-guided percutaneous medical procedures. The small, lightweight device attaches directly to a patient and remotely aims and inserts a tiny probe at a tumor or other health abnormality. The radiologist is thus able to perform both the diagnosis and treatment, such as essential biopsies (often of the lung) and tissue ablations with pinpoint accuracy.
Dr. Gupta has made use of CIMIT assets in several ways:
He recognized the value of the 2.75 MIT course, and linked with the bright and energetic Dr. Slocum to develop a plan
From this class, he recruited thoughtful and energetic graduate students whose immediate careers are tied to the success of the project
The Robopsy team has received about $100,000 in CIMIT grants and has obtained more than $80,000 in additional grants and awards
The team has developed a financial relationship with Johnson Electric in Hong Kong and Germany, which is helping to fund the enterprise as Robopsy moves from animal (now) to human tests (next year)
“Without CIMIT, we wouldn’t have gotten off the ground,” said Dr. Gupta. “We started with the 2.75 program, and I realized these bright grad students had ideas that improved upon what I had conceived. We received a CIMIT grant, and a lot of facilitation and guidance from CIMIT Central.
“We were a winner of the MIT $100K Entrepreneurship Competition and we won the first-place award at the 2008 ASME Innovation Showcase. Our science has been validated, and I feel we have a big future.”
Team members on the technical and business side are doctoral candidates Nevan Hanumara and Connor Walsh, and Dr. Slocum. Leading the initiative on the clinical and animal testing side are Dr. Gupta and Jo-Anne Shepard, MD, who is director of the Thoracic Radiology Division at MGH.
Dr. Gupta says the Robopsy team has been talking with venture capitalists but needs more work in the lab before finalizing corporate plans. “At the right time we’ll probably look for a CEO,” Dr. Gupta said. “We have been successful so far, but I think a business executive would be a good addition to the team.
“If we do become a commercial enterprise – and it appears that we will - we will all look back and thank CIMIT.”
At the SolidWorks World 2009 Convention keynote speaker Jeff Ray used the CIMIT & Dtm "Car Part" Incubator as an example of innovation and great designs during hard times.
Richard Branson, CEO of Virgin, also said: "Working on a new kind of [baby] incubator is more important than getting drunk every night."
Check out Jeff's Keynote and the "Car Part" Incubator video here...
The
CIMIT Prize for Primary Healthcare competition has been launched, and
this was one case where a full-court (national) press produced a winning
result.In
our first year, CIMIT got 78 pre-proposals from 44 universities in 21
states. Ten have been chosen as Finalists, and their completed applications
will be due May 31. Announcement of the top winners will be made June
30.
Your
Scribe sees several reasons why the applications were numerous and the
quality is high:
A generous prize structure
An interest in primary
care
An intense drive to
inform engineering schools of the competition
To
start, the CIMIT Prize offers a great opportunity. Rarely do 10 finalist
teams get $10,000 each. That amount would be a generous prize for a
winner (remember, most team members are undergrad and grad students).
But to get $10,000 to work on the final version in pursuit of the $150,000
top prize must have inspired many engineers. Secondly,
the subject matter is appealing. We all know a little something about
primary care; most have pondered about “a better way” while we wait
to be seen when we arrive at a medical office. Numerous entries focused
on ways to store and access one’s medical information so it can be
accessed quickly – and with a guarantee of privacy. Its organizers
identified a real need. Also,
at CIMIT we were pretty busy. We approached all the engineering deans
in the country; in addition, we contacted chairpersons of bioengineering
and biomedical engineering departments. And we engaged public-affairs
officials at the universities to ask them to spread the word of our
big contest. We
sent more than 600 emails to engineering honchos to inform – and then
remind - them of the competition. Well, the word got out and many quality
applications came in. In
sponsoring this exciting event, the Gelfand Family Charitable Trust
was sagacious about choosing the focus of the contest and generous about
setting the financial parameters. We look forward to June when the winners
are announced - and to the months after that when many fine ideas to
improve primary care might well be put into action.
Moderator: Alex Slocum,
PhD, Pappalardo Professor of Mechanical Engineering and MacVicar Faculty
Fellow, MIT, slocum@mit.edu
Design and Testing of a 3-axis Machine Used to Characterize the Performance
of Running Shoes Clinician: Danny Abshire,
Co-Founder, Vice President, Director of Global Marketing, Newton Running,
danny@newtonrunning.com MIT Student Team: Aaron Gawlik, Mathew Gilbertson, Priam Pillai,
Folkers Rojas, Adam Wahab
Current ASTM tests on running
shoes are insufficient because they do not reliably capture the loads
and displacements applied to shoes during running. This team will discuss
a 3-axis machine that can be used to test running shoes that mimic's
natural running more accurately than conventional tests. The design
is comprised of a phantom foot that replicates the passive properties
of a human foot and an actuated base that can impose the relevant kinematics
to the running shoe. The shoe is mounted on motor to give a rotational
degree of freedom. The shoe and the base are instrumented to measure
force and displacement dynamically during the running cycle. The machine
can be calibrated to emulate different types of runners by adjusting
the trajectories of the base. As a proof of concept we have collected
force, displacement and energy data from the machine.
Design and Testing of a Novel Device for Rapid Retrograde Intubation Clinician: Joan Spiegel, MD,
Instructor in Anesthesia, Beth Israel Deaconess Medical Center, Harvard
Medical School, jspiegel@bidmc.harvard.edu MIT Student Team: Charlie Ambler, Maria Luckyanova, William
Palm
This team will present a suite of novel device concepts that simplify
and expedite retrograde intubation. Traditional methods of tracheal
intubation employ a laryngoscope for placement of the endotracheal tube
(ETT) via the oropharynx. For patients with an acquired or inherited
abnormal airway (trauma, tumor, swelling, obesity, etc) these methods
may be impractical or detrimental. In such cases, a retrograde approach
via the cricothyroid region may be safer and more successful, but the
method has not gained widespread acceptance due to the excessive time
required and the difficulty in passing the ETT over a retrograde guidewire.
The novel concepts presented herein overcome prior limitations by reducing
the number of steps required and employing a stylet that guides anterograde
placement of the endotracheal tube easily through the vocal cords. Initial
testing using a mannequin simulator suggests that the new concepts may
offer superior performance over current methods.
Design of a Low-Cost Pressure Monitoring Syringe Clinician: Joan Spiegel, MD, Instructor in Anesthesia, Beth Israel Deaconess Medical Center, Harvard
Medical School, jspiegel@bidmc.harvard.edu MIT
Student Team: Sarah Cooper-Davis, Sam Duffley, Ryan King, Adrienne Watral
Endotracheal intubations are performed on thousands of patients every
day, part of which is done by inflating a cuff on the distal tip of
the tube to seal off the trachea. The air pressure inside the cuff must
be sufficient to seal the trachea from unwanted flow of fluids, yet
low enough to avoid cutting off capillary blood flow in the surrounding
tissues. We evaluated several strategies and concepts to achieve correct
cuff pressure and designed a syringe with an internal bellows pressure
monitor. Many patents currently exist for pressure monitors external
to the syringe; however, none of these devices are regularly used by
doctors because they require too many changes to standard intubation
techniques. This syringe uses a bellows inside the plunger to measure
and display the internal cuff pressure. The bellows incorporates a spring
and a seal into a single elastomechanical device, allowing for highly
repeatable measurements. The design also maintains much of the traditional
syringe design, in that only the plunger is modified. The device was
calibrated to an external manometer and successfully tested by doctors
at Beth Israel Deaconess Medical Center. This alpha prototype design
successfully solves the problem of measuring air pressure in endotracheal
tube cuffs and is a viable candidate for low cost mass-production.
With the goal of engaging graduate
students and accelerating ideas into prototypes, teams of MIT graduate
engineering students spend a semester collaborating with clinicians
in CIMIT-affiliated hospitals to develop innovative medical devices.
Clinicians (physicians, nurses, and scientists) present clinical problems
and initial ideas. Students form teams to work with the clinicians to
turn these ideas into reality. The goal is for the students to deliver
a working prototype and a journal-quality article in one semester. In
its fifth year, the course has been a great opportunity for clinicians
to test out new ideas and to stimulate new collaborations. For example,
Robopsy, a robotic device to assist radiologists performing tumor biopsies
was invented by an MIT team led by Rajiv Gupta, MD, in 2004. The team
was awarded the 2007 MIT $100K prize, the world's leading entrepreneurship
competition and the 2008 ASME Innovation Showcase.
Moderator: Alex Slocum,
PhD, Pappalardo Professor of Mechanical Engineering and MacVicar Faculty
Fellow, MIT, slocum@mit.edu
A Novel Catheter Navigation System Clinician: Rajiv Gupta, MD, PhD,
Director, VCT Lab and Assistant Radiologist, Department of Radiology,
Massachusetts General Hospital, rgupta1@partners.org MIT Student Team: Jean Chang, Ellen Chen, Kenny Cheung, Alison
Greenlee
There no techniques that allow
doctors to quickly and accurately maneuver a catheter during an extravascular
procedure. Presently utilized techniques restrict catheters to simple
paths and therefore limit a doctor's ability to position the catheter
in a poorly constrained environment. The proposed catheter navigation
system overcomes these limitations and positions the catheter tip while
the overall catheter shape is maintained. The system consists of a disposable
set of "Tension Stiffening Guide-Wires," a double-lumen catheter,
and an external reusable control system that is used to remotely maneuver
the catheter. The "Tension Stiffening Guide-Wires" are composed
of a set of beads with spherical bearing surfaces so that when the beads
are held in tension, a friction lock forms between each bead. Mathematical
analysis was performed to predict contact forces between beads, change
in guide-wire conformation due to external forces, tip deflection, and
failure modes. The catheter navigation system is not path limited and
can make a number of three-dimensional turns inside the body. The goal
of this prototype is to present doctors with a working catheter positioning
system that will enable faster and accurately extravascular procedures
to be conducted faster and more accurately.
Design and Prototyping of a Head Fixation Device for Transcranial Magnetic
Stimulation Clinician: Alvaro Pascual-Leone, MD, PhD, Professor of Neurology, Harvard Medical School; Director of the Berenson-Allen
Center for Noninvasive Brain Stimulation and Attending Neurologist and
Director of Research, Behavioral Neurology Unit, Beth Israel Deaconess
Medical Center, apleone@bidmc.harvard.edu MIT Student Team: Dodd Gray, Lawrence Maligaya, Adam Paxson
For applications of transcranial
magnetic stimulation (TMS) and other cranial procedures involving relatively
small instruments, this team will present a device for fixturing these
instruments relative to a patient's head. The device consists of an
ergonomic base table in which the patient rests face-down. The patient's
head is supported by a custom-molded face restraint compliantly fixed
to the base table. Indexing of the patient's skull is accomplished with
a molded dental insert. Each stage of the design process is discussed
with emphasis on a systematic approach based on structural analysis
and bench-level experimentation. The performance of the final prototype
is evaluated using digital image analysis. Our device achieves a positioning
repeatability of 2.5mm, with a maximum displacement of 1.3mm over a
five-minute period once the device has been affixed.
Interbody Device and Procedure for Endoscopic Lumbar Fusion Clinician: Kevin McGuire, MD, MS,
Chief, Orthopaedic Spine Service, Beth Israel Deaconess Medical Center;
Co-director, Comprehensive Spine Center and Combined Spine Fellowship
Program; Instructor, Harvard Medical School,
kjmcguir@bidmc.harvard.edu MIT Student Team: Nadia Cheng, Sourabh Kumar, Ryan Slaughter,
Maria Telleria
This team designed an interbody device and procedure that allows for
performing minimally invasive lumbar fusion operations. Minimally invasive
fusion techniques are currently limited due to non-availability of suitable
interbody devices which can pass through an endoscopic tube and still
obtain and maintain the required disc height for fusion. Here, a balloon
based expandable device is presented which fulfills all the requirements
of an interbody device used for lumbar fusion. It consists of an open-ring
shaped balloon which is inserted into the disc space through the endoscopic
cannula in the deflated state. The disc space is propped open by filling
in pressurized saline into another balloon placed inside the ring. Once
properly placed in the disc space, the ring shaped balloon is filled
with fast solidifying bone cement slurry causing it to expand into the
final ring structure. The saline balloon is eventually removed out of
the disc space allowing for a large central space for packing bone graft
material. The entire technique is described here, highlighting the essential
features of the device. A successful device can be designed with a suitable
choice of bone cement and balloon material. Available values for material
properties suggest that the designed device would successfully allow
for a complete lumbar fusion. Future in-vivo studies are needed to fully
assess the success of the device.
Inhalation Gases in Biomedical Research Warren M. Zapol, MD,
Professor of Anaesthesia, Harvard Medical School; Reginald Jenney Professor
of Anaesthesia, Harvard Medical School; Director, Anesthesia Center
for Critical Care Research, MGH, wzapol@partners.org
Warren Zapol presents his studies and views of two gases with medical therapeutic interest.
Nitric oxide is inhaled by 20,000 Americans per year for neonatal persistent
pulmonary hypertension and peri-operative pulmonary hypertension, and
Hydrogen Sulfide is being studied in the laboratory for its ability
to rapidly create metabolic arrest in rodents.
Aerosols and Aerosol Drug Delivery Systems: Basics and Beyond Myrna Dolovich, P ENG,
Associate Clinical Professor, Medicine, Faculty of Health Sciences;
Head, Firestone Research Aerosol Laboratory/Center for Molecular Imaging
of the Lung, McMaster University, St Joseph's Healthcare, mdolovic@mcmaster.ca
Inhaled medications continue to
be the most widely used form of therapy for treating respiratory disease
in adults and children. Developments in inhaler technology and design
have led to improvements in the production of therapeutic aerosols and
with greater efficiencies of delivery and ease of use from the variety
of inhalers available. Novel designs continue to be approved by the
regulatory agencies and commercialized by manufacturers and, as a result,
numerous delivery systems are currently available for drugs administered
in aerosol form. Devices range from hydrofluoroalkane (HFA) pressurized
metered-dose inhalers (pMDIs) with and without attached spacer devices,
dry powder inhalers (DPIs), and nebulizers for providing continuous
or intermittent aerosols of liquid solutions or suspensions. Within
these three categories are a variety of devices producing aerosols with
somewhat similar characteristics but with a range of fine particle lung
delivery efficiencies, the current indicator of lower respiratory tract
deposition and anticipated clinical advantage.
Delivering aerosolized medications
to the lung is a challenge: the combination of drug formulation properties,
delivery system characteristics, patient ventilatory technique and compliance,
and the nature of the lung disease all influence the success of therapy.
The dose of drug deposited in the lower
respiratory tract is affected by the inhalation technique adopted by
the patient (inspiratory flow rate, inspiratory volume, and breath-hold
time). Most importantly, the degree of airway narrowing, which varies
with the type and severity of the lung disease, further influences the
distribution of that dose within the lung and potentially, the response
to the therapy.
In the last 10–15 years, major
design changes have occurred in all three categories of drug delivery
devices. Examples of Innovative features introduced into newer types
of inhalers are dose counters and integrated electronic management systems
to track treatments and maintain treatment schedules, all designed with
a view to improve compliance.
Aerosol products for the treatment
of respiratory diseases have the simple advantage of depositing a specific
drug directly to the appropriate receptors, thus bypassing GI barriers
and general systemic exposure. Inhalers should provide a predictable,
consistent dose of drug, operate in a patient friendly manner, and provide
a reasonable cost of treatment per day. The patient must be able to
use their device easily, maintain it and derive clinical benefit from
the drug provided from the system. Physicians and patients must also
recognize that if one system does not work, an alternative can be tried.
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