Welcome!

Websphere Authors: Carmen Gonzalez, Yeshim Deniz, Elizabeth White, Sanjeev Sharma, Liz McMillan

Blog Feed Post

How the world’s first open source MRI happened

You wouldn’t think that a hang gliding accident could start a revolution in medicine. But when a teenager fell 150 feet into a lake several years ago, the subsequent events that sparked a revolutionary new diagnostic method, what I am calling the first open source MRI. The story is a fascinating look at what one family can accomplish if they keep asking questions and getting the right people into a room to talk to each other.

MRIs are big proprietary machines made by a dozen large equipment manufacturers (such as Siemens, Hitachi and Toshiba) and cost plenty: think of them as what IBM mainframes of the 1980s were when PCs first started entering the corporate ecosystem. You have to train people how to operate them and interpret their scans, and once they are setup, you have to run them more or less continuously to realize the return on your investment. If your hospital or imaging center buys equipment from one vendor, you are pretty much locked into that vendor’s line of accessories and upgrades. And they are designed for very specific diagnostic situations. One of them that they aren’t very good at is looking at spinal cord abnormalities.

This is what Spencer Stein faced when he hit that lake after his hang gliding accident. His fall ended up giving him four spinal fractures, which he found after a week of living with back pain and going to the doctor. That was to be expected, given the height of his fall: he was lucky to be mobile. But what the doctors also found was a cavernous angioma, a series of blood clots inside his spine that he had since birth. The defect wasn’t related to the fall, just something that had been with him all his life, silent and symptom-free. The clots could stay that way, or they could bleed out and paralyze him instantly from the chest down.

Spencer had a tough choice; “I faced a dilemma. Leaving my defect alone, without surgery, could mean permanent loss of all bodily sensation, hideous neurological pain, or loss of functioning and movement in the lower half of my body. Yet an operation on this ultra-important, all-but-inaccessible part of my body could cause any of the same problems. It seemed like a no-win situation.” He wrote this for an article in the local San Diego newspaper this past summer chronicling his adventures.

As Spencer says, the fall was really a gift to learn about his birth defect. Without his fall, it would have never been discovered. So should he get the operation, or leave it alone? It wasn’t an easy decision. First, he had to find a surgeon who did many of these operations: this is a very highly specialized field, and only a few people actually do more than a few spinal operations a year of this nature. Second, many of the doctors Spencer saw didn’t want to do high-risk surgery on someone so young and otherwise so healthy, and said they wouldn’t dare operate. Spencer’s parents left the decision up to him. Can you imagine having to make the call of opening up a spinal cord on an extreme athlete?

Spencer with his parents visited a few of the doctors who specialize in this two-hour procedure, and eventually found one who was willing to proceed with the surgery in Arizona. That was great. But to really understand the structure of the clot, this doctor wanted better, higher-resolution pictures.

Back to the MRIs. Most of the machines that are available to the general public use 1.5 to 3 Tesla magnets (this is a measurement of magnetic force, named after the scientist that did a lot of early work, not the contemporary electric car company). Stein had a series of these MRIs to see what was going on inside his spine. But these images only told part of the story. The way to get to higher res images is to use a bigger magnet, just like our camera phones have a bigger image sensor in them.

It so happens that there is a 7 Tesla magnet at NYU Medical Center, but it was used for medical research unrelated to spinal imaging. No one had ever thought to use this research magnet in this way before.

That’s where Spencer’s dad came into our story. His dad made a few phone calls, and knew some of the leading edge diagnosticians in medical imaging. He managed to bring together people from bio-imaging, neurosurgery, and other clinicians to collaborate on how to use this magnet to take the right kind of spinal pictures.

Spencer’s dad is Lee Stein, someone that I have known for decades for his work in tech. Lee was part of the initial digital payments efforts in the mid-1990s, before there was a PayPal, before there was a Square, when paying for something online using a credit card was new. Now we take these things for granted, but back then Lee and a group of Internet pioneers assembled an elegant way to pay for things using nothing more than email. The effort never took off, but the founders of the firm laid the groundwork for how we pay for things online today.

I have written about Lee before, in another effort that he has been working on for several years called Prize Capital. As a result of this work, Lee became familiar with the TED Med community. (You can watch his TED Talk here :)

He is a very unassuming and modest man for someone who has led some pretty amazing technologic efforts over the years. “Spencer was no longer a patient, but a catalyst for forming a new center at NYU.” When I met up with Lee a few months ago, he told me that he just made a couple of phone calls. Yeah, right. The scan brought together many specialists who were able to cobble together this open source solution in real time, rather than years that it would have normally taken. As you can see in the TED video, the doctors are sitting together, hunched around the MRI monitor, sharing knowledge and ideas on the spot.

As a result of Spencer’s scan and his parents’ efforts, more than $22 million dollars was raised for this new center, including contributions from Siemens, the MRI vendor used at NYU. “It has been a remarkable experience for us as a family to see how NYU has come together to do this,” Lee says in his TED lecture.

The Steins brought together these very highly specialized doctors at NYU, and now they are figuring out ways to use the equipment for a variety of diagnoses of different diseases. It is quite thrilling.

However, the irony of all this is that the 7 Tesla images didn’t help Spencer’s situation. Turns out, the large blood clot concentrates iron molecules in one place, and the large amount of iron deflects the higher-intensity MRI beams so no additional information could be gleaned from these higher res pictures.

But Spencer went ahead with the operation, and fortunately it was successful. He is back in school at Cornell. The Stein family, being who they are, created a prize of $5,000 as part of an ongoing annual business plan competition held by the school.

Their prize is given for the business plan that best addressed issues of disability or environmental sustainability. The first one was given to an idea called EcoFishFeed that raises forager fish for feed at salmon aquaculture farms. The Stein Family Prize will continue to be a part of future Cornell business plan competitions.

It is a fitting testimonial to Spencer’s fall from the sky.


Read the original blog entry...

More Stories By David Strom

David Strom is an international authority on network and Internet technologies. He has written extensively on the topic for 20 years for a wide variety of print publications and websites, such as The New York Times, TechTarget.com, PC Week/eWeek, Internet.com, Network World, Infoworld, Computerworld, Small Business Computing, Communications Week, Windows Sources, c|net and news.com, Web Review, Tom's Hardware, EETimes, and many others.

@ThingsExpo Stories
We are reaching the end of the beginning with WebRTC, and real systems using this technology have begun to appear. One challenge that faces every WebRTC deployment (in some form or another) is identity management. For example, if you have an existing service – possibly built on a variety of different PaaS/SaaS offerings – and you want to add real-time communications you are faced with a challenge relating to user management, authentication, authorization, and validation. Service providers will want to use their existing identities, but these will have credentials already that are (hopefully) i...
"Matrix is an ambitious open standard and implementation that's set up to break down the fragmentation problems that exist in IP messaging and VoIP communication," explained John Woolf, Technical Evangelist at Matrix, in this SYS-CON.tv interview at @ThingsExpo, held Nov 4–6, 2014, at the Santa Clara Convention Center in Santa Clara, CA.
Connected devices and the Internet of Things are getting significant momentum in 2014. In his session at Internet of @ThingsExpo, Jim Hunter, Chief Scientist & Technology Evangelist at Greenwave Systems, examined three key elements that together will drive mass adoption of the IoT before the end of 2015. The first element is the recent advent of robust open source protocols (like AllJoyn and WebRTC) that facilitate M2M communication. The second is broad availability of flexible, cost-effective storage designed to handle the massive surge in back-end data in a world where timely analytics is e...
How do APIs and IoT relate? The answer is not as simple as merely adding an API on top of a dumb device, but rather about understanding the architectural patterns for implementing an IoT fabric. There are typically two or three trends: Exposing the device to a management framework Exposing that management framework to a business centric logic Exposing that business layer and data to end users. This last trend is the IoT stack, which involves a new shift in the separation of what stuff happens, where data lives and where the interface lies. For instance, it's a mix of architectural styles ...
The Internet of Things will put IT to its ultimate test by creating infinite new opportunities to digitize products and services, generate and analyze new data to improve customer satisfaction, and discover new ways to gain a competitive advantage across nearly every industry. In order to help corporate business units to capitalize on the rapidly evolving IoT opportunities, IT must stand up to a new set of challenges. In his session at @ThingsExpo, Jeff Kaplan, Managing Director of THINKstrategies, will examine why IT must finally fulfill its role in support of its SBUs or face a new round of...
Cultural, regulatory, environmental, political and economic (CREPE) conditions over the past decade are creating cross-industry solution spaces that require processes and technologies from both the Internet of Things (IoT), and Data Management and Analytics (DMA). These solution spaces are evolving into Sensor Analytics Ecosystems (SAE) that represent significant new opportunities for organizations of all types. Public Utilities throughout the world, providing electricity, natural gas and water, are pursuing SmartGrid initiatives that represent one of the more mature examples of SAE. We have s...
The Internet of Things will greatly expand the opportunities for data collection and new business models driven off of that data. In her session at @ThingsExpo, Esmeralda Swartz, CMO of MetraTech, discussed how for this to be effective you not only need to have infrastructure and operational models capable of utilizing this new phenomenon, but increasingly service providers will need to convince a skeptical public to participate. Get ready to show them the money!
One of the biggest challenges when developing connected devices is identifying user value and delivering it through successful user experiences. In his session at Internet of @ThingsExpo, Mike Kuniavsky, Principal Scientist, Innovation Services at PARC, described an IoT-specific approach to user experience design that combines approaches from interaction design, industrial design and service design to create experiences that go beyond simple connected gadgets to create lasting, multi-device experiences grounded in people's real needs and desires.
P2P RTC will impact the landscape of communications, shifting from traditional telephony style communications models to OTT (Over-The-Top) cloud assisted & PaaS (Platform as a Service) communication services. The P2P shift will impact many areas of our lives, from mobile communication, human interactive web services, RTC and telephony infrastructure, user federation, security and privacy implications, business costs, and scalability. In his session at @ThingsExpo, Robin Raymond, Chief Architect at Hookflash, will walk through the shifting landscape of traditional telephone and voice services ...
Scott Jenson leads a project called The Physical Web within the Chrome team at Google. Project members are working to take the scalability and openness of the web and use it to talk to the exponentially exploding range of smart devices. Nearly every company today working on the IoT comes up with the same basic solution: use my server and you'll be fine. But if we really believe there will be trillions of these devices, that just can't scale. We need a system that is open a scalable and by using the URL as a basic building block, we open this up and get the same resilience that the web enjoys.
The Internet of Things is tied together with a thin strand that is known as time. Coincidentally, at the core of nearly all data analytics is a timestamp. When working with time series data there are a few core principles that everyone should consider, especially across datasets where time is the common boundary. In his session at Internet of @ThingsExpo, Jim Scott, Director of Enterprise Strategy & Architecture at MapR Technologies, discussed single-value, geo-spatial, and log time series data. By focusing on enterprise applications and the data center, he will use OpenTSDB as an example t...
The Domain Name Service (DNS) is one of the most important components in networking infrastructure, enabling users and services to access applications by translating URLs (names) into IP addresses (numbers). Because every icon and URL and all embedded content on a website requires a DNS lookup loading complex sites necessitates hundreds of DNS queries. In addition, as more internet-enabled ‘Things' get connected, people will rely on DNS to name and find their fridges, toasters and toilets. According to a recent IDG Research Services Survey this rate of traffic will only grow. What's driving t...
Enthusiasm for the Internet of Things has reached an all-time high. In 2013 alone, venture capitalists spent more than $1 billion dollars investing in the IoT space. With "smart" appliances and devices, IoT covers wearable smart devices, cloud services to hardware companies. Nest, a Google company, detects temperatures inside homes and automatically adjusts it by tracking its user's habit. These technologies are quickly developing and with it come challenges such as bridging infrastructure gaps, abiding by privacy concerns and making the concept a reality. These challenges can't be addressed w...
Explosive growth in connected devices. Enormous amounts of data for collection and analysis. Critical use of data for split-second decision making and actionable information. All three are factors in making the Internet of Things a reality. Yet, any one factor would have an IT organization pondering its infrastructure strategy. How should your organization enhance its IT framework to enable an Internet of Things implementation? In his session at Internet of @ThingsExpo, James Kirkland, Chief Architect for the Internet of Things and Intelligent Systems at Red Hat, described how to revolutioniz...
Bit6 today issued a challenge to the technology community implementing Web Real Time Communication (WebRTC). To leap beyond WebRTC’s significant limitations and fully leverage its underlying value to accelerate innovation, application developers need to consider the entire communications ecosystem.
The definition of IoT is not new, in fact it’s been around for over a decade. What has changed is the public's awareness that the technology we use on a daily basis has caught up on the vision of an always on, always connected world. If you look into the details of what comprises the IoT, you’ll see that it includes everything from cloud computing, Big Data analytics, “Things,” Web communication, applications, network, storage, etc. It is essentially including everything connected online from hardware to software, or as we like to say, it’s an Internet of many different things. The difference ...
Cloud Expo 2014 TV commercials will feature @ThingsExpo, which was launched in June, 2014 at New York City's Javits Center as the largest 'Internet of Things' event in the world.
SYS-CON Events announced today that Windstream, a leading provider of advanced network and cloud communications, has been named “Silver Sponsor” of SYS-CON's 16th International Cloud Expo®, which will take place on June 9–11, 2015, at the Javits Center in New York, NY. Windstream (Nasdaq: WIN), a FORTUNE 500 and S&P 500 company, is a leading provider of advanced network communications, including cloud computing and managed services, to businesses nationwide. The company also offers broadband, phone and digital TV services to consumers primarily in rural areas.
"There is a natural synchronization between the business models, the IoT is there to support ,” explained Brendan O'Brien, Co-founder and Chief Architect of Aria Systems, in this SYS-CON.tv interview at the 15th International Cloud Expo®, held Nov 4–6, 2014, at the Santa Clara Convention Center in Santa Clara, CA.
The major cloud platforms defy a simple, side-by-side analysis. Each of the major IaaS public-cloud platforms offers their own unique strengths and functionality. Options for on-site private cloud are diverse as well, and must be designed and deployed while taking existing legacy architecture and infrastructure into account. Then the reality is that most enterprises are embarking on a hybrid cloud strategy and programs. In this Power Panel at 15th Cloud Expo (http://www.CloudComputingExpo.com), moderated by Ashar Baig, Research Director, Cloud, at Gigaom Research, Nate Gordon, Director of T...