NCCR Co-Me Final Report Starting Point and Goals (I) Research The Co-Me field in CH (or at any Swiss University) initially was not a strategic priority (in spite of its huge potential on the MedTech field), in particular with regard to multidisciplinary convergence focused on clinical problems Few established groups with occasional interaction Missing competencies in crucial technologies Main goal: Establish complementary partnerships between research groups with expertise in image analysis, computer animation, navigation, biomechanics, engineering and to combine this with clinical expertise Specific goals: Decrease invasiveness by navigation techniques; establish computer simulation for prediction of treatment outcome (pioneering efforts in VPH); create sensing technology for the surgeon in the OR; explore the potential of non-contact treatment control 1
Starting Point and Goals (II) Knowledge and Technology Transfer The strategic vision was to advance healthcare by integrating education, discovery, innovation and entrepreneurship. This should be achieved by cultivating translational research projects based on clinical practice needs, and by providing an effective framework for KTT. The KTT framework encompassed - a contractual base with IPR agreement and internal rules, - a technical board (TAB) and related PO support, - monitoring and coaching, such as by the Co-Me Tour de Suisse, - collaboration with the TT structures and the Swiss innovation system, - a novel partnership between MDs and technologists. Special attention was paid to the relation with the Medtech industry - industry involvement in MS & PhD programs, - joint master and doctoral theses, - involvement of experts of the industry in events. Starting Point and Goals (III) Education A major goal was to introduce education and training of the Co-Me field into the standard engineering and medical curricula, and at the same time bundling up the interdisciplinary components in study paths and related programs in health science and health technology such as by Mastersand PhD-programs. A specific goal was to introduce computer assisted methods (such as virtual and augmented reality) into the medical curricula, and to develop related courses for continued education. The school- and undergraduate level should be addressed for motivating and promoting purposes by frequent participation in open doors, science days or high-school visits, in particular by helping the SATW to establish the TechDays and continuously supporting it. 2
Achievments of Co-Me Progressed from a set of individual groups to a network of collaborators and institutions with common goals. Established computer aided and image guided medical interventions as a strong, highly competitive field in Switzerland, in a multidisciplinary effort that would not have been possible without NCCR funding. Created an identity visible to the outside and gaining international recognition as well as credibility and acceptance from the clinical and industrial communities. Established a very powerful innovation chain overarching the whole spectrum from basic research to commercial and clinical translation. Effective funding pipeline between SNSF and CTI ensured smooth transition in financing Co-Me resulted in (I) 11 new full professors 11 new assistant professors 3 replacements of chairs 14 habilitations 291 PhD-students and postdoctoral fellows (= 87% of SNSF funding; 60% pursuing academic career) 20% female PhD-students 350 Masters in Biomechanical Engineering 140 Full-time positions in 11 start-up companies 3
Co-Me resulted in (II) 40 Participations in EU and international programs 141 formal research collaborations 136 industrial collaborations 36 CTI projects 35 Patents 11 Start-up companies Output (publications) 1 000 Publication; MNCS significantly above world average (MNCS = 1) &"$#!"#$%&%%'()$*+,-./0$(1%2"*3($*1%3(1%4$5$*$267$*1$2%8$9% :;<+/$=($19%>#?!@AB%CDDC&CDEE%% &"!# %"$# #./01# %"!#!"$#!"!# &!!&#'#&!!$## &!!(#'#&!!)## &!!*#'#&!!+## &!!$#'#&!!,## &!!)#'#&!!-## &!!+#'#&!%!## 4
Output (other) Workforce (person months)!"""$ +"""$ #)"($ #"""$ *"""$ ("""$ %"""$ &"""$ "$!"#$,-./-01$23045-678$904:;8$ %#&'$ <-=>40$?-1-.06@-0$ &(!'$ 3417/46740.A$17:/-=7$ B46740.A$17:/-=7$ &%!*$?-1-.06@$C1146>.7-$ 48 % of work done by PhDstudents; 70 % coming form abroad Total persons CH DE FR US CN GR Other nations Management 19 13 4 0 0 0 0 2 Doctoral students 185 53 33 9 2 11 7 70 Postdoctoral students 106 31 17 11 8 4 3 32 Research associates 141 81 14 9 1 1 2 33 Senior researchers 249 119 72 10 6 2 5 37 Other staff 91 68 5 2 0 1 0 15 #'+$ D7@-0$17.E$ #)&$ F.=.G-H-=7$ 5
Structural Impact (I) ETH: Long-term strategic targets in medical technologies Hochschulmedizin Zürich / EXCITE Biomedical Engineering core of D-ITET Creation of D-HEST Center of Imaging Science and Technology (CIMST) Micro & Nanosystems Platform Master in Biomedical Engineering Master in Micro and Nanosystems CIMST Summer School in Biomedical Imaging Several Chairs at D-ITET and D-MAVT Structural Impact (II) Bern: Chairs: L-P. Nolte, M. Caversaccio, K. Siebenrock, S. Weber, Ph. Zysset ARTORG Interfacultary Center for Biomedical Engineering, directed by S. Weber & M. Caversaccio; creation of 9 junior professor positions. Institute for Surgical Technologies and Biomechanics (ISTB) Center for Computer Assisted Surgery (ARTORG) KTT Competence Center for Medical Technology (CCMT) Master in Biomedical Engineering in conjunction with BFH 6
Structural Impact (III) Basel: Medical Faculty chair H-F. Zeilhofer (CMF surgery) CMBE (Clinical Morphology & Biomedical Engineering) as 5th main research area HFZ (H.-F. Zeilhofer) Biomaterials Science Center (B. Müller) Medical Image Analysis Center, MIAC (P. Cattin) PhD-Program Image Understanding and Intelligent Data Analysis, Computer Sciences. Geneva: Medical Faculty chair Ch. Becker (Radiology) Highlights (I) MR-guided High Intensity Focused Ultrasound (HIFU) for ablation of thalmic tissue to treat brain disorders as chronic pain was successfully tested in a clinical study and reported in Annals of Neurology, 2009, vol. 66, p. 858-861. This Swiss FUS-study has been considered by MIT Review as one of the most important findings in Biomedicine 2009. SoniModul SA 7
6/27/13 Highlights (II) Standard workflow and instrumentation for planning, simulation and intraoperative navigation of surgical interventions in CMF (UHBS navigation SW by ARTORG, equipment by CAScination AG). Applied to non-complex routine surgeries and adapted to complex treatment in rare craniofacial disorders. Prospective clinical trial started in fall 2012. Highlights (III) ORL robot for minimally invasive cochlea implantation. Based on the concept of image guidance with unprecedented accuracy, effectively enabling image guidance on a microsurgical level. (Inselspital/ARTORG) 8
Highlights (IV) Untethered magnetic microrobots for minimally invasive microsurgery inside the eye (ETH/IRIS). In 2010, creation of Aeon Scientific AG focusing on wireless control of magnetic structures inside the human body. Currently aims at the steering of a catheter within the heart for the treatment of arrhythmias. Intraocular microrobot inside porcine vitreous humor (ex vivo) controlled by external magnetic fields, generated by the OctoMag. Highlights (V) Neuroglide 4 DOF robot for neurosurgery, tested in cadaver experiments for placing transarticular screws in the upper two vertebrae of the human cervical spine (VRAI Group, EPFL ). KB Medical SA 9
6/27/13 Highlights (VI) Statistical Shape Modeling (UniBS/ Gravis, UniBe/ISTB, ETH/BIWI). Population-based implant design SSM based 2D/3D reconstruction for a true 3D planning of total knee arthroplasty from clinically available x-ray radiographs The innovation pipeline at work Basic research in VR-based surgical training simulation: landmark results e.g. in modeling soft tissue behaviour Translation to prototype: Hysteroscopy Simulator (ETH/CVLab) Commercialization: VIRTAMED AG: HystSim listed in "TOP 100 Startups 2012" in Switzerland. Broadening product portfolio: CTI support Sold over 150 devices, profitable since 2 years with a single financing round (seed + business angels) Winner of the 2013 Swiss Economic Award 23 employees, US subsidiary 10
KTT Start-up (I) Crisalix SA, a spin-off from ISTB UniBe. Based on a portfolio of generic algorithms Crisalix develops web-based 3D technologies for plastic surgery and aesthetic procedures. The company is located in Lausanne at the Scientific Park of the EPFL with a subsidiary in Barcelona, Spain. Awarded as a top life science start-up at the European Venture Contest 2012. KTT Start-up (II) CAScination AG, emerged from Co-Me soft-tissue modelling (ARTORG/ Inselspital) for imageguided soft tissue interventions such as oncological liver resections. CAS One installed in 9 hospitals. 11
Experience The bottom-up based organizational structure with an MC of 7-12 PIs from the main partner institutions completed by a strong PO worked well. The challenges over the 12 years encompassed - Implementation: Line up of interdisciplinary collaboration and ensure quality and volume of publication output; - Operation: Establish the NCCR as a strong force of integration with strengthened quality- and cooperationcoaching; - Finalization: Find the right strategy for focusing and concentration, and find the proper way for a sustained visible follow-up procedure/organisation. Conclusion NCCR: A funding instrument with unique, distinctive features 12 years period, large financial commitment; absolutely necessary for the sustainable establishment of cross-disciplinary thinking and spirit between separate communities clinical testing and introduction of new technologies covering the whole innovation spectrum from basic research to marketable products creating the expected sustainable structural impact Co-Me demonstrated that cutting-edge basic research and successful technology transfer are cooperative targets Strong support from the Panel, SAB and SNSF offices 12