ERCIM News No.47, October 2001 [contents]
QuantifiCare: A new INRIA spin-off in Medical Image Processing
by Jean-Philippe Thirion
QuantifiCare is a newly created spin-off of INRIA, located in Sophia-Antipolis and dedicated to Medical Image Processing applications. Its first target is the quantification of disease evolution for the objective measurement of drug efficacy.
Created by several former researchers of INRIA in March 2001, QuantifiCare S.A. is a French company, located in Sophia-Antipolis and dedicated to the applications of Medical Image Processing. The first phase of its activity is to design specific protocols for the follow-up of disease evolution such as ischemia, arrhythmia, osteoporosis, lesions or tumors volumes. Amongst the studied pathologies are Coronary Artery Disease, Multiple Sclerosis, Stroke and Cancer. QuantifiCares techniques take as input volumetric images such as Magnetic Resonance Images (MRI), cat-scans, Nuclear Medicine images (SPECT, PET), 3D ultrasound and provide quantitative measurements of physical parameters.
QuantifiCare is relying upon a unique expertise in 3D image matching in order to track very precisely subtle changes along time. Inter-patients image matching is also used to relate the information of different individuals and allow for population model analysis or data mining applications. An important technology transfer, relying on a large number of general-purpose libraries, as well as on dedicated matching methods, including three patents, has been signed between QuantifiCare and INRIA in June 2001. This technology has been developed over the years by an INRIA research team called EPIDAURE, created in 1989 by Nicholas Ayache. Jean-Philippe Thirion, the Chief Executive Officer of QuantifiCare as well as several other co-founders of the company, are former senior researcher of EPIDAURE.
Two product lines have already been developed by QuantifiCare and are currently improved: MPS-Quant, based on the analysis of Myocardial Perfusion Scintigraphy (MPS) studies for Coronary Artery Disease (CAD) and MS-Quant for the follow-up of Multiple Sclerosis (MS).
According to the American Heart Association, more than 7 million Americans have a history of Coronary Artery Disease and 600,000 people are dying each year in the US, due to this disease. Two current treatments are proposed, which are bypass grafting (600,000 operations per year) and angioplasty (500,000 operations per year). As these operations are costly and invasive, many alternative treatments are currently being developed, such as angiogenesis, laser revascularization, thrombolitics, radiation therapy. MPS-Quant is currently used in two retrospective drug trial studies, one for Angiogenesis, involving 60 patients and one for laser revascularization, with 260 patients.
Multiple Sclerosis corresponds to fewer, but younger patients: about 350,000 patients are identified in the US and 450,000 in Europe. These patients are generally aged between 20 and 40 years. Some drugs have already been approved for a subset of MS patients, who are presenting the 'relapsing-remitting' form of the disease. It has been shown, from MRI measurements, that the number of relapses was decreasing when beta-interferon is used. However, no long term beneficial effects have been demonstrated and many alternative treatments are currently under evaluation, for which QuantifiCare's technology is providing highly accurate evaluation of changes, not only with respect to the number of plaques, but also with respect to hidden effects of the pathology such as 'mass effects', that is, local volume variations within the brain or brain atrophies. QuantifiCare owns the right on a patented technology, which has allowed, for the first time, to quantify such effects.
The first customers are pharmaceutical companies. QuantifiCare is designing dedicated measurement to quantify drug efficacy and takes care of all aspects related to imagery in Phase II or Phase III drug trials. The proposed services are including the centralization of image data coming from multiple clinical centers, the archiving and remote processing of the image data and also original image-based data mining capacities. The results of QuantifiCare's computation can be used directly to support evidence of efficacy for the registration of a new drug or a new treatment.
The current effort of the company is to establish a set of research contracts and drug trial participation with pharmaceutical companies. It is currently recruiting Marketing and Sales persons from the pharmaceutical field. A mid-term objective is to establish formal collaborations with other academic research teams in image processing, within or outside INRIA, to keep the technology of the company updated. Each percent gained in sensitivity for the measurement of disease evolution can lead to gains of several orders of magnitude in the statistical results of a trial involving hundreds or thousands of patients and can decide upon the registration or rejection of the new drug. The stakes are high and QuantifiCare's ambition is to maintain its technology to the up most level, to increase the chances to measure the slightest effect of a drug, when medical imaging is used to monitor the evolution of patients.