Clinica's MedTech Ventures: Vision RT
This article was originally published in Clinica
Clinica’s MedTech Ventures: Vision RT
Specialty area(s): Motion management for radiation therapy
Based in: London, UK
Founded in: 2001
No. of employees: 54
Total investment received to date: £6.4m ($10.3m)
Investors: Includes YFM Equity Partners
Radiotherapy is now a widespread and well-accepted treatment for cancer, but it is not without its problems. Making sure therapy is targeted at the tumor and doesn’t harm healthy tissue is of paramount importance to reduce the risk of complications and increase the chance of successful treatment.
One issue that can affect this is patient movement – these can be big shifts, or even something as subtle as breathing, which can have an impact. Nowadays, cone beam CT is used to image patients before radiotherapy and help plan the procedure; but this cannot be used to track the patient during therapy.
UK company Vision RT has come up with a solution that can track patient movement and automatically shut off radiotherapy if they move out of the correct position. The firm’s AlignRT product uses three cameras, each with two sensors, which are placed around the treatment room. The cameras create a 3D image of the patient and provide real-time feedback on their movement before and during treatment.
The technology, which the firm is already commercializing in the US and elsewhere around the world, is used in various applications including breast, brain, lung and liver cancers, as well as sarcomas, which often develop in the limbs.
In breast cancer, it is important to direct radiation carefully because the heart and lung are close to the treatment site, Vision RT CEO Norman Smith told Clinica. He added that AlignRT is particularly useful in left-sided breast cancer, where radiotherapy can lead to heart problems in later life. For these cases, Vision RT has developed a technique to enable the patient to take a controlled “deep inspiration breath hold.”
When a person takes a deep breath and holds it, the heart moves slightly lower, towards the right and the back of the chest, which increases the distance between the heart and the chest wall or breast tissue. Deep Inspiration Breath Hold helps the linear accelerator (linac) deliver radiation when the patient takes a deep breath and stops it when they breathe out, therefore targeting the breast or the chest wall with significantly less exposure to the heart, according to the company.
The lung and liver are also particularly susceptible to respiratory motion, so Vision RT’s technology is also useful in these patients; while in sarcoma, limbs have a greater range of movement than the torso, making it challenging to deliver radiation to the right area.
In addition, AlignRT offers benefits in stereotactic radiosurgery, which is used for brain tumors. This therapy needs to be very precise so nearby healthy brain structures aren’t damaged, but current methods leave a lot to be desired. In conventional stereotactic radiosurgery, patients are fitted with large metal frames that often need to be screwed into their head, a time-consuming process as well as being uncomfortable for the patient.
Vision RT has created an open face mask, moulded from plastic, which fixes the patient’s head in place but is more comfortable and less invasive and claustrophobic than a metal frame. The firm’s technology can also detect any movement in real time, and stop treatment if this is out of the pre-set threshold.
The London-based company has seen a steady ramp-up in interest in its products since Dr Smith co-founded the firm in an attic in 2001. From those humble beginnings, Vision RT now has over 300 systems installed worldwide, and over 200 of these in the US, where it has so far been focusing most of its efforts. The firm initially targeted big research institutions, but this has broadened out to more mainstream clinical practices in the last few years, the CEO said.
The company is making a profit, but Dr Smith declined to give any more details of its financial results, except to say it was “cash generative, and growing fast.”
Although it is unusual for the medtech world that Vision RT has got so far without an IPO or trade sale, the firm has had help from some of the big boys, notably number-one radiotherapy player Varian Medical Systems. The two firms have had a relationship since 2009, and a 2010 distribution deal became an OEM agreement in 2012.
Varian previously bought another image-guided radiotherapy player, Zmed, in 2003, but later phased out this product. This leaves Vision RT in the enviable position of being Varian’s main partner in the image-guided therapy field. But Dr Smith was quick to point out that Vision RT’s aim is to have its technology in every radiotherapy machine in the world – so its agreement with Varian is by no means exclusive.
The company was previously working with Siemens, which exited the radiotherapy market as part of its Agenda 2013 streamlining initiative.
Vision RT’s technology could also be used in the growing field of proton therapy, the CEO believes, which has “incredible precision” but also maybe even more serious consequences if it isn’t targeted accurately. There are around 10 major players in the sector, Dr Smith estimates, including Varian, Belgium’s Ion Beam Applications (IBA), Hitachi, Mevion Medical Systems and ProTom International. Vision RT has collaborated with a number of the proton therapy vendors “both technically and commercially,” the CEO said.
The next step for Vision RT is broadening its sales base outside the US, and it is currently formulating a plan of how to do this, ascertaining where it will sell direct and where it would benefit from using a distributor. “As a small company, we can’t do everything, so we focused on the US first,” Dr Smith said. “But now we can start investing in other markets.”
The company plans to showcase its technology at the American Society for Radiation Oncology (ASTRO) meeting in San Francisco on 14-17 September, which should help boost awareness.
The CEO believes the firm is about to reach an inflection point which could see its sales rocket. “We’ve had the early adopters, but now we have to cross the chasm before it becomes mainstream – then it will be the rollercoaster stage,” concluded Dr Smith.
Norman Smith, president and CEO. firstname.lastname@example.org
Vision RT Ltd, Dove House, Arcadia Avenue, London, N3 2JU, UK