• I-SEE

A spin-off from the University of Turin and INFN, I-SEE specializes in creating Monte Carlo-based simulations for medical physics applications including radiotherapy, proton therapy, radiobiology and radiation protection. The company develops simulation software tailored to each customer's particular requirements and specifications. It also provides a web interface that allows users to access and run these simulations on I-SEE's computer clusters. "Our clients can just access the web application and quickly get all of their results," Faiza Bourhaleb, I-SEE's founder and CEO, told medicalphysicsweb.

Speaking at ICTR-PHE's dedicated start-ups session, Bourhaleb presented examples of the company's products, including the Virtual Patient, a full virtual anthropomorphic phantom for use in quality assurance, biological modelling, radiology and radiation protection investigations. I-SEE can also offer Monte Carlo simulations for linac modelling and validation, verification of treatment planning systems, design and simulation of beam delivery lines, and radiotherapy detector design. Within radiation protection, products include simulations to determine the distribution of secondaries in a particle therapy treatment room, for example, or to perform high-accuracy shielding calculations.

• OncoRadiomics

OncoRadiomics is developing tools and imaging biomarkers for automated medical image analysis. The technology is based around a unique quantitative image analysis software that provides automated diagnosis from standard images, and can identify patients with a high risk of cancer or recurrence. The company's main product offering is RADIOMICS, software for extracting quantitative image features and generating predictive signatures to guide personalized treatment. "We first want to apply this to the world of oncology, and then move to radiology, where they have even more images available," explained chief scientific officer Ralph Leijenaar.

Leijenaar described a proof-of-concept study, in which OncoRadiomics' software was used to extract and rank 440 features (quantifying tumour image intensity, shape and texture) from CT images of over 1000 patients with lung or head-and-neck cancer. These features were combined to create a radiomics signature, which was then validated in three independent datasets (225 lung cancer, and 136 and 95 head-and-neck cancer cases). "We could see that the radiomics signature performed better than TNM [classification]," he said. "Even though artefacts were present in the head-and-neck images, our signature still validated them well."

The company, based in Maastricht, the Netherlands, plans to launch eight product lines by 2020. This includes DISTRIM, a new image analysis approach that allows the use of distributed medical data sets, without the data having to leave the hospital. Presenting the company's "vision of the future", Leijenaar predicted that one day, all radiological images will be automatically analysed with a "quantitative radiomics" approach, radiomics signatures will be continuously updated via distributed learning, and ultimately, "all hospitals in the world will use radiomics".

• SMART Scientific Solutions

Launched last June in the Netherlands, SMART Scientific Solutions will provide tools to guide the entire workflow of preclinical radiotherapy studies. "Modern biological experiments are very complex, we thought we could help by developing software that can help in all the steps," explained Frank Verhaegen, the company's co-founder. Verhaegen and colleagues at the Maastro Clinic developed SmART-Plan, a Monte Carlo-based treatment planning system for small-animal irradiation. "This software is licensed to PXi [Precision X-Ray] for now, but from next year on, we will have this product in our own company," he explained.

As well as the treatment planning tools, the company's initial products include the PlastiMouse and PlastiRat phantoms (anatomically-accurate plasticized animals), a multimodality scanning bed, software for dual-energy CT scans, as well as a product to help with image and dose guidance. Verhaegen says that by helping biologists with scheduling of animal experiments, SMART Scientific Solutions can enable more efficient studies. "We have software that will help you set up trials, run them, analyse the data and even translate to human trials," he told medicalphysicsweb."

• e-Learning4Health

According to Adriana Berlanga, scientific director and co-founder of e-Learning4Health, there's a bottleneck in cancer therapy associated with training staff on the latest medical advancements. In some cases, patients don't have access to the most advanced treatments because doctors are not trained to use them.

Berlanga explained that traditional training methods often cannot keep up to date with new developments and can be time consuming. Current e-learning approaches, meanwhile, tend to be technology-oriented and don't necessarily focus on the real needs of medical professionals. What's needed, she said, is a training approach that's relevant to clinical practise, easy to update and maintain, cost-effective, fun, short and to the point, and mobile.

To meet these requirements, e-Learning4Health has teamed with healthcare professionals to create a series of certified healthcare and life sciences training and education tools. These training programmes incorporate awareness of the latest advances in different fields, as well as offering the ability to combine multiple fields. Berlanga presented some examples, including an interactive e-learning module for the Truebeam radiotherapy system, which incorporates videos, learning activities, self tests and final tests. There's also a virtual patient module based on real cases, in which users have to decide which treatment fits the patient and justify their decision.

• diXit

Piergiorgio Cerello, co-founder of Turin-based diXit, described the company's first product: WIDEN, a web-based image and diagnosis exchange network. Designed to ease the imaging workflow in clinical trials, WIDEN allows secure image exchange with a panel of experts. Once the images have been reviewed, the findings are notified to the centre that performed the scans. The system also sends real-time notifications about the trial status to the coordinators. As the system is accessed via the Internet, Cerello explained, no dedicated hardware or software is required.

WIDEN can also perform imaging quality assurance for clinical trials. Cerello highlighted two PET-related features, including a plug-and-play PET phantom that can be shifted between sites during a trial, enabling scanner equalization for quantitative PET. In addition, the company has a patent-pending technique for liver-based standardized uptake value (SUV) validation. "WIDEN has been used for about three years now, by about 200 centres in the world," he told the conference delegates.

• Colnec Health

"We know that patients don't always follow their prescriptions," said Yves Mboda, founder of French/Swiss company Colnec Health. He explained that most of the patient's actions take place outside of the doctor's clinic. But the doctor needs to know how the patient is behaving to provide appropriate support, and the patient may need help to achieve their health goals. To address this issue, the company has developed a mobile phone-based "real-time collaborative care platform".

The approach involves devising a care plan that fits with the patient's lifestyle. This plan specifies three factors: the patient's goals, such as a target weight or blood pressure; a realistic set of actions, such as taking medication, exercising and/or following a diet; and the team, which comprises at least the doctor, patient and an advisor. This plan is synchronized on the team's mobile devices, enabling instant email contact and ongoing follow-up without the patient having to keep revisiting the doctor's office.

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