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Its all about the Its all about the timing… timing… Echo cardiogram enhancement Echo cardiogram enhancement through ECG/EKG triggering through ECG/EKG triggering A presentation by Prof. David A. A presentation by Prof. David A. Rivkin, PhD Rivkin, PhD President & Chief Scientist, GCPI President & Chief Scientist, GCPI Adjunct Professor, Drexel Adjunct Professor, Drexel University University IEEE Senior Member, EMBS Distinguished Lecturer IEEE Senior Member, EMBS Distinguished Lecturer Chairman, IEEE SCV Instrumentation and Measurement Chairman, IEEE SCV Instrumentation and Measurement Society Society Chairman, IEEE Instrumentation and Measurement Chairman, IEEE Instrumentation and Measurement Society Technical Committee 34 “Nanotechnology In Society Technical Committee 34 “Nanotechnology In Instrumentation and Measurement” Instrumentation and Measurement” IEEE Nanotech Council Executive Member IEEE Nanotech Council Executive Member AdvaMed Medical Device Industry Council Advisor AdvaMed Medical Device Industry Council Advisor ISO TC-229 “Nanotechnology Standards” IEEE Liaison ISO TC-229 “Nanotechnology Standards” IEEE Liaison Chairman, STI Emerging Technologies SIG Chairman, STI Emerging Technologies SIG Fellow, Society for Industrial & Applied Mathematics Fellow, Society for Industrial & Applied Mathematics
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Page 1: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

““Its all about the timing…Its all about the timing…Echo cardiogram enhancement Echo cardiogram enhancement

through ECG/EKG triggeringthrough ECG/EKG triggering””A presentation by Prof. David A. Rivkin, A presentation by Prof. David A. Rivkin,

PhDPhDPresident & Chief Scientist, GCPIPresident & Chief Scientist, GCPI

Adjunct Professor, Drexel UniversityAdjunct Professor, Drexel University

IEEE Senior Member, EMBS Distinguished LecturerIEEE Senior Member, EMBS Distinguished LecturerChairman, IEEE SCV Instrumentation and Measurement Chairman, IEEE SCV Instrumentation and Measurement SocietySocietyChairman, IEEE Instrumentation and Measurement Society Chairman, IEEE Instrumentation and Measurement Society Technical Committee 34 “Nanotechnology In Instrumentation Technical Committee 34 “Nanotechnology In Instrumentation and Measurement”and Measurement”IEEE Nanotech Council Executive MemberIEEE Nanotech Council Executive MemberAdvaMed Medical Device Industry Council AdvisorAdvaMed Medical Device Industry Council AdvisorISO TC-229 “Nanotechnology Standards” IEEE LiaisonISO TC-229 “Nanotechnology Standards” IEEE LiaisonChairman, STI Emerging Technologies SIGChairman, STI Emerging Technologies SIGFellow, Society for Industrial & Applied MathematicsFellow, Society for Industrial & Applied Mathematics

Page 2: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Timing of the PresentationTiming of the Presentation

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

Page 3: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

The Problem – Blurry The Problem – Blurry PicturesPictures

X-RayX-Ray Echo Echo

CardiogramCardiogram CTCT 3D Ultrasound3D Ultrasound PETPET Electrical Electrical

Impedance Impedance Tomography Tomography (IET)(IET)

Page 4: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

The Problem – Blurry The Problem – Blurry PicturesPictures

IssueIssue Patient MovesPatient Moves BreathingBreathing Heart BeatingHeart Beating

Possible Possible SolutionSolution

Restrain PatientRestrain Patient Hold BreathHold Breath Nothing…till nowNothing…till now

Page 5: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

The Problem – Echo The Problem – Echo CardiogramsCardiograms

Measurements of Measurements of cardiac muscle and cardiac muscle and arteries need to be arteries need to be takentaken

Heart BeatingHeart Beating Dimensions Dimensions

Change over Heart Change over Heart Rhythm CycleRhythm Cycle

Page 6: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

The Problem – 3D ImagingThe Problem – 3D Imaging

3D Ultrasound3D Ultrasound 3D Echocardiogram3D Echocardiogram X-Ray Computed X-Ray Computed

TomographyTomography MRIMRI

Page 7: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

The Problem – InvasionThe Problem – Invasion

When Imaging Is When Imaging Is Inconclusive, Inconclusive, Invasive measures Invasive measures must be takenmust be taken

E.g. Open Heart E.g. Open Heart SurgerySurgery

Always a risk of Always a risk of complicationscomplications

Page 8: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Previous Solutions – Previous Solutions – Big Computers…Big Computers…

NASANASA Bartron Medical Bartron Medical

Imaging (defunct)Imaging (defunct) GCPIGCPI

Redundant ShadowingRedundant Shadowing Advanced CT Advanced CT

algorithmsalgorithms Cluster Computing & Cluster Computing &

SupercomputersSupercomputers

Page 9: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Previous Solutions – Previous Solutions – Big Computers…Big Computers…

NASANASA Bartron Medical ImagingBartron Medical Imaging GCPIGCPI

Redundant Shadowing – Redundant Shadowing – Determine Regions of Determine Regions of Motion Causing ErrorMotion Causing Error

Advanced CT algorithmsAdvanced CT algorithms Compensate for Motion Compensate for Motion

with estimation and with estimation and redundant dataredundant data

Page 10: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

New Solution – New Solution – Embedded Monitor/TriggerEmbedded Monitor/Trigger

Electro Cardiogram Electro Cardiogram (ECG/EKG)(ECG/EKG)

Use ECG Data to Use ECG Data to Trigger ImagerTrigger Imager

Signal Processing to Signal Processing to Determine Trigger Determine Trigger PointPoint

Page 11: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

New Solution – New Solution – Embedded Monitor/TriggerEmbedded Monitor/Trigger

Electro Cardiogram Electro Cardiogram (ECG/EKG) Data:(ECG/EKG) Data: Well knownWell known Simple to collectSimple to collect

Up to 12 Point Data Up to 12 Point Data CollectionCollection

Page 12: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

New Solution – New Solution – Embedded Monitor/TriggerEmbedded Monitor/Trigger

Peaks can act as Peaks can act as simple triggerssimple triggers

E.g. Trigger on E.g. Trigger on Ventricular Ventricular Contraction Contraction

Page 13: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

New Solution – New Solution – Embedded Monitor/TriggerEmbedded Monitor/Trigger

ECG Signals ECG Signals Indicate more Indicate more complex activities complex activities of the heart than of the heart than just Ventricular just Ventricular ContractionContraction

Any Phase of the Any Phase of the Cardiac Rhythm Cardiac Rhythm can be determinedcan be determined

Page 14: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

New Solution – New Solution – Embedded Monitor/TriggerEmbedded Monitor/Trigger

ECG with Signal ECG with Signal Processing can Trigger Processing can Trigger at any point, on any at any point, on any peak or with delayspeak or with delays

Some imagers (such Some imagers (such as ultrasound) have as ultrasound) have inherent delay inherent delay allowing for triggering allowing for triggering to be after the image to be after the image is already collectedis already collected

Page 15: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

New Solution – New Solution – Embedded Monitor/TriggerEmbedded Monitor/Trigger

ECG based ECG based software control of software control of triggeringtriggering

Advanced Advanced algorithms can be algorithms can be used to trigger only used to trigger only upon abnormalities upon abnormalities in ECG datain ECG data

Page 16: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

New Solution – New Solution – Embedded Monitor/TriggerEmbedded Monitor/Trigger

Proper triggering can Proper triggering can enhance location of enhance location of abnormalities in abnormalities in heart dimensions or heart dimensions or functionfunction

E.g. Abnormal Blood E.g. Abnormal Blood Flow indicating hole Flow indicating hole in heart wall in heart wall otherwise not otherwise not detecteddetected

Page 17: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Unified Solution – Unified Solution – Best Timely ResultsBest Timely Results

Combining Combining Advanced Advanced Triggering with Triggering with Advanced CT Advanced CT Algorithms results Algorithms results in the best imagesin the best images

Page 18: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Overview of Design – How it Overview of Design – How it worksworks

Standard 3M RedDot adhesive electrodesStandard 3M RedDot adhesive electrodes Standard connectors and cablingStandard connectors and cabling

Page 19: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Overview of Design – How it Overview of Design – How it worksworks

Virtex-4 LX25 FPGA Virtex-4 LX25 FPGA 24,192 Logic Cells 24,192 Logic Cells 128 MB RAM 128 MB RAM 64 MB Flash ROM 64 MB Flash ROM JTAG Hardware Debugging JTAG Hardware Debugging 48 Billion Multiply and 48 Billion Multiply and

Accumulates / Second Accumulates / Second

Mechanical SpecificationMechanical Specification Temperature Range: -40° C to Temperature Range: -40° C to

+85° C +85° C

Developed on Standard Developed on Standard Virtex4 Prototype BoardVirtex4 Prototype Board

Page 20: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Overview of Design – How it Overview of Design – How it worksworks

Virtex4 Versions Virtex4 Versions ConsideredConsidered DX - PowerPC DX - PowerPC

Core/DualCoreCore/DualCore SX - XtremeDSP Slice SX - XtremeDSP Slice

Overkill for the Overkill for the applicationapplication

Would have taken Would have taken longer to developlonger to develop

Page 21: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Overview of Design – How it Overview of Design – How it worksworks

Developed Entirely in Developed Entirely in SystemCSystemC

Prototyped on Dual Prototyped on Dual Processor AMD64 Processor AMD64 desktopdesktop

SystemC to VHDL by SystemC to VHDL by SystemCrafter SCSystemCrafter SC

Xilinx IDE WebPackXilinx IDE WebPack GBit Ethernet, USB or GBit Ethernet, USB or

Serial Update of Serial Update of EEPROMEEPROM

Page 22: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Overview of Design – How it Overview of Design – How it worksworks

Isolation/Instrumentation Isolation/Instrumentation Amplifiers and Isolation Amplifiers and Isolation Power SupplyPower Supply

TTL, CMOS, RS-232 and TTL, CMOS, RS-232 and USB Trigger Lines USB Trigger Lines Provided for different Provided for different manufacturers manufacturers interfacing needsinterfacing needs

Miniature Stainless Steel Miniature Stainless Steel EnclosureEnclosure

EMI Shielded CablingEMI Shielded Cabling

Page 23: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Overview of Management – Overview of Management – Why its on time…and under Why its on time…and under

budgetbudget 5 Months from conception to First Articles 5 Months from conception to First Articles

generated by CEM, scheduled for 6 generated by CEM, scheduled for 6 monthsmonths

Under Budget by 4%Under Budget by 4% Entering Clinical Trials currentlyEntering Clinical Trials currently Compliant with ISO13485:2005 and Compliant with ISO13485:2005 and

21CFR82021CFR820 ““Avoid Verbal Orders, Say It In Writing”Avoid Verbal Orders, Say It In Writing”

Page 24: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Overview of Management – Overview of Management – Why its on time…and under Why its on time…and under

budgetbudget Program Management Program Management

Under:Under: GPESGPES Stochastic MethodsStochastic Methods

Quality Scientific & Quality Scientific & Engineering Engineering CollaborationCollaboration NASANASA Distributed Engineering Distributed Engineering

Team at GCPITeam at GCPID T Ze 2

Page 25: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Overview of Management – Overview of Management – Why its on time…and under Why its on time…and under

budgetbudget GPES – Global GPES – Global

Performance Performance Evaluation SystemEvaluation System

Real-Time Program Real-Time Program & Project Status& Project Status

Developed by NASA Developed by NASA at Johnson Space at Johnson Space CenterCenter

Open Source ASP on Open Source ASP on MS SQLServerMS SQLServer

Page 26: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Overview of Management – Overview of Management – Why its on time…and under Why its on time…and under

budgetbudget GPES Source Code GPES Source Code

Modified to Use Modified to Use Stochastic MethodsStochastic Methods

(o) = Most optimistic (o) = Most optimistic durationduration - - everything everything will go according to will go according to plan with a minimal plan with a minimal amount of difficulties. amount of difficulties.

(p) = Most pessimistic (p) = Most pessimistic duration - everything duration - everything will not go according will not go according to plan and maximum to plan and maximum potential difficulties potential difficulties will develop.will develop.

(m) = Most likely (m) = Most likely duration - will most duration - will most often occur should this often occur should this effort be repeated effort be repeated over and over again over and over again

= the sum of all critical path expected = the sum of all critical path expected times.times.

= the sum of all critical path = the sum of all critical path variances.variances.

= the number of standard deviations = the number of standard deviations of a normal distribution (the of a normal distribution (the standard normal deviate)standard normal deviate)

D T Ze 2

Te2

ZTE

o m p

Variancep o

4

6

62

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

Page 27: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Overview of Management – Overview of Management – Why its on time…and under Why its on time…and under

budgetbudget Quality Scientific & Engineering Quality Scientific & Engineering

CollaborationCollaboration NASA – 5 ResearchersNASA – 5 Researchers

AMES Research CenterAMES Research Center Johnson Space CenterJohnson Space Center

GCPI – 18 Engineers (EEs, SEs, ME)GCPI – 18 Engineers (EEs, SEs, ME) 3 Offices: San Jose, Baltimore, London3 Offices: San Jose, Baltimore, London Telecommute Design StaffTelecommute Design Staff

Medical Imaging PartnersMedical Imaging Partners GE, PhilipsGE, Philips

Contract Manufacturing PartnersContract Manufacturing Partners Flextronics, BenchmarkFlextronics, Benchmark

Page 28: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Conclusion – Its about timeConclusion – Its about time

New and exciting technologies are New and exciting technologies are changing the way products are changing the way products are developed.developed.

SystemC offers new ways to design, SystemC offers new ways to design, prototype and develop unified prototype and develop unified Software/Hardware products using Software/Hardware products using non-traditional computing methodsnon-traditional computing methods

Page 29: Its all about the timing… Echo cardiogram enhancement through ECG/EKG triggering Its all about the timing… Echo cardiogram enhancement through ECG/EKG.

Conclusion – Its about time!Conclusion – Its about time!

Any Questions?Any Questions?

Thank you for your Thank you for your patience!patience!

By Prof. David A. Rivkin, By Prof. David A. Rivkin, PhDPhD

[email protected]@gcpintl.com


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