Good July 30th article for new investors Ventripoint’s diagnostic imaging system: opening up a billion dollar market and lowering healthcare costs
30th Jul 2013, 9:00 am by Fiona MacDonald
Capturing usable images of the right side of the heart has always been a challenge. By its very nature, the heart is an organ in constant motion, one that is encased in “a bone cage”, as Dr. George Adams, CEO of Ltd. (), puts it, and the right side is close to the ribs and poses a particularly poor vantage for image capture. All the more challenging are congenital heart problems, which cluster on the right ventricle (a problem on the left side almost always would not result in a live birth) and are misshapen.
With cardiologists tending not to use ultrasound for the right side of the heart due to the blurry nature of the resultant image, they are forced to employ MRI to gather critical information about the right side of the heart - a solution that involves costs and inconvenience for all parties.
Under the current system, one to two hours of the patient’s time must be spent inside the MRI, while analysis clocks in at between 15 and 45 minutes of the radiologist’s time. MRIs also involve a second visit to the MRI centre for the patient and a third appointment back to the cardiologist in order to establish treatment.
For some patients, an MRI might be a necessity, but might not be practical. Take the case of a child – by the nature of the ailment, some sufferers of congenital heart defects will be very young – being asked to lie motionless inside the massive metal chamber for hours. In cases like these, the infant and toddlers must be put under a general anaesthetic -- which always carries a risk of death – thus necessitating the presence of “four very expensive people to conduct the procedure,” says Dr. Adams, including an anaesthesiologist, cardiologist, radiologists and MRI technician.
The time-intensive nature of a cardiac MRI is also a concern to staff negotiating long lines of patients waiting for access.
It is this cluster of needs that the Ventripoint Medical System, variously known as VMS and Angelo, seeks to address. The VMS creates a 3D-rendering visualization of the right ventricle that puts existing technology in the shade.
The technology itself is a patented and proprietary system that Dr. Adams says works by “connecting the dots” -- the VMS gathers standard 2D ultrasound data and uses it to create a 3D model, via the method of placing dots on the image coincident with anatomical landmarks, such as heart valves, and from these dots builds an accurate 3D model, using as a reference the Ventripoint’s ‘knowledge-based reconstruction library.’
This library, a sizable database that contains reconstructions of hearts both of normal dimensions and those with a variety of abnormalities corresponding to different kinds of heart disease, provides a catalog of potential shapes and sizes. A 25-point constellation of dots is used to build the heart shape that matches (with, Adams says, 99% accuracy) and the resultant image is used to calculate such aspects as heart volumes. The image can be rotated to complete the visualization and allows the cardiologist to visually verify the model’s accuracy.
It is the “connecting-the-dots” aspect that has given rise to the other name by which the VMS is known: Angelo, short for Michelangelo, the great master who taught his students to put dots on a page to gauge proportionality before drawing an image.
The company reports that independent research by leading cardiologists around the world has shown the numbers arrived at as a result of these calculations are just as accurate as MRI and better than 3D echo, or any other means of measuring the heart.
The benefit, however, of such new scrutiny of the right side of the heart is only one aspect of this new technology. While the technology returns a highly accurate picture of the heart, it does so in a much shorter time than other methods: the 2D ultrasound examination takes around 5 minutes and the analysis takes another 10 minutes. This compares with upwards of two hours for MRI. This fact alone is attention-grabbing for hospitals, as once cardiac patients are removed from the line-up for the MRI, the volume of the queue is cut by a fifth. Perhaps even more important to a money-minded hospital is the fact that cardiac screening is among the least profitable uses to which an MRI can be put.
An economic analysis for a U.S. pediatric hospital put the rate of net income that can be generated by the VMS as coming in at $1,000 per hour, well above the $350 brought in by an MRI for the same amount of time for doing cardiac procedures.
Once the time “liberated” for the MRI is factored in, another $250,000 per year -- generated from using the MRI more efficiently for other procedures -- thus flows, albeit indirectly, from the VMS. And it seems that the sky is the limit.
While the first application for VentriPoint’s technology relates specifically to congenital heart disease, the company has a suite of applications planned for all major heart diseases, including pulmonary hypertension, cardiovascular disease and heart failure -- multi-billion dollar market potential.
Already, VentriPoint is working on an additional possible application – Dr. Adams says he was “amazed” at the discovery that 26 per cent of heart patients return to hospital within a month of initial discharge, which seems to indicate that while current therapies work well on the majority of people, a sizable proportion of patients need more aggressive monitoring and therapy. Under the current American system, whereby patients are re-admitted for reassessment, the cost of the subsequent hospital stay – which is not counted as a new admission – has doubled in the last decade to hit $33,079 in 2010, according to the University of Washington.
As Dr. Adams points out, judging from available figures, it would take as little as a month and as few as three eliminated returns to cover the cost of the VMS system. A study with a large American hospital to prove this assertion is underway. If proven, right heart analysis will likely become mandatory and revolutionize cardiac care worldwide.
And the list price of $100,000 for the actual machine is backed up by recurring income in the form of $10,000 per year for access to the database, software support, training and hardware maintenance and various value-adds that can drive annual per-unit revenue up by up to $40,000 per year.
At present, Canada and Europe have granted approval for the sale of the diagnostic tool with Ventripoint now pursuing approval from the U.S. FDA with one last hurdle to clear, Dr. Adams says. The FDA is seeking “one final piece of information”, which Adams is due to submit by the end of the summer, with approval anticipated to come early in the fall.
Already, 12 are installed in the U.S. for the purposes of clinical trials, with 10 spread over Europe and four in Canada.
Ventripoint’s quest to connect the dots is proceeding apace.
Shares in Ventripoint are currently trading at about 9 cents on the TSX Venture Exchange, giving it a market cap of just under $13 million.