For decades, NASA has been using advanced cameras to create images of the universe never before seen and then transmit these pictures back to Earth, where scientists then ask themselves, “What exactly are we looking at?”

ArterioVision uses ultrasound image-capturing and analysis software to non invasively identify the risk for atherosclerosis, the major cause of heart attack and strokes.

That question was answered at NASA’s Jet Propulsion Laboratory (JPL) in the Image Processing Laboratory, founded in 1966 to receive and make sense of spacecraft imagery. There, NASA-invented VICAR (Video Image Communication and Retrieval) software has, through the years, laid the groundwork for understanding images of all kinds. The original software, created by a JPL team of Robert Nathan, Fred Billingsley, and Robert Selzer, is in use today, although with greater accuracy and effectiveness due to decades of advancements.

During the last 15 years of his career as a government scientist, Selzer, as head of the JPL Biomedical Image Processing Laboratory, was using the imaging technology for healthcare diagnosis. The project began when the imaging team developed the idea of using the VICAR software to analyze X-ray images of soft tissue. Typically, the X-ray is ineffective when used to analyze soft tissues, though the researchers were curious to see if the imaging software could broaden the application of this readily available diagnostic procedure. The results were interesting, but too much quality was lost in transferring the pictures into a digital format for analysis.

Selzer’s team, partnering with scientists from the University of Southern California, began to image X-rays of arteries. With marginal success using Xrays, they came upon the idea of using the same methodology, but applying it to ultrasound imagery, which was already digitally formatted. The new approach proved successful for assessing amounts of plaque buildup and arterial wall thickness, direct predictors of heart disease. Testing continued, and the team began looking for outside funding and methods of distribution. At this point, Gary F. Thompson entered the picture.

Thompson has a history of heart disease in his family. Thompson was understandably concerned, but feeling confident, when he approached his 50th birthday. Seven days after his birthday, while running a marathon, Thompson suffered a moderate heart attack and lost 48 percent of his heart muscle. Months later, he inquired to David Baltimore, then president of the California Institute of Technology (Caltech), whether there were any new heart-related breakthroughs and heard about a new technology developed at JPL. It was a noninvasive diagnostic system with the ability to accurately predict heart health.

A technician performed an ultrasound scan on either side of Thompson’s neck, the location of the carotid arteries. When the results were in, the technician told him that he needed to meet with the doctor immediately. The test showed that Thompson had the thickest artery walls of the over 3,000 other people tested, a direct indicator that he was in danger of a heart attack or stroke.

Thompson developed a business plan, secured an exclusive license for the JPL-developed technology from Caltech, and invested his own money to start Medical Technologies International (MTI) in Palm Desert, CA. MTI licensed 14 research institutions around the world for pre-U.S. Food and Drug Administration (FDA) clearance, research-only use of the analysis software and then incorporated feedback from these groups into the new clinical product it was developing. It patented the new developments and then submitted the technology to a rigorous review process at the FDA, which cleared the device for public use.

How it Works

The software is being used in MTI’s ArterioVision, a carotid intima-media thickness (CIMT) test that uses ultrasound image-capturing and analysis software to noninvasively identify the risk of atherosclerosis, the major cause of heart attack and strokes. It is a buildup of cholesterol and fatty substances in the arteries, combined with arterial hardening. The result is that blood flow through the heart is restricted, hampering oxygen supply. Heart attacks occur when the heart does not get the necessary oxygen, and strokes are the result of oxygen not reaching the brain.

ArterioVision provides a direct measurement of atherosclerosis before it causes these symptoms by safely and painlessly measuring the thickness of the first two layers of the carotid artery wall using an ultrasound procedure and advanced image-analysis software. The carotid artery supplies blood to the brain, and it can therefore be examined noninvasively. ArterioVision essentially performs a skin surface imaging “biopsy” to examine the arterial wall.

Atherosclerosis begins in the abdomen and ascends to the heart and the carotid arteries. A diagnostic tool for examining it in the abdomen is the computerized tomography (CT) scan, but CT comes with a certain level of risk. Unlike ultrasound, which is safe enough that it is used on unborn babies, CT scans rely on radiation to produce results. The NASA-based technology can distinguish among 256 different shades of gray and differentiate nuances at a sub-pixel level of interpolation, making it the most accurate in this field, and it is compatible with all existing ultrasound machines, making it more readily accessible to physicians.

Where it Stands

While ArterioVision is not the only FDA-cleared CIMT tool on the market, it is the only one that offers a predictive report for the physician and patient. It explains the significance of test results using a proprietary database and JPL-developed algorithms, and can extrapolate to show percentile of risk.

One particular feature of the report is the revelation of arterial age. It can show the patient that while he may be 50 years old, his arteries may be the equivalent of a patient 75 years old. This real-world number is something patients can identify with and helps promote compliance with drug therapies and other forms of treatment — one of the most difficult aspects of preventing and treating heart disease. The ArterioVision patient report provides a significant warning sign and gives concrete examples. The report then becomes part of a serial examination.

Currently, the technology is available in all 50 states and in many countries throughout the world.

More Information

For more information on ArterioVision software, visit .