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CASI DMT SOFTWARE AND HARDWARE DEVELOPMENT EFFORT


RESEARCH PROGRESS REPORT SECOND QUARTER (2Q) COMPUTER AIIDED SURGERY INCORPORATED OMPUTER DED URGERY NCORPORATED
3 0 0 E A S T 3 3 R D S T R E E T ,, S U IIT E 4 N 300 EAST 33RD ST REET SU T E 4N N E W Y O R K ,, N E W Y O R K 1 0 0 1 6 U S A NEW YORK NEW YORK 10016 USA
http://www.casi.net

T E L E P H O N E :: 1 ( 2 1 2 ) 6 8 6 8 7 4 8 TELEPHONE 1 (212) 686 8748 F A X :: 1 ( 2 1 2 ) 4 4 8 0 2 6 1 FAX 1 (212) 448 0261 E - M A IIL :: K A R R O N @ C A S I . N E T E-MA L KARRON@CASI.NET

Date of Publication: 5/1/2002 3:56 AM. Address: 300 E. 33rd St., Suite 4N, New York, NY 10016 USA. Telephone/Fax: (212) 686-8748, (212) 448-0261.

Research Technical Progress report 02 for

NIST ATP COOPERATIVE AGREEMENT 70NANB1H3050


Prepared by D. B. Karron, Ph.D. Principle Investigator

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Abstract ................................................................................................................ 1:3 Progress Metrics ................................................................................................... 2:4 2.1 GANTT Charts ............................................................................................. 2:5 2.2 Flow Charts................................................................................................. 2:10 2.3 Resource Charts .......................................................................................... 2:13 Collaborations and Partnerships........................................................................... 3:21 3.1 SGI ............................................................................................................. 3:21 3.2 City University of New York (CUNY)......................................................... 3:21 3.3 NYU Medical Center (Department of Radiation Oncology).......................... 3:22 3.4 Columbia University (Departments of Medical Informatics and Radiology) .. 3:22 Accomplishments Narratives............................................................................... 4:24 4.1 Accomplishments........................................................................................ 4:24 4.2 Infrastructure, Hardware and Software Systems Report ................................ 4:24 4.2.1 Network Hardware Overview: ............................................................. 4:25 4.2.2 Network Architecture: ......................................................................... 4:25 4.2.3 Requirements: ..................................................................................... 4:26 4.2.4 Shortcomings and Solutions:................................................................ 4:26 4.3 Guide to CASI software under development:................................................ 4:27 4.4 Graph Generation (Dr James Cox). .............................................................. 4:27 4.5 Wolberg Accomplishments.......................................................................... 4:28 4.6 Screen Shots ............................................................................................... 4:32 CASI Business Activities (Gurfein) ..................................................................... 5:41 5.1 ITAC .......................................................................................................... 5:41 5.2 InQTel Proposal.......................................................................................... 5:41 5.3 SGI ............................................................................................................. 5:41 5.4 NYSTAR.................................................................................................... 5:42 Appendix............................................................................................................ 6:43 6.1 SGI Developers Contract ............................................................................. 6:43 6.2 InQTel Proposal.......................................................................................... 6:49 6.2.1 Proposal .............................................................................................. 6:49 6.2.1.1 II. ATP Grant .................................................................................. 6:49 6.3 ITAC Proposal ............................................................................................ 6:53 6.3.1 Proposal .............................................................................................. 6:53 6.3.2 II. ATP Grant ...................................................................................... 6:53 6.4 Copy of JMIV Paper Acceptance Letter ....................................................... 6:58

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6.4.1.1 JMIV Paper (As revised per JMIV reviewers).......Error! Bookmark not defined.

ABSTRACT
Digital Morse Theory is a novel theoretical rubric for describing the topology of n-dimensional functions described in pixels, as opposed to traditional Morse Theory, which describes topology of function in analytic or continuous (Morse) spaces. Demonstration of the practical application of Morse Theory to hard problems of segmentation in clinical Medical Modeling radiation (and eventually surgical) therapies is the goal of this project. A major theme of this project is preserve dimensional fidelity and accuracy from the image source in the segmented 3-D models. We intend to extend our preliminary results in 3-D scalar images (Black and White CT images and MRI images) to 3-D fused RGB color, CT, and MRI data into single 3-D model. Significant technical hurdles remain to be overcome. We have made tentative progress in overcoming our formidable challenges. We are formally into our first year, or 1/6 of the project. Medical imagery technology generates large images, and many of them. New theoretical findings, just being tested, indicate the promise of DMT to reduce the information density of an image without distorting connectivity or topological relationships in an image. Traditional Gaussian or other blurring or multi resolution algorithms can complicate segmentation because the blurring distorts or merges objects that are separated at higher resolutions. It is these relationships that we need to preserve in DMT analysis, because clinically small features can separate large objects. Blurring these objects can make segmentation of these objects impossible or subject to interpretation. Therefore, we need to process large images down to a graph representation. This report describes preliminary development of this graphing software, and outlines our pathway to generating a software tool for graphical exploration and segmentation of large opaque bricks of data it to clinically useful dimensionally accurate models suitable for per patient therapeutic usage.

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PROGRESS METRICS

The main work of this quarter was the development large scale networked based pixel services, of rudimentary DMT graphs, and simple 3D display code. The interactive linkage between the graph and the image is not yet implemented. 3D Isosurfaces as a segmentation technique suffer from problems selecting isosurfaces, and managing how they run together. Sample illustration of this problem is given below. We need to identify where two objects connect, and how to disconnect them by selecting the proper isosurface seed (simple segmentation) or by building a barrier between the objects (carving segmentation). DMT Graph Generation and display by Dr Cox (generation) and Dr Wolberg. Large Image Storage RAID built by Dr. Karron Pixel sharing facility for large image memory mapping by Dr. Karron The following section gives Microsoft Project 2000 snapshot GANTT, Flow, and Resource Charts of our project underway. As these are big charts, fitting them to the page may make sections hard to read. Since this document is designed to be read in Adobe Acrobat Reader, you can zoom in and enlarge the detail on these charts in the software reader that you may not be able to see in the printed form on paper.

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2.1 GANTT CHARTS

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2.2 FLOW CHARTS

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2.3 RESOURCE CHARTS

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COLLABORATIONS AND PARTNERSHIPS

Currently CASI has not entered into any partnership agreements other than the specific instances given below.

3.1 SGI
Sgi has provided two machines, one remains their property, and the other was ordered but not paid for pending invoicing. We can only assume that despite repeated requests to pay for the equipment, SGI is in no hurry for payment. CASI must be careful not to spend the funds allocated for this purchase, and not to let it turn into a loaner. CASI wants clear ownership of the code we develop by developing the code only on equipment it clearly owns. The developer organization has made an agreement with CASI, a copy of which is in the appendix. Since that agreement was signed, the developer organization has increased the discounts offered to participating developers from 50% to 70% for full system purchases. A copy of the new developer discount schedule is appended. SGI has provided liberal technical support, and has been supportive of our effort. Dr Karron plans to spend some time at SGI as a visiting scientist sometime this summer. The potential for kickback or quid-pro-quo understandings exists with any large corporation. This must be scrupulously avoided. CASI expects to build its foundation system on large SGI supercomputers, and SGI expects to sell systems through CASI. However, no specific actions on the part of CASI or SGI are predicated on any exchange of money, or agreements to purchase. CASI seem to be enjoying the benefits of being the golden boy or pet developer of the SGI medical marketing organization.

3.2

CITY UNIVERSITY OF NEW YORK (CUNY)

CASI has not yet managed to come to a mutually beneficial agreement with City University of New York a/k/a CUNY either as a research collaborator-supplying faculty or as an incubator, supplying office and laboratory space... This does not mean that CASI cannot come to an agreement in the next project year. Part of the problem is that the PI (Dr Karron) teaches at CUNY (specifically, he is an adjunct professor of computer science in the City College of New York a/k/a CCNY, part of the City University of New York). Another mitigating situation is that all of the research and student staff at CASI is already CCNY faculty or students, and the academic standing of the researchers attracts faculty support on a personal level, instead of an institutional level, at significant cost savings to CASI and ATP.

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3.3 NYU MEDICAL CENTER (DEPARTMENT OF RADIATION ONCOLOGY)


Our collaboration with NYUMC is based on support the clinical efforts of Dr Bruce Ellerin, MD PHD. Dr Ellerin works mainly in clinical prostate treatment, and is responsible for managing the department caseload. He would be our most direct customer once our software is ready for an unsophisticated computer user. Because of this, we have pushed back the starting date for our NYUMC collaboration until we can let Bruce loose on our computers without danger to either of us.

3.4 COLUMBIA UNIVERSITY (DEPARTMENTS OF MEDICAL INFORMATICS AND RADIOLOGY)


A new exciting proposed collaboration between Columbia University (Dr Imielinska & Dr Laine) and CASI (Dr Karron) will expand on our clinical thrust in prostate therapy. In our proposal, we proposed to focus on Prostate and Breast as the clinical problems with the greatest national benefit both economically and for the American standard of living. With Drs Imielinska and Laines research on developing segmentation and visualization tools for Surgical Planning and Training for Retropubic Radical Prostatectomy, we see a natural basis for collaboration by mutual interests. Significantly, Dr Imielinska also worked with Dr Karron in the Visible Human Project, where she is a PI, and Dr Laines radiological research makes use of Morse Theory. This team has significant computer and image processing experience that our NYUMC collaborators lack. However, NYUMC is right across the street, and we plan to run cases right out of their clinic when the software development state warrants and we clear human subject protocols. Prostate cancer is the most commonly diagnosed cancer in American men and the second most common cause of cancer deaths. Last year in the United States, it was estimated that 184,500 men were diagnosed with prostate cancer and about 39,200 men will die of it. Over the last decade, the number of radical prostatectomies to treat men with newly diagnosed prostate cancer has quadrupled. The rise in the number of radical prostatectomies has occurred for several reasons. One reason is the dramatic increase in the detection of localized disease attributed primarily to the use of serum prostate-specific antigen (PSA) testing in conjunction with digital rectal examination. More than 95% of tumors detected in aggressive early-detection programs are clinically organ-confined, thus, a higher proportion of newly detected tumors are potentially amenable to radical prostatectomy. Radical retropubic prostatectomy has become the treatment of choice for otherwise healthy patients with clinically localized prostate cancer whose life expectancy exceeds 10 years. This technique is technically demanding with many perioperative and postoperative complications. The anatomic location of the prostate contributes largely to the technical difficulty encountered in this procedure. The prostate is located beneath the pubic symphysis making visualization and resection of the prostate and peri-prostatic structures difficult.

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Despite advances in our understanding of male pelvic anatomy, radical prostatectomy remains a difficult operation with a steep learning curve. With the rise in incidence of localized prostate cancer, the necessity for this operation has markedly increased. The goal of this project is to develop and evaluate tools for segmentation and 3D visualization of male pelvic anatomy, from patient specific image data, for use in training urologists to perform radical prostatectomy. The long-term goal of this research will be to improve and develop tools to assist and enable surgeons in minimally invasive procedures. Tailoring a segmentation methodology for a specific application (A) (radical prostatectomy), specific body region (B) (pelvis, abdomen), and imaging protocol (P) (e.g. Spiral CT scans of the abdomen and pelvis) will result in 3D visualization of patient anatomy that is best suited for a computer aided surgical tool.

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ACCOMPLISHMENTS NARRATIVES

4.1 ACCOMPLISHMENTS
Dr Karron has been taking responsibility for building a state of the art image-processing infrastructure supporting the growing image processing requirements of DMT. Key to winning clinical acceptance is intuitive interactivity, close coupling between the DMT graph and the rendered image. This is required for rapid and repeatable segmentation. We are in the process of scaling up the size of the images we can graph, and learning optimization techniques to reduce the algorithm complexity to achieve the desired graphing. Dr Karron has is developing a standard format based shared memory system that will enable users and programmers to attached to data pre-loaded into memory on a host machine, and share that memory on the same machine or over a network. The data can be accessed in various fashions, to reduce long memory accesses with the resultant cash invalidation and memory cash thrashing. This tuning effort is being done in collaboration with Silicon Graphics. By using the new SGI system, older software developed by Dr Karron is coming back to life. Dr Karron will present animation sequences that were too slow and large on the previous casi computers now run fluidly and demonstrate the power and beauty of the SpiderWeb isosurface algorithm, on which DMT is being built on. Dr Karron and Dr Cox have presented two professional meetings since the first Q report, namely the SIAM (Society of Industrial and Applied Math) Special Interest Group on Medical Imaging in Boston, as well as at CCNY Biology Department seminar series, hosted by Dr Karen Hubbard.

4.2 INFRASTRUCTURE, HARDWARE AND SOFTWARE SYSTEMS REPORT


In order to achieve the innovative high-end performance required of high-end image and 3D modeling research, CASI elected to build its own computers and computer network from almost scratch, from components. The crown jewel of the CASI development shop is its two Octane 2 super workstations both with dual R14000 CPU. Additionally, each computer has two network interfaces, a slow public interface, and a private gigabit network, to segment high-speed interaction between computers from interaction between each computer and the greater internet. This is done for security and performance issues. CASI has built a super high performance image storage system out of redundant arrays of inexpensive hard disks. CASI built two raids, a super high performance raid constructed

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of 24 each fast access 34 gigabyte 15,000 RPM Seagate Cheetah disks, the fastest available in the industry, and a mirror raid of 10 each immense 180 gigabyte slow 7200 rpm Barracuda disks. In building such a high performance computer network, CASI stretches the state of the art in both hardware and software. CASI has also created a serious noise problem from the high capacity cooling fans and the low capacity air conditioning and power supplies available in Dr. Karrons home.

4.2.1 Network Hardware Overview:


The onsite network consists of twelve workstations and two servers. Six workstations are Intel Xeon / Pentium 4 Processor-based machines, used primarily for office management, literature research, multimedia, and accounting. All six machines were purchased under the NIST ATP Cooperative Program. Two workstations are Silicon Graphics Octane workstations, used solely for software development. One Silicon Graphics Octane was purchased under the NIST ATP Cooperative Program, the other contributed by Dr Karron. Three workstations are Silicon Graphics Indigo machines, used as additional seats for software development, with one running as a domain name server. All three Indigo workstations were contributed by Dr Karron. One IBM ThinkPad Notebook was also purchased under the program. It is used primarily for remote office management and development. Two SCSI RAID Servers are employed for data storage. One was purchased under the NIST ATP Cooperative Program, the other contributed by Dr Karron. The network is built on an Extreme Networks Summit 7i Switch, also purchased under the program.

4.2.2 Network Architecture:


The current network architecture is divided into two Virtual Local Area Networks (VLAN), namely Public and Private. This is done for the purposes of isolating highbandwidth traffic to the faster Private network, leaving the slower Public network for less demanding traffic. The Private network is also used for security, isolating data that should not be publicly accessible. The Public network consists of a 15 static internet protocol (IP) address block with ISDN service, provided by Thorn Communications. Each workstation is assigned one static IP address over a 10/100Base-T Ethernet connection. Domain name serving is done on-site. The private network consists of a Class-C address block (192.168.0.0-192.168.255.255), over a 1000Base-T Ethernet connection. Each workstation/device is assigned one static Private address via a secondary network interface installed in the workstations. Additional 2Q NIST ATP report by Dr Karron. 5/1/2002 3:56 AM

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internet access is available over the Private network from cable modem connections provided by Time Warner Cable and RCN.

4.2.3 Requirements:
The network must be structured such that local data transfers and storage can be conducted reliably and efficiently. This is achieved using the 1000Base-T Ethernet connections over the private network regulated by the Summit 7i Switch, and RAID servers. In/Outbound traffic to/from the internet must be fast and always on, allowing for constant on-site internet access and remote access to the local network for authorized users. This is achieved by employing a reliable and sufficiently robust Internet Service, on-site DNS, and backup internet access via ISDN, cable modem, and dialup. Sharing and interoperability of data between platforms (Windows 2000, UNIX, LINUX, etc.) must be available. Sufficient redundancy of platform bridging must also be present. This is achieved using various sharing applications such as Samba, NFS Share, Sharity, etc.

4.2.4 Shortcomings and Solutions:


The current network configuration fails to meet requirements such that data storage is not reliable due to hardware failures caused by improper cooling and power outages. To fully resolve this issue, the site must be relocated to a location fitted with proper air-conditioning and capable of meeting our power demands. Sufficient data-backup and backup-power systems are also needed. In/Outbound connections are not reliable since ISDN lacks the appropriate bandwidth to handle our traffic volume. Cable modem access is only a partial solution. To fully resolve this issue, a commercial grade T-1 connection must be employed, either through site installation or through relocation to a site pre-equipped. Backup connections (ISDN, cable, dial-up, etc.) must remain available in case of failure. The current public IP address block is not large enough to accommodate the current number of workstations and devices. This will significantly hinder future growth of the network if left unattended. To resolve this issue, a larger IP block must be purchased. This is easily available upon deployment of a T-1 connection.

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Sharing of data and interoperability between platforms is not fully functional due to software/hardware configuration problems and pending license purchases. Upon purchase of required software licenses and proper configurations, sharing and interoperability will be fully functional.

4.3 GUIDE TO CASI SOFTWARE UNDER DEVELOPMENT:


The main driver routine is ZoneSegmentor. It calls the Critical Detector module and then calls the Zone Locator Module the output produced consists of the criticality tree file that indexes a random access zone file (which contains cell lists for each zone). The cells are the volume elements or voxels needed for constructing isosurfaces within each zone. The zone database is used by the front-end software under development by Dr Wolberg.

4.4

GRAPH GENERATION (DR JAMES COX).


Dr Cox is working on the DMT decomposition preprocessing software that converts image data into DMT Tree and associated zones. Dr Cox is working with Dr Wolberg and Dr Karron, who is working on the front-end visualization software that utilizes the DMT backend, in optimizing the backend, and in integration of the entire system. This will complete project milestones 3 and 4. Dr Cox wrote code to process scalar volume data that produces a list of DMT criticalities in the data. Initially the code found maximum and minimum pixel criticalities in the data, which consisted of a stack of slides. The code was then expanded to include pixel saddle criticalities and verified on an artificially constructed data set for which criticalities were known the program was then expanded to recognize interstitial criticalities induced by socalled ambiguous Voxel faces. These are the disambiguation points that induce a global topology change in the isosurfaces. The computation was again verified on several artificially produced data sets (supplied by Dr Nazma Ferdous) for which the criticalities were known. The code was then expanded to include critical isosets. These can occur when there are groups of adjacent identically valued data points. These were also tested on generated (artificial) data. The code was then tested on actual image data from the Visible Human. During February, Dr Cox worked on the code to compute the DMT criticality graph (tree) from the criticality information. This involved a substantial amount of coding. The generated trees were verified against the generated data with known DMT decomposition. They were subsequently tested on image data.

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Next, we wrote the code to generate the zone decomposition during the DMT decomposition. Initially, for testing, the points in each zone were listed. Then I modified the code so that each zone was written as a sorted list of cells (voxels) for processing by the imaging software. I modified the DMT tree representation to make it a search data structure. We first tested the DMT decomposition with an implementation of SpiderWeb imaging software using the OpenGL GLUT library. This code was developed by Dr Cox and Dr Ferdous. We subsequently interfaced with the new (and much improved) imaging software of Dr Wolberg for further testing. The new imaging software incorporates an optimized version of our SpiderWeb, together with sophisticated visualization tools developed by Dr Wolberg. In March, I modified the DMT decomposition to create a single direct access file with the zones, with the DMT tree serving as the index data structure. We included a computation of each zones volume. This volume is an approximation based on the pixel (or voxel) size of each zone. Dr Wolberg has a more precise computation. Our volume computation suffices for testing purposes. Testing of the DMT preprocessing and tuning of the code continues. The tests have included some RGB data that Dr Karron has supplied, using Dr Karron's recently developed technique for conversion of RGB data into multiple related scalar volume data sets based on image content. Dr Karron has converted CT data from the VHP data set to TIFF format. Dr Karron and I developed software (a filter) to read and convert the TIFF slices into the scalar data set that the DMT preprocessing requires. We then modified the code to produce a second DMT tree, in a simplified format for Dr Wolberg, who is working on a sophisticated tree display system. I also began work with Dr Karron on a simplified DMT tree display system for testing purposes. Dr Cox is presently working on the DMT decomposition of the head from the VHP data set. The size of the data requires some modification and tuning of the DMT code, and he is presently engaged in this task. He has already successfully partially tested criticality tree culling software that removes inessential nodes for a more manageable tool. This is important because blurring the data by traditional means distorts the topology connectivity. Frequently important separate medically significant objects are separated by small thin membranes that disappear when an image is reduced by traditional multiresolution blurring algorithms.

4.5 WOLBERG ACCOMPLISHMENTS


The objective of Dr Wolbergs software effort during the first part of this review period this period was to accurately compute the volume of a 3D polyhedral region using Stokes theorem. The purpose of this work is to build up an important validation suite that tests the accuracy of the segmentations derived from Digital Morse Theory. Accurate volume calculations serve as key members to this validation suite.

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It is well known from calculus that Stokes theorem provides the formulas by which surface integrals can be transformed into line integrals. Since our surface geometry is represented as polyhedral models derived from voxel data, a variant of Stokes theorem is necessary for our domain. We began by first deriving two equivalent approaches to this problem. This led to the derivation of two compact equations relating the volume to the vertices of the polyhedral model. We opted to implement the streamlined scalar triple product approach because it offers greater computational benefits, i.e., fewer calculations. The software was tested on surfaces for which the precise volume is known analytically: a sphere and a torus. The sphere tests the simple case of a convex object. The torus tests the more difficult case of a convex object. In both cases, the software first determines that the supplied object constitutes a closed surface. This is done by checking that every triangle has three neighboring triangles, i.e., one per side. A graphical user interface was implemented to permit the user to read graphic files in a vertex/face format and visualize it in real-time. The user is able to modify the resolution of the displayed surfaces and recomputed the volume instantly. In this case, resolution changes take place by subdividing or merging existing triangular faces. It is important to note that we will ultimately handle a change of resolution by subdividing or merging voxel data, and then extract the polyhedral data directly from the voxel. Work was also conducted on a curve-editing tool that permits the outline of a serial section to be drawn using a Bezier curve. The area of that drawn curve is then computed using a summation of cross products computed among consecutive pairs of vertices. It can be shown that this approach is derivable from Green's Theorem. It is planned that an animation be created that can help the user visualize the transition from one layer of data to the next, and see its effect on volume. For this pedagogical tool, both Green's theorem and Stokes theorem are necessary to compute the volume over a 2D region and a 3D surface, respectively. The objective of our software effort was the implementation of a graphical user interface to permit the user to read graphic files in a vertex/face format and visualize it in real-time. The user is able to modify the resolution of the displayed surfaces and recompute the volume instantly. In this case, resolution changes take place by subdividing or merging existing triangular faces. It is important to note that we will ultimately handle a change of resolution by subdividing or merging voxel data, and then extract the polyhedral data directly from the voxel. This quarter I also began to write graphical user interface software that makes use of quaternions. Quaternions are a useful mathematical construct that facilitates an intuitive 3D rotation controller using 2D mouse input. It is important to note that counter-intuitive results often occur when trying to rotate 3D objects with a 2D pointing device because rotation does not commute. That is, there is more than one way to rotate a sphere from one orientation to another. Quaternions are widely acknowledged to offer the best solution to this problem. The objective of this work is to permit the user to freely and intuitively rotate volumetric data without the familiar gimbal lock effects that plague conventional techniques based on Euler angles.

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I also worked on the SpiderWeb algorithm for determining hit points in voxels and the resulting generation of triangles to render. The code also addresses the manipulation of volumes that are too large to fit in RAM. As a result, a preprocess is run which decomposes the volumetric data into interval trees that facilitate the rapid identification of active voxels that must be rendered in response to a user-specified isovalue. The SpiderWeb algorithm has been integrated into the unified software test bed under development. We endeavored the design and implementation of graphical user interface software that makes use of quaternions. The software interface consists of two large concentric circles drawn in the window. The object to be rotated is construed to lie in a bounding sphere. The edge of the inner circle is interpreted to be the silhouette of the sphere. If the user moves the mouse inside the inner circle, the sphere (and enclosed object) rotates according to the intuitive quaternion behavior. It is often common to select constrained rotation axes, such as the x-, y-, or z-axes. To facilitate this option, four small circles are drawn in the north, south, east, and west positions between the two large concentric circles. The following rules apply for the determination of the rotation axis that is used, depending on where the user begins dragging the mouse. Starting point, P, for mouse dragging Rotation axis ------------------------------------------------Inside inner circle line perpendicular. to vector connecting previous pt to current point outside outer circle z-axis north/south circles x-axis east / west circles y-axis Elsewhere between two concentric circles line perpendicular. to P and circle if the SHIFT key is held down while the mouse is dragged, the rotation takes place using the object's (local) coordinate system. Otherwise, the rotation takes place about the camera/world (fixed) coordinate system. Dr Wolberg started the design and implements a tool to display and navigate a criticality tree. He wrote software to parse the tree data, as supplied by Dr Jim Cox. The parsing software performs the following operations: 1) Allocates nodes[], an array of tree nodes. Each node contains the following info: a) Volume: volume associated with node (available in tree input file), b) Depth: level of the tree in which the node lies, c) ChildNum: the number of children for that node, d) Children: an integer array containing indices of the children.

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e) childMax: the maximum number of children allowable in children[] (initially 8). If we try to install more than 8 children for a node, we run a call to realloc() and update the max number to 16, or 24, as required dynamically). 2) While parsing the file and setting up nodes[], we simultaneously init depth[], an array of tree depths (levels). For each entry in depth[], there is a data structure that contains the following info: a) nodeNum: how many nodes are present at that depth, b) nodeMax: maximum allowable nodes that can be stored c) nodes: an integer array that indicates which tree nodes are present at that depth. Visualization software has been written to take the above data and draw it in one of several modes: flat 2D tree display, concentric circles (with the root at the center), and hemispherical mapping (with the root at the North Pole). The design and implementation of tree visualization tool to display and navigate a criticality tree continued with the implementation by Dr Wolberg of three different forms of tree visualization: 1) Flat 2D rendering with nodes lying along horizontal/vertical rows and columns. a) 2) Concentric ring 2D rendering with the root located at the center and all children on the next outer concentric ring. This act as a bird's eye view of hemispheric rendering (see (3)). b) 3) Hemispheric 3D rendering with tree draped upon hemisphere. The root lies on the North Pole, the leaves lie along the equator. The spacing between the nodes is determined by their respective volumes. I have already implemented precise volume computations based on the scalar triple product (a variant of Stokes theorem). Those nodes that represent volumetric data with high volume occupy a larger segment of the hemisphere than low volume nodes. Various interface options are available to permit the user to rotate and navigate the tree without being overwhelmed by the potentially large number of tree nodes. The program reads/parses a criticality tree file. When the user double-clicks on a drawn node in any of the above three methods, the descendants of that node become minimized, i.e., they collapse into the node. Doubleclicking again then exposes them. When a branch is minimized, the remaining tree is redrawn to best fit the new space. A flag can be used to override this feature. Quaternion code is used to permit the user to intuitively manipulate the hemisphere. The next stage of the code will couple the tree visualization with the volume. Pointing to nodes of the tree will render volumes that correspond to the node's isovalues. In addition to rendering the subvolumes, they can be highlighted within the whole volume with the use of transparency functions and cut-away views. The benefit of this approach is that a convenient dual form of the volume will be available to the user for direct editing.

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4.6 SCREEN SHOTS

flat.jpg: A flat 2D tree display. The root lies in the top-left corner. All six children of the root are depicted as nodes in the next row. In general, the children of a node are always depicted in the Subsequent row. A unique color is applied to an entire branch Stemming from the root. This display clearly illustrates the Topology of the tree. In a future version, the actual values of the volume and isovalues associated with the nodes will be depicted with the use of scaled color value and radii, respectively.

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ring.jpg: A flat 2D polar representation of the tree. The root lies in the center. Each successive generation of nodes is made to lie on a series of concentric rings. The outermost ring consists exclusively of leaves.

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sphere1.jpg: A 3D representation of the tree. The ring.jpg data is essentially draped onto a hemisphere. The root sits at the North Pole and the Equator consists exclusively of leaves. This figure occludes all Back-facing nodes.

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sphere2.jpg: Same as sphere1.jpg except that the back-facing nodes are visible, i.e., no blackface culling is applied. This version helps give the User a sense of the complete, albeit cluttered, views of the tree.

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volume1.jpg: Each node along a branch of the tree represents a volume associated with a particular isovalue. This figure depicts one such volume.

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volume2.jpg,

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volume4.jpg: Several depictions of a volume rendered with incrementally Larger isovalues. These images are associated with successive Nodes along a branch of the criticality tree.

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CASI BUSINESS ACTIVITIES (GURFEIN)

5.1 ITAC
In an effort to enable CASI to expand its horizons and to capitalize on the technical progress made via the ATP grant, two proposals were submitted to the Industrial Technology Assistance Corporation (ITAC), a non-profit economic development arm, funded by New York State and New York City. The first proposal was for a broad-based effort, for $2.4 million, to pursue various potential attractive applications of Digital Morse Theory (DMT). CASI proposed an iterative market analysis/technical feasibility approach to be followed by applying the knowledge developed from the activity funded by the ATP grant. The potential applications to be examined ranged from several medical areas to reconnaissance, meteorology, metrology, mapping, commercial animation and decoding, among others.

5.2 INQTEL PROPOSAL


A second proposal was submitted to In-Q-Tel, via ITAC, at their request, for an application to be chosen by In-Q-Tel. (In-Q-Tel is a venture capital company that is wholly owned by the Central Intelligence Agency. Its role is to access new IT companies, solutions, and approaches to address the CIAs priority problems.) This proposal, for $1 million, would likely be in the field of reconnaissance or decoding, but that is not certain what applications they have in mind yet.

5.3 SGI
CASI is currently a participant is SGIs Developer Program. Among other potential benefits, Developers receive substantial discounts (varying from 40-50% on many items) on purchases from SGI. CASI has already saved considerably via this program. (See the attached agreement.) CASI has been approached by SGI senior scientists at SGI for assisting CASI in our DMT effort, enabling CASI to optimize its use of SGI equipment. There have been no agreements made specifically in this regard, verbal or written. Any prospective agreements would be submitted for ATP approval. A group at SGI that does business development has also solicited CASI to provide equity based funding. As CASI is still in the basic research

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phase, CASI feels it is premature to start selling the company until it has some customers and products.

5.4 NYSTAR
CASI is likely to submit a proposal in cooperation with Columbia University in the first Q of next fiscal year for joint NYSTAR funding of Columbia-CASI collaboration. A technical description of the collaboration is given above.

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APPENDIX

6.1 SGI DEVELOPERS CONTRACT

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6.2 INQTEL PROPOSAL


Virtual Reality, Tele-operation, Simulation, and Advanced Imagery Research 300 East 33rd Street, Suite 4N, New York, New York, 10016
Telephone and Voice Mail: +1(212) 686 8748 Fax: +1(212) 448 0261. Electronic Mail: karron@casi.net Internet/World Wide Web: http://www.casi.net

6.2.1

Proposal

I. Overview: Computer Aided Surgery, Inc. (CASI), established in 1995, is a cuttingedge software developer that has emphasized medical research applications. CASI has won a number of past grants from the Defense Advanced Research Projects Agency (DARPA) and the National Institutes of Health (NIH). In October of 2001, CASI was awarded an Advanced Technology Program (ATP) grant from the National Institute of Standards and Technology (NIST). This grant is aimed at generating software using Digital Morse Theory (DMT) for enabling accurate and precise segmentation of anatomical organs from difficult medical imagery. Essentially, the goal, as cited in the grant, is for this software to delineate edges between adjacent soft tissue organs. The primary applications are for radiation oncology planning and for surgical planning. The benefit to be derived from this software will relieve the radiation oncologist from the tedious and time-consuming effort of carefully circumscribing the volume to be treated; it will yield a more accurate and repeatable volume. When reduced to practice, this will result in significant cost savings to the payers as well as attractive growth and income for CASI. ATP funds are restricted for direct technical research and development costs only. Additional funds are now needed for the overhead costs of this project and the commercialization of this technology for these medical applications and a wide range of other applications.
6.2.1.1 II. ATP Grant

II.a. the Goal of the ATP Grant: The goal of the ATP grant is to generate the algorithms and thereby the DMT software necessary for segmenting soft tissue organs from each other, enabling the accurate automated circumscription of anatomical organ volume. The typical modality is CT imagery, using Houndsfield numbers (density). The density between adjacent organs is very similar, making this a non-trivial problem. (Note: There are competing products in the marketplace, but they are not useful in soft tissue adjacent to soft tissue organs, but only in soft tissue adjacent to bone.) In addition to developing the DMT software, CASI will validate the software and will have clinical validation performed at NYU Medical Center. II.b. Potential DMT Applications: In addition to the medical applications noted above, there are numerous potential timesaving applications where DMT can be applied, yielding 2Q NIST ATP report by Dr Karron. 5/1/2002 3:56 AM

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superior results. There are many fields where the raw data imagery is either diffuse, lacks resolution, and contains low contrast, among other shortcomings. DMT may be an effective tool for a wide range of imagery applications. These include satellite imagery for reconnaissance, mapping, geodesy, surveying, and topography; meteorology; air traffic control; medical education and training; medical animation; entertainment industry animation and fluid mechanics, among many others. II.c. the ATP Advantage: Piggybacking on the technical foundation to be derived from the ATP activity, CASI proposes to apply DMT software to the applications of interest to In-Q-Tel. Some of this effort may be accomplished in parallel to the ATP activity. III. Benefits of DMT Software IIIa. Economic benefits are expected to be very significant. Taking the example of radiation therapy planning for prostate cancer, it takes a radiation oncologist about an hour to carefully circumscribe the volume of the prostate, using a cursor on a computer monitor image. This is done slice-by-slice and is very tedious. Medicare currently pays $770 per radiation plan. DMT software would enable this cost to be around $250, saving over $500 per patient. On a national scale, with 200,000 new prostate cancer cases in 2001, this would amount to a saving of over $100 million per year just for prostate cancer. III.b. Clinical benefits are numerous. The physician will have more time to spend with patients. The physician will be relieved of a tedious task. The software should provide a more accurate and repeatable volume, thereby avoiding the predisposition of the physician of being either too generous (radiating too much and affecting adjacent organs, e.g., bladder, rectum, with harsh results) or conversely to plan on radiating too little and leaving too many cancer cells untreated. The patients overall quality of care will be markedly improved and the physician will have more time to attend to patients. III.c Collaborators For radiation oncology, CASI will be collaborating with university academic medical scientists. For other disciplines, CASI will be engaging collaborators, who are bellwether hands-on state-of-the-art researchers. Specifically, for satellite imaging we intend to engage specialists involved in reconnaissance and mapping, such as the National Reconnaissance Office (NRO), and the National Imagery and Mapping Agency (NIMA). For meteorology, experts from the National Oceanic and Atmospheric Administration (NOAA) will be invited to be collaborators. III.d. generally it is expected that other applications will benefit from both the time saving aspects and the accuracy and repeatability of DMT software.

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IV. Need for Funds: Restrictions on our current ATP grant necessitate additional cofunding, as the ATP funds may not be used for commercialization, market surveys or any function not directly related to the approved technical proposal. V. Use of Funds: The primary use of funds will be for: a. Investment in technology infrastructure support equipment including computers, high speed Internet, high quality photographic imaging printers, data backup and uninterruptible power supplies; b. Adapting the software developed for the ATP activity to the three most promising applications of interest to In-Q-Tel; c. Examining the feasibility of distributing the software via Internet; d. Hiring staff e. Leasing data port-equipped specially air-conditioned computer lab facilities; f. Building patent position; g. Marketing of products via license and /or Internet ASP. VI. Rationale and Schedule of Activities and Expenditures: a. ATP funds may be only applied to the specific research tasks delineated in the grant. This applies to both activities and equipment. Additional infrastructure equipment is needed to expand our commercial horizons. b. The aim is for CASIs intellectual property portfolio to be diversified for product balance and future growth. . . In addition to adapting the DMT software for other (non-medical) applications, CASI will engage professional consultants in order to get a hands-on understanding of the ultimate users needs. As an example, if meteorology is selected, we will engage a meteorology concern to enable CASI to fully understand the needs of a meteorologist in analyzing weather imagery/data. c. A data communications design feasibility study will be performed to determine suitability of establishing an Application Service Provider for distributing products. This is one of the two primary approaches that will be pursued to market/distribute the DMT software; the other being licensing to software companies that specialize in the various application technologies. d. Support staff will be required. CASI will hire a marketing professional to implement marketing effort. CASI will employ an administrator and a bookkeeper, which will manage fiscal reporting and audit requirements.

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e. In contemplation of hiring personnel and obtaining high-powered computing equipment, CASI will move into suitable commercial / industrial space. Requirements for this space are 10 workstations for scientists, technologists, programmers, management, and support specialists. f. To preserve and optimize the intellectual property developed by this project we will engage patent counsel services. Developing patentable intellectual property is key to attracting private capital investment and assures CASIs ability to license its technology. g. In order to educate, promulgate, and disseminate the knowledge developed from this project, many papers will be presented at national symposia, and international meetings. Hands on demonstrations at conference exhibitions will help accomplish dissemination of this technology. VII. Key Personnel: (See attached bio sketches) Dr. D.B.Karron-CEO & Chief Technology Officer has been active in computer science for medical applications for over fifteen years. A former research professor of Surgery at NYUMC and current professor of computer science specializing in BioInformatics at CCNY, he is the Principal Investigator of the current ATP grant. Dr. Karron has broad knowledge of the needs of the medical disciplines. He co-invented DMT with Professor J L Cox. Dr. Karron has been awarded previous grants from DARPA and NIH. E. Gurfein-Chief Operating Officer has over 25 years of business experience in scientific and technical companies. He has an undergraduate degree in mathematics, with advanced training from Courant Institute. He earned an MBA and managed technical projects at Sperry-Rand, General Precision, Perkin-Elmer Corporation and Engelhard Industries. He has extensive technical marketing and commercialization background. He was director of technical marketing for the Hubble Space Telescope. Mr. Gurfein has technical familiarity with optical systems and imagery, laser technology and applications, inertial guidance systems, ballistic missile operations and catalytic combustion, among others.

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6.3 ITAC PROPOSAL


Virtual Reality, Tele-operation, Simulation, and Advanced Imagery Research 300 East 33rd Street, Suite 4N, New York, New York, 10016
Telephone and Voice Mail: +1(212) 686 8748 Fax: +1(212) 448 0261. Electronic Mail: karron@casi.net Internet/World Wide Web: http://www.casi.net

6.3.1

Proposal

I. Overview: Computer Aided Surgery, Inc. (CASI), established in 1995, is a cuttingedge software developer that has emphasized medical research applications. CASI has won a number of past grants from the Defense Advanced Research Projects Agency (DARPA) and the National Institutes of Health (NIH). In October of 2001, CASI was awarded an Advanced Technology Program (ATP) grant from the National Institute of Standards and Technology (NIST). This grant is aimed at generating software using Digital Morse Theory (DMT) for enabling accurate and precise segmentation of anatomical organs from difficult medical imagery. Essentially, the goal, as cited in the grant, is for this software to delineate edges between adjacent soft tissue organs. The primary applications are for radiation oncology planning and for surgical planning. The benefit to be derived from this software will relieve the radiation oncologist from the tedious and time-consuming effort of carefully circumscribing the volume to be treated; it will yield a more accurate and repeatable volume. When reduced to practice, this will result in significant cost savings to the payers as well as attractive growth and income for CASI. ATP funds are restricted for direct technical research and development costs only. Additional funds are now needed for the overhead costs of this project and the commercialization of this technology for these medical applications and a wide range of other applications.

6.3.2 II. ATP Grant


II.a. the Goal of the ATP Grant: The goal of the ATP grant is to generate the algorithms and thereby the DMT software necessary for segmenting soft tissue organs from each other, enabling the accurate automated circumscription of anatomical organ volume. The typical modality is CT imagery, using Houndsfield numbers (density). The density between adjacent organs is very similar, making this a non-trivial problem. (Note: There are competing products in the marketplace, but they are not useful in soft tissue adjacent to soft tissue organs, but only in soft tissue adjacent to bone.) In addition to developing the DMT software, CASI will validate the software and will have clinical validation performed at NYU Medical Center. II.b. Potential DMT Applications: In addition to the medical applications noted above, there are numerous potential timesaving applications where DMT can be applied, yielding superior results. This plan addresses some of the more compelling applications. There are

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many fields where the raw data imagery is either diffuse, lacks resolution, and contains low contrast, among other shortcomings. DMT may be an effective tool for a wide range of imagery applications. These include satellite imagery for reconnaissance, mapping, geodesy, surveying, and topography; meteorology; air traffic control; medical education and training; medical animation; entertainment industry animation and fluid mechanics, among many others. II.c. the ATP Advantage: Piggybacking on the technical foundation to be derived from the ATP activity, CASI plans to apply DMT software to the most compelling of the applications cited. While all of the applications will be examined, finally the three most attractive ones will be given a highly comprehensive evaluation. In addition to technical consideration from among the various modalities, i.e., visible spectrum, infrared, color, Houndsfield number, etc., for each application, a market survey will be performed for all. Some of these investigations will be performed in parallel with the ATP work. III. Benefits of DMT Software IIIa. Economic benefits are expected to be very significant. Taking the example of radiation therapy planning for prostate cancer, it takes a radiation oncologist about an hour to carefully circumscribe the volume of the prostate, using a cursor on a computer monitor image. This is done slice-by-slice and is very tedious. Medicare currently pays $770 per radiation plan. DMT software would enable this cost to be around $250, saving over $500 per patient. On a national scale, with 200,000 new prostate cancer cases in 2001, this would amount to a saving of over $100 million per year just for prostate cancer. III.b. Clinical benefits are numerous. The physician will have more time to spend with patients. The physician will be relieved of a tedious task. The software should provide a more accurate and repeatable volume, thereby avoiding the predisposition of the physician of being either too generous (radiating too much and affecting adjacent organs, e.g., bladder, rectum, with harsh results) or conversely to plan on radiating too little and leaving too many cancer cells untreated. The patients overall quality of care will be markedly improved and the physician will have more time to attend to patients. III.c Collaborators As with radiation oncology, CASI will be collaborating with university academic medical scientists. CASI will be engaging collaborators, who are bellwether hands-on state-of-the-art researchers. Specifically, for satellite imaging we will engage specialists involved in reconnaissance and mapping, such as National Reconnaissance Office (NRO), National Imagery and Mapping Agency (NIMA). For meteorology, experts from the National Oceanic and Atmospheric Administration (NOAA) will be invited to be collaborators. III.d. generally it is expected that other applications will benefit from both the time saving aspects and the accuracy and repeatability of DMT software.

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IV. Need for Public Funds: Restrictions on our current ATP grant necessitate additional co-funding, as the ATP funds may not be used for commercialization, market surveys or any function not directly related to the approved technical proposal. The nature of DMT software development, while extremely encouraging, is not sufficiently mature to attract private equity funds. Therefore, on the expectation that DMT will be of great broad-based economic benefit, CASI is seeking co-funding in the range of $2 million dollars. These funds will be employed as described below.

V. Use of Funds: The primary use of funds will be for: h. Investment in technology infrastructure support equipment including computers, high speed Internet, high quality photographic imaging printers, data backup and uninterruptible power supplies; i. Market surveys for each of six (6) potential DMT applications; j. Adapting the software developed for the ATP activity to the three most promising applications; k. Examining the feasibility of distributing the software via Internet; l. Hiring staff m. Leasing data port-equipped specially air-conditioned computer lab facilities; n. Building patent position; o. Presenting papers, attending seminars and publicity; p. Marketing of products via license and /or Internet ASP. VI. Rationale and Schedule of Activities and Expenditures: h. ATP funds may be only applied to the specific research tasks delineated in the grant. This applies to both activities and equipment. Additional infrastructure equipment is needed to expand our commercial horizons. i. CASI will engage the market research arm of the Industrial Technical Assistance Corporation (ITAC), as an independent marketing research consultant, for designing a market survey. From over a dozen initial candidates, six potential applications will be selected based on technical, marketing and profitability factors. The aim is for CASIs intellectual property portfolio to be diversified for product balance and future growth. A market research study will be performed in parallel on each of the six provisional (6) applications areas. This research will be done along with the ITAC market research activity. Based on these research results, the three most promising applications will be selected for product development. In addition to adapting the DMT software for each application, CASI will engage professional consultants in order to get a hands-on understanding of the ultimate users needs. As an 5/1/2002 3:56 AM

j.

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example, if meteorology is selected, we will engage a meteorology concern to enable CASI to fully understand the needs of a meteorologist in analyzing weather imagery/data. k. A data communications design feasibility study will be performed to determine suitability of establishing an Application Service Provider for distributing products. This is one of the two primary approaches that will be pursued to market/distribute the DMT software; the other being licensing to software companies that specialize in the various application technologies. l. Support staff will be required. CASI will hire a marketing professional to supervise the various marketing studies and then to implement marketing effort. CASI will employ an administrator and a bookkeeper, which will manage fiscal reporting and audit requirements.

m. In contemplation of hiring personnel and obtaining high-powered computing equipment, CASI will move into suitable commercial / industrial space. Requirements for this space are 10 workstations for scientists, technologists, programmers, management, and support specialists. n. To preserve and optimize the intellectual property developed by this project we will engage patent counsel services. Developing patentable intellectual property is key to attracting private capital investment and assures CASIs ability to license its technology. o. In order to educate, promulgate, and disseminate the knowledge developed from this project, many papers will be presented at national symposia, and international meetings. Hands on demonstrations at conference exhibitions will help accomplish dissemination of this technology. VII. Key Personnel: (See attached bio sketches) Dr. D.B.Karron-CEO & Chief Technology Officer has been active in computer science for medical applications for over fifteen years. A former research professor of Surgery at NYUMC and current professor of computer science specializing in BioInformatics at CCNY, he is the Principal Investigator of the current ATP grant. Dr. Karron has broad knowledge of the needs of the medical disciplines. He co-invented DMT with Professor J L Cox. Dr. Karron has been awarded previous grants from DARPA and NIH. E. Gurfein-Chief Operating Officer has over 25 years of business experience in scientific and technical companies. He has an undergraduate degree in 2Q NIST ATP report by Dr Karron. 5/1/2002 3:56 AM

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mathematics, with advanced training from Courant Institute. He earned an MBA and managed technical projects at Sperry-Rand, General Precision, Perkin-Elmer Corporation and Engelhard Industries. He has extensive technical marketing and commercialization background. He was director of technical marketing for the Hubble Space Telescope. Mr. Gurfein has technical familiarity with optical systems and imagery, laser technology and applications, inertial guidance systems, ballistic missile operations and catalytic combustion, among others.

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6.4 COPY OF JMIV PAPER ACCEPTANCE LETTER

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