Real-Time MRI-Guided Robotic Interventions for Improved Patient Outcome

1. MRI-guided Robotic Interventions and Surgeries Image While You Operate for improved patient outcome and cost-effectiveness This technology was supported by the NSF award CNS-0932272 entitled “Multimodal Image-guided Robot-Assisted Surgeries (MIROS)”

2. However … Limited Clinical Use … Real-time MRI Guidance • Image While You Operate • Continuous visualization of the tool and the tissue for on-the-fly adjustment of the tool path • Continuous monitoring of the procedure for optimal delivery of therapy (e.g. laser or cryo-ablations) • No X-ray radiation (vs. fluoroscopy & CT) • Superb contrast and image quality (vs. fluoroscopy & ultrasound) Improved Patient Outcome Accurate, Safer and Faster

3. Faster Accurate Safer Improved Patient Outcome Cost Real-time Guidance Limited Access to Patient Increased Duration Current Practice No “true” Real-time MRI Robots General Solution Expensive & limited apps Limited Patient volume Access to Patient & Real-time Guidance The Problem Technology

4. Low-cost technology of foundational building blocks One basic system: Scalable & adaptable for a wide range of procedures and virtually any part of the patient’s body Our Solution Real-time Guidance MR Compatible Robotics Expensive Technology Limited Patient volume

5. The MIROS-CPS • The MIROS modular technology addresses those challenges, while creating multiple lines of products: • The novel “solid-fluid transmission” (SFT) actuation • A simple, scalable and modular SFT-actuated robot adaptable for use at different anatomies • Novel real-time MRI methods • Control software that uses real-time MRI • Haptic interfacing • Seamless integration

6. Abdomen & thorax Breast Brain Our Solution vs. The Competition • Cost-effective (& independent from non-US technology) • Scalable and adaptable for procedures to virtually any area - Widest range of procedures & volume of patients - Larger market base – operators • Biopsies • Tumor Ablations (laser/Cryo/RF) • Placement of Brachytherapy Seeds • Placement of Deep Brain Stimulators • Localized delivery of drugs • … • Interventional radiologists • Cancer specialists • Urologists • Neurosurgeons • Pain-management specialists • Cardiothoracic surgeons

7. Market (I) Image Guided Surgical procedures $1.89 billion (2012) Compound annual growth rate (CAGR) = 5.7% All modalities (million procedures/year) Expected growth 2-5% annual Interventional MRI ($M) MRI 10% of global market CAGR = 3.2% WW MRI scanners 20,000 Interventional MRI (million procedures/year)

8. Breast cancer US market Opportunity > $835M Neurologic Interventions US Market Opportunity > $16 billion • Parkinson’s DBS sub-segment - $1.1 billion • Epilepsy Focal Ablation sub-segment - $1.8 billion Market (II) The MIROS market opportunity can be equivalent to the US and eventually the WW market opportunity CURRENT MIROS interventions interventions IGI IGI MRI MRI

9. How: A Pipeline of Products • Common building blocks (hardware & software) • Scalable, adaptable & upgradable platform Spine Abdominal Basic system Cardiothoracic Breast Prostate Neuro Disposables • EXIT STRATEGIES • Acquisition by one or more of the existing MRI scanner OEM (e.g. GE, Philips, Siemens) or MRI accessory (e.g. Medtronic, Boston Scientific, MRI Interventions) companies • The venture continues operation and becomes a supplier to one or more existing MRI scanner OEM or MRI accessory companies

10. The Team Dept. of Computer Science, University of Houston Nikolaos V. Tsekos, PhD: MRI methods, MR-compatible robotics Nick von Sternberg, PhD: MR compatible robotics Clinical Collaborations: Methodist Hospital at Houston: Cardiothoracic Interventions MD Anderson Cancer Center: Breast Cancer & Prostate Cancer Business Collaborations: Bauer College of Business; University of Houston - MBA program Wolff Center for Entrepreneurship, University of Houston

11. NSF Award CNS-0932272 MIROS: Image While You Operate for improved patient outcome and cost-effectiveness THANK YOU!