Surgeons' anatomical knowledge augmented, so process is faster

A London biotechnology company is using software it developed to take the guesswork out of determining where epileptic seizures originate in the brain.

Atamai Inc.'s Epilepsy Viewer software fuses multiple medical images, creating a 3-D brain that shows the location of electrodes and allows doctors to determine where seizures are occurring.

"No one else is doing this," says Atamai's president Yves Starreveld.

Starreveld, who owned a computer consulting company before pursuing neurosurgery, now divides his time between the hospital and Atamai.

Melanie Chambers, Business Edge
Atamai Inc.'s principals, left to right, are Kirk Finnis, David Gobbi and Yves Starreveld.

"Specialized image analysis is done in bits and pieces, and the drive to start that is just beginning to happen in terms of radiology," Starreveld says. "(Doctors are) still just looking at images and interpreting them rather than coming up with objective measurements on data sets.

"The Epilepsy Viewer automatically fuses a patient's MRI (magnetic resonance image) and CT (computed tomography) scan to reveal the important details specific to each modality."

Adds Kirk Finnis, vice-president and chief operating officer: "The MRI provides the brain topography, which we render in 3-D, while the CT provides the positions of the metal electrodes that were placed along the surface of the brain by a neurosurgeon in a previous operation. All of the important information is then presented to the surgeon as a single 3-D view."

The medical-imaging software and consulting company was started in 2000 by Starreveld, Finnis and David Gobbi, who is vice-president and chief executive officer. The three met while doing doctoral research involving image-guided surgery at London's Robarts Research Institute.

Atamai, which comprises one part-time and two full-time computer programmers, also supplies doctors and researchers in the medical field with customizable software packages such as Image-Guided Surgery and Instrument Tracking, as well as the viewer. Their smallest package costs $5,000 to $10,000, while more sophisticated software ranges between $500,000 and $1 million.

While it is a small company, there are advantages. "If we make a customizable package and the customer wants to do six different things, six different ways, that's no problem," Finnis says. "If they were to purchase a similar package from a very large company, the turnaround time to make modifications would be considerably longer, if not impossible."

The viewer is being used for research and study purposes until clinical trials are complete, Finnis says. The viewer is being used at Foothills Hospital in Calgary and Queen Elizabeth II Health Sciences Centre in Halifax, while related software is in use at Sunnybrook and Women's College Health Sciences Centre and The Hospital for Sick Children in Toronto.

Ron Hill, image-guided and robotics co-ordinator at Halifax's Queen Elizabeth, says the viewer could one day be standard equipment in all Canadian hospitals.

"We were actually pursuing another company to develop this," he says. "In general, (3-D) visualization is the way neurosurgery in particular is going. But also numerous other surgical practices - cardiology is doing 3-D visualization of the heart.

"It allows the surgeons' anatomical knowledge to be augmented ... this doesn't replace the surgeon's knowledge ... but it augments his knowledge and helps speed up the process," Hill says.

Image courtesy Atamai Inc.
The new software merges different types of brain scans into a single, cohesive image, making it easier to locate seizures.

To help speed up the process even more, Atamai joined forces last year with supercomputer specialists Silicon Graphics Inc. (SGI), based in Mountain View, Calif.

"It's a combination of cutting-edge, domain-specific software and cutting-edge performance on the hardware," says Glenn Koehler, SGI's Mississauga-based director of Ontario sales.

Gobbi says that if a customer has a large volume of medical images that need to be processed, SGI's computers are capable of speeding up the results considerably. An image-processing task that used to take eight to 12 hours of computing time now takes three to five minutes on SGI's hardware, he adds.

"You have a limited amount of time between when a patient gets scanned and when a doctor needs that image back," Gobbi says.

Currently, the SGI and Atamai combination is only being used at Robarts' virtual augmentation and simulation for surgery and therapy (VASST) lab, although the team has a number of future clients lined up in the next few months, Koehler says.

Atamai is one of eight medical companies spawned from the Robarts Research Institute since 1998. Robarts was set up as an independent research institute in 1986 from the then-University Hospital and The University of Western Ontario.

In addition to pursuing medical research, Robarts focuses on commercializing biotechnology in fields such as neurological, cardiovascular and immune-related disorders including heart disease, stroke and cancer. The institute has helped companies make the transition from research ideas to viable commercialized services and products, says Michael Crowley, the institute's vice-president of business development.

"We help incubate companies within our offices - providing administration and support through all aspects of the business to get them up and running. We even help with fund-raising efforts if needed," he says.

Crowley says it takes most companies three or four years to become independent enough to be able to raise their own revenue.

Robarts has helped develop software companies such as CT Perfusion - which was sold to GE Healthcare in 2002 in a multimillion-dollar deal. One application of its CT scanner involves accessing tumour activity and prognosis. Another company, Viron Therapeutics Inc., is developing anti-inflammatory drugs.

All eight spinoffs are still operating, employing more than 70 people and securing more than $45 million in investment capital.

Atamai is moving methodically and thoughtfully to perfect the software, Crowley says, but it is the kind of forward thinking needed to improve medical procedures.

"It's an interesting story because it merges researchers and clinicians - and that's when you get some very powerful solutions," Crowley says.

But what the Atamai partners may lack in business savvy they more than make up for in their medical networks.

"Most of our software is being marketed to research groups," Gobbi says.

"We are scientists and a lot of people that we market to are people that we know and are members of the same scientific community that we meet at conferences."

(Chambers can be reached at