“Its all about the timing…
Echo cardiogram enhancement through
ECG/EKG triggering ”
A presentation by Prof. David A. Rivkin, PhD
President & Chief Scientist, GCPI
Adjunct Professor, Drexel University

IEEE Senior Member, EMBS Distinguished Lecturer

Chairman, IEEE SCV Instrumentation and Measurement Society

Chairman, IEEE Instrumentation and Measurement Society Technical
Committee 34 “Nanotechnology In Instrumentation and Measurement”

IEEE Nanotech Council Executive Member

AdvaMed Medical Device Industry Council Advisor

ISO TC-229 “Nanotechnology Standards” IEEE Liaison

Chairman, STI Emerging Technologies SIG

Fellow, Society for Industrial & Applied Mathematics








The Problem – Blurry Pictures…
Previous Solutions – Big Computers…
New Solution – Embedded Monitor/Trigger
Unified Solution – Best Timely Results
Overview of Design – How it works
Overview of Management – Why its on time
Conclusion – Its about time







X-Ray
Echo Cardiogram
CT
3D Ultrasound
PET
Electrical
Impedance
Tomography (IET)




Issue
Patient Moves
Breathing
Heart Beating

Possible Solution
Restrain Patient

Hold Breath

Nothing…till now

The Problem – Echo Cardiograms



Measurements of cardiac muscle and arteries need to be taken
Heart Beating
Dimensions Change over Heart Rhythm
Cycle





3D Ultrasound
3D Echocardiogram
X-Ray Computed
Tomography
MRI




When Imaging Is
Inconclusive, Invasive measures must be taken
E.g. Open Heart
Surgery
Always a risk of complications

Previous Solutions –
Big Computers…



NASA
Bartron Medical
Imaging (defunct)
GCPI



Redundant Shadowing
Advanced CT algorithms
Cluster Computing &
Supercomputers

Previous Solutions –
Big Computers…



NASA
Bartron Medical Imaging
GCPI



Redundant Shadowing –
Determine Regions of
Motion Causing Error
Advanced CT algorithms
Compensate for Motion with estimation and redundant data

New Solution –
Embedded Monitor/Trigger



Electro Cardiogram
(ECG/EKG)
Use ECG Data to Trigger
Imager
Signal Processing to
Determine Trigger Point

New Solution –
Embedded Monitor/Trigger

Electro Cardiogram
(ECG/EKG) Data:

Well known

Simple to collect

Up to 12 Point Data
Collection

New Solution –
Embedded Monitor/Trigger


Peaks can act as simple triggers
E.g. Trigger on
Ventricular
Contraction

New Solution –
Embedded Monitor/Trigger


ECG Signals Indicate more complex activities of the heart than just Ventricular
Contraction
Any Phase of the
Cardiac Rhythm can be determined

New Solution –
Embedded Monitor/Trigger


ECG with Signal
Processing can Trigger at any point, on any peak or with delays
Some imagers (such as ultrasound) have inherent delay allowing for triggering to be after the image is already collected

New Solution –
Embedded Monitor/Trigger

ECG based software control of triggering

Advanced algorithms can be used to trigger only upon abnormalities in ECG data

New Solution –
Embedded Monitor/Trigger


Proper triggering can enhance location of abnormalities in heart dimensions or function
E.g. Abnormal Blood
Flow indicating hole in heart wall otherwise not detected

Unified Solution –
Best Timely Results

Combining Advanced
Triggering with
Advanced CT
Algorithms results in the best images

Overview of Design – How it works


Standard 3M RedDot adhesive electrodes
Standard connectors and cabling

Overview of Design – How it works

Virtex-4 LX25 FPGA





24,192 Logic Cells
128 MB RAM
64 MB Flash ROM
JTAG Hardware Debugging
48 Billion Multiply and Accumulates
/ Second

Mechanical Specification

Temperature Range: -40° C to
+85° C

Developed on Standard Virtex4
Prototype Board

Overview of Design – How it works



Virtex4 Versions
Considered

DX - PowerPC
Core/DualCore

SX - XtremeDSP Slice
Overkill for the application
Would have taken longer to develop

Overview of Design – How it works





Developed Entirely in
SystemC
Prototyped on Dual
Processor AMD64 desktop
SystemC to VHDL by
SystemCrafter SC
Xilinx IDE WebPack
GBit Ethernet, USB or
Serial Update of EEPROM

Overview of Design – How it works




Isolation/Instrumentation
Amplifiers and Isolation
Power Supply
TTL, CMOS, RS-232 and
USB Trigger Lines Provided for different manufacturers interfacing needs
Miniature Stainless Steel
Enclosure
EMI Shielded Cabling

Overview of Management –
Why its on time…and under budget





5 Months from conception to First Articles generated by CEM, scheduled for 6 months
Under Budget by 4%
Entering Clinical Trials currently
Compliant with ISO13485:2005 and 21CFR820
“Avoid Verbal Orders, Say It In Writing”

Overview of Management –
Why its on time…and under budget


Program Management
Under:


GPES
Stochastic Methods
Quality Scientific &
Engineering Collaboration

NASA

Distributed Engineering
Team at GCPI D


T e

Z

 2

Overview of Management –
Why its on time…and under budget




GPES – Global
Performance
Evaluation System
Real-Time Program &
Project Status
Developed by NASA at
Johnson Space Center
Open Source ASP on
MS SQLServer

Overview of Management –
Why its on time…and under budget

GPES Source Code
Modified to Use Stochastic
Methods



(o) = Most optimistic duration everything will go according to plan with a minimal amount of difficulties.
(p) = Most pessimistic duration - everything will not go according to plan and maximum potential difficulties will develop.
(m) = Most likely duration
- will most often occur should this effort be repeated over and over again


T e
 2
Z
D
= the sum of all critical path expected times.
= the sum of all critical path variances.
= the number of standard deviations of a normal distribution (the standard normal deviate)
TE
 o

4 m
 p
6

Variance
  2 

 p
 o
6


2

T e

Z

 2
Values for Z can be taken from “Project Management, A Managerial Approach,”
Jack R. Meredith and Samuel J. Mantel, Jr., John Wiley & Sons, NY, 1995

Overview of Management –
Why its on time…and under budget

Quality Scientific & Engineering Collaboration




NASA – 5 Researchers


AMES Research Center
Johnson Space Center
GCPI – 18 Engineers (EEs, SEs, ME)


3 Offices: San Jose, Baltimore, London
Telecommute Design Staff
Medical Imaging Partners

GE, Philips
Contract Manufacturing Partners

Flextronics, Benchmark



New and exciting technologies are changing the way products are developed.
SystemC offers new ways to design, prototype and develop unified
Software/Hardware products using nontraditional computing methods


Any Questions?

Thank you for your patience!


By Prof. David A. Rivkin, PhD david.rivkin@gcpintl.com