Q&A With Victor Chan, VP of Marketing for Body Vision Medical

Chan discusses the AI imaging technology recently used alongside a steerable needle during a successful lung biopsy.

Victor Chan

Victor Chan
VP of Marketing
Body Vision Medical

Body Vision’s real-time, AI-based intraoperative imaging technology was recently used with Serpex’s steerable needle to successfully perform a lung nodule biopsy at Cleveland Clinic in Cleveland, Ohio. Victor Chan, VP of marketing for Body Vision Medical, spoke with Medical Device & Technology about the AI-based technology and how it can be used with devices like the steerable needle to improve the lung cancer diagnosis process.

(MDT:) How does Body Vision’s AI technology differ from traditional imaging technology?

Chan: A traditional CT scan is a series of 2D X-ray images taken from different angles around a patient’s body which a computer then uses an imaging algorithm to process into a 3D representation of the body which a clinician can then view as cross-sectional slices. What Body Vision has developed is a proprietary AI-driven, learning imaging algorithm that is specifically designed to work with a C-arm, a commonly available piece of X-ray imaging equipment found in virtually every hospital.

Unlike gantry-based CT scanners which takes high-resolution X-ray images at pre-determined points of a motorized 360-degree spin around the patient, producing a CT-like scan using a C-arm is a much more challenging proposition as a C-arm is typically spun manually and takes lower resolution X-ray images in a narrower arc. So there is greater variability and less imaging data to work with.

That’s where AI comes in. We’ve entrained our imaging algorithm with a clinical data lake of over 10,000 clinician-annotated X-ray images so that the algorithm can produce near-CT quality scans in real-time during a procedure from these inherently lower fidelity C-arm images. The first commercial application of our technology is in pulmonology where LungVision™ enables bronchoscopists to use a C-arm to provide real-time, intraoperative imaging when performing endobronchial lung biopsies. The same technology could potentially be applied to other disciplines and procedures that would benefit from real-time intraoperative imaging.

(MDT:) What is the clinical problem or challenge that Body Vision’s AI-based imaging addresses?

Chan: It's estimated that 1.7 million people are diagnosed with lung cancer annually and most are caught at stage III or stage IV, where the five-year survival rate is less than 10%. One reason is the lack of systematic lung cancer screening. Compared to breast, cervical, and colorectal cancer, where the percentage of people recommended to receive screening who are screened is around 70%, the percentage of folks in the U.S. who are identified as high-risk for lung cancer that receive lung cancer screening is less than 5%.

Another reason is the inability to definitively diagnose or rule out lung cancer in patients where something suspicious is seen in the lung on a CT scan. It’s important to realize that the interventional pulmonologists and thoracic surgeons that perform these endobronchial lung nodule biopsies have not, until very recently, had the benefit of real-time imaging during the diagnostic bronchoscopy procedure. While several different technologies have been developed to help bronchoscopists more accurately navigate to the lung nodule, all of them are reliant on a static pre-operative CT which may not accurately represent where the lung nodule is during the procedure. Without the ability to see where the lung nodule is during the procedure and visually confirm that biopsy samples are being taken from the nodule, it’s not surprising that the diagnosis success rate of these procedures have generally not exceeded 70%.

Our AI-based imaging technology fundamentally changes how a clinician approaches diagnostic bronchoscopy. With the aid of our system and a C-arm, bronchoscopists can see exactly where the lesion is and where their bronchoscope and biopsy tools are relative to the lesion in real-time, providing them the critical image-guidance they need to accurately navigate to the lesion, biopsy, and make informed clinical decisions during the procedure. Real-world experience by our customers supports that LungVision cost-effectively adds precision, efficiency, and improved diagnostic success to the diagnostic bronchoscopy procedure.

(MDT:) How does Serpex’s steerable needle work?

Chan: If you look at the pulmonology space over the last five years, some of the biggest innovations have been real-time, intraoperative imaging and the introduction of robotic bronchoscopy platforms. One benefit of robotics is that, compared to a manual, catheter-based bronchoscope, the system has greater articulation, enabling bronchoscopists to theoretically navigate to more challenging to reach locations in the lung. However, the cost of a robotic bronchoscopy platform can be upwards of half a million dollars, putting it out of reach for many rural and community hospitals in the U.S. and most institutions outside of the US.

What Serpex has come up with is a steerable biopsy needle that enables clinicians to actively deflect or bend the tip in real-time during a procedure, replicating some of the articulation benefits of a robot in a simpler and much less expensive device. The steerable needle can travel beyond the reach of the scope reaching the bronchoscope into the peripheries of the lung where the most difficult nodules reside. This ability to “steer” the biopsy needle gives the bronchoscopist greater control over needle throw trajectory and where they are taking biopsy samples from, increasing the likelihood for a definitive diagnosis.

Whereas Body Vision’s LungVision provides the real-time imaging necessary for accurate navigation to the lung nodule and visual confirmation of tool-in-lesion prior to and during biopsy, the Serpex Compass steerable needle physically enables clinicians to access and precisely sample from lung nodules in the most difficult to reach lung locations both centrally and peripherally. This combination has the potential to enhance the level of care for lung patients in need of endobronchial lung nodule biopsies by providing them with access to medical technology and, most importantly, clinical outcomes that were previously thought to be attainable only with more expensive alternatives.