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  • Thank you for your interest in the Focused Ultrasound Foundation. Please note that directions to various slide functions can be found in the Notes section throughout the presentation. Prior to starting the presentation, please ensure the sound on your computer has been silenced.
  • This slide contains a series of videos and images. Please click the page to advance the slide.
  • Because of its variety of effects or biomechanisms, this technology is applicable to a variety of diseases, and the research opportunities are abundant. The three primary mechanisms of focused ultrasound are destroying tissue, delivering drugs, and dissolving blood clots. Other mechanisms are also being investigated.
  • Each of the images to the right act as a link to slides depicting the treatment of that specific indication.
  • This global landscape slide shows milestones reached by each of the different diseases that are currently being treated or have been proposed for treatment using focused ultrasound technology. Uterine Fibroid treatment has benefitted 8,000 patients worldwide while earning the CE Mark and FDA approval. Treatment for Bone Metastases has provided pain relief to several hundred patients, and this CE Mark therapy achieved FDA approval in 2012. Researchers performed a pilot study at the University of Virginia in 2011 on 15 patients with Essential Tremor, and the initial results have initiated a continued study. Researchers at the University of Zurich have treated 30 patients with intractable Neuropathic Pain from conditions like shingles, amputations, or nerve with injuries. Data from studies conducted on several hundred patients with Breast Tumors in Japan, Germany, and Italy has been stuck at the FDA for 4 years; hopefully this log jam will soon be broken. Two patients with Parkinson’s Disease were treated in Zurich, and we began a pilot study at the University of Virginia in October 2012. Other cancer studies include Prostate Cancer (30 patients in Russia, Italy, Canada, Singapore, and India); Pancreatic Tumors (5 patients in London and Rome); Liver Tumors (a handful in London); and Brain Tumors (new studies enrolling in Toronto, Zurich, and Charlottesville). Ongoing experiments that will lead to clinical trials are currently being conducted on Stroke, Diabetes, Benign Prostatic Hypertrophy, Alzheimer’s Disease, Osteoarthritis, and Osteoid Osteoma. Preclinical studies are underway for Epilepsy. Experiments for Hypertension, Kidney Tumors, Thyroid Tumors, Esophageal Tumors, Colon Tumors, Bladder Tumors, and other Soft Tissue Tumors are on the drawing board. Finally, Korean researchers are organizing a trial for Obsessive-Compulsive Disorder.
  • Imagine treating a brain tumor without surgery, radiation therapy and/or the harmful effects of chemotherapy.
  • Focused ultrasound technology is not applicable to all conditions. It will not work to treat aneurysms (in the head or abdomen), multiple sclerosis (better treatments are on the horizon), leukemia (there is nothing to target), lung tumors (ultrasound does not go through air), or traumatic brain injuries.
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  • The Focused Ultrasound Foundation is a unique, innovative medical technology research, education and advocacy organization that serves as the catalyst for the development and adoption of focused ultrasound.The Foundation was founded in 2006 as an entrepreneurial, tax-exempt organization that is market driven, high performance, and action and results oriented.  It is located in Charlottesville, Virginia but exerts a global impact.The Foundation's uniqueness derives from the fact that it is addressing a technology rather than a pharmaceutical. Furthermore, it is a platform technology that exerts a wide range of biological effects ̶ or mechanisms of action ̶ on a wide variety of medical disorders.The Foundation is on the leading edge of both the venture philanthropy and social entrepreneurship movements and has become a prime example of how private philanthropy can work in conjunction with academia, government and industry to bridge the gap between laboratory research and widespread patient treatment.
  • Click the first blue arrow to read more about the Foundation’s management practices. Click the second blue arrow to learn how the Foundation ‘primes the pump.’
  • To execute this strategy, the foundation has created an organization which is very flat and flexible and responsive to rapid shifts in the market and technology.  The organization was built with the philosophy that ‘A's attract A's and B's attract C’s’ and is populated by individuals who are athletes – who can perform multiple functions. 
  • Select the blue arrows to view further details, including a donor list and appropriation of funds.
  • This slide marks the end of the presentation. The slides that follow are linked to various places within the previous slides.
  • Seven years ago, one small, pioneering Israeli company (InSightec) began commercializing focused ultrasound technology. Today, the industry has grown to nine companies worldwide. Philips Electronics, a large, conservative Dutch company that has a reputation for creating very high quality medical devices, jumped in with both feet and embraced this technology a few years ago, and this fact is a true validation of the field.
  • At this early stage of innovation (infancy, as previously noted), approximately 100 commercial treatment sites are located around the world. This number represents only 2% of the estimated 5,000 sites needed when focused ultrasound is in widespread use. Another 150 research sites are conducting scientific studies, and about half of these are in the United States.
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  • To execute this strategy, the foundation has created an organization which is very flat and flexible and responsive to rapid shifts in the market and technology.  The organization was built with the philosophy that ‘A's attract A's and B's attract C’s’ and is populated by individuals who are athletes – who can perform multiple functions. 
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  • Fusf presentation to share 11.20

    1. 1. Focused Ultrasound
    2. 2. “Without health there can be no happiness.”
    3. 3. Two Stories Focused Ultrasound Technology Focused Ultrasound Foundation
    4. 4. Focused Ultrasound Early stage, revolutionary, noninvasive therapeutic technology Alternative or adjunct  Surgery  Radiation therapy  Drug delivery Transform treatment  Benign and malignant tumors  Metastatic cancer  Parkinson‟s disease & epilepsy  Back pain, hypertension
    5. 5. Early Stage MR 30 years ago  Unknown  Revolutionized diagnoses  Affects everyone Focused Ultrasound today  Unknown; “Medicine‟s Best Kept Secret”  As important to therapy as MR is to diagnoses  In 10 years, may affect everyone Infancy  Not science fiction  Real today
    6. 6. Essential Tremor Treatment Awake, no anesthesia No incisions No burr holes No electrodes No infection No blood clots No brain damage
    7. 7. Uterine Fibroid Pre-treatment
    8. 8. Uterine Fibroid Hysterectomy        Major surgery General anesthesia Painful Hospitalization 6 weeks recovery Side effects No more children Focused Ultrasound        Noninvasive, no incision Conscious sedation Minimal discomfort Outpatient 1 day recovery No side effects Preserved fertility
    9. 9. Uterine Fibroid Pre-treatment 9 months post-treatment
    10. 10. Breast Cancer Pre-treatment Two weeks post treatment
    11. 11. What is Focused Ultrasound? How does it work?
    12. 12. Marriage of Two Innovative Technologies Focused ultrasound  Treat tissue deep in body non-invasively
    13. 13. Marriage of Two Innovative Technologies Magnetic resonance (MR) or ultrasound (US) imaging  Identify and target tissue to be treated  Guide and control treatment in real time  Immediate confirmation of effectiveness
    14. 14. Focused Ultrasound: The Principle Analogous to a magnifying glass focusing rays of the sun…
    15. 15. Focused Ultrasound: The Principle Multiple intersecting beams of ultrasound  Focused with extreme accuracy (1 mm diameter)  Target in body • Individual beams pass harmlessly through adjacent tissue • Profound effect at point of convergence
    16. 16. Effects at Focal Point Thermal ablation Histotripsy Deliver drugs Dissolve clots: sonothrombolysis Radiation sensitization Drug activity enhancement Sonodynamic therapy Coagulate blood vessels Amplification of cancer biomarkers Immunomodulation Neuromodulation Vasodilation Vasoconstriction Variety of effects, variety of disorders Stem cell delivery
    17. 17. Destroy Tissue: Thermal Ablation Heating any tissue to 130 F (56 C) for 1 second  Denatures proteins  100% cell death: normal and abnormal
    18. 18. Focal Drug Delivery Deliver drugs in high concentrations  Precisely where needed, minimizing systemic toxicity
    19. 19. Lipid Microbubbles
    20. 20. Lipid Microbubbles Chemotherapeutic agents; genes; growth factors
    21. 21. Microbubbles Injected
    22. 22. Distribution of Microbubbles
    23. 23. Drugs Released at Focal Point
    24. 24. Focused Ultrasound Procedure Targeting Planning Treating Confirming Uterine Fibroids Essential Tremor Brain Tumors
    25. 25. Focused Ultrasound vs Radiation Single treatment Immediate and verifiable effect Greater precision and accuracy Real time localization No cumulative dose No limitations on lesion size No limitations on number of treatments No secondary malignancies 100% cell death Sharp margins
    26. 26. Sharp Margins Liver Treated 1 mm Brain
    27. 27. Global Development Landscape Conceptual Preclinical Anecdotal Pilot Pivotal Other Approvals FDA Reimbursement Neurological Oncological Musculoskeletal Essential Tremor Parkinson‟s Disease Neuropathic Pain Brain Tumors OCD Epilepsy Stroke Hydrocephalus Trigeminal Neuralgia Alzheimer‟s Disease Cancer Pain Depression Bone Prostate Tumors Thyroid/Parathyroid Breast Cancer Pancreas Soft Tissue Liver Kidney Head, Neck Cancer Lung Bladder Colon Esophagus Back Pain Osteoid Osteoma Osteoarthritis Sacroilitis Women’s Health Cardiovascular Miscellaneous Uterine Fibroids Uterine Adenomyosis Breast Fibroadenomas Hypertension Atherosclerosis Atrial Fibrillation Septal Perforation Acute Tubular Necrosis Obesity Diabetes Glaucoma Benign Prostatic Hypertrophy Ureterocele
    28. 28. Global Development Landscape Reimbursement Sparse Clinical Trials Regulatory: FDA Uterine Fibroids Pain from Bone Metastasis Anecdotal Osteoarthritis Thyroid/Parathyroid Brain Tumors Hypertension Breast Tumors OCD Pancreatic Tumors Kidney Tumors Liver Tumors Neuropathic Pain Parkinson‟s Disease Essential Tremor Soft Tissue Tumors Prostate Cancer Uterine Adenomyosis Breast Fibroadenomas Regulatory: Outside US Essential Tremor Parkinson‟s Disease Neuropathic Pain Uterine Fibroids Uterine Adenomyosis Breast Fibroadenomas Breast Tumors Prostate Cancer Thyroid/Parathyroid Pain from Bone Metastasis Pancreatic Tumors Liver Tumors Soft Tissue Tumors Osteoid Osteoma Back Pain Kidney Tumors Preclinical Hydrocephalus Epilepsy Alzheimer‟s Disease Stroke Atherosclerosis Obesity Atrial Fibrillation Diabetes Septal Perforation Sacroilitis Trigeminal Neuralgia Glaucoma Acute Tubular Necrosis Benign Prostatic Hypertrophy Head & Neck Cancer Lung Cancer Ureterocele Conceptual Cancer Pain Bladder Cancer Colon Cancer Esophageal Cancer Depression
    29. 29. Imagine the Future Advances in technology  Imaging  Focused ultrasound  Focal drug delivery Undreamed-of applications
    30. 30. Snake Oil: Cure-all
    31. 31. Magnetic Resonance Imaging Insert MR videos
    32. 32. Limitations Scoliosis Leukemia Traumatic Injuries
    33. 33. Potential Impact on Millions of People Urgent need: widespread availability of focused ultrasound  Saving time, saving lives Delay results in unnecessary death, disability and suffering  Countless individuals: friends, family, you
    34. 34. The Problem Medical device development and adoption slow Decades: concept to adoption as standard of care
    35. 35. Process, Complicated and Inefficient Patient advocacy Evidence, safety, efficacy, cost Technology R&D IP generation and protection Design, engineering, manufacturing Pre-clinical proof of concept Regulatory approval Marketing, sales, support Training and credentialing Insurance reimbursement Physician and Scientist education Physician advocacy
    36. 36. Organizations with Different Agendas Patients Academic research sites Private philanthropy Disease specific foundations NIH Venture capital, private equity Industry FDA Insurers Patient advocacy organizations Medical societies Treatment facilities Physicians, numerous specialties
    37. 37. Obstacles Technical and engineering Awareness and acceptance, patients and physicians Cultural and turf issues Financial Regulatory Reimbursement
    38. 38. The Solution Obscure No roadmap, examples or formulas Obligated to invent
    39. 39. The Challenge "There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things."
    40. 40. It‟s all about the patients saving time, saving lives
    41. 41. Purpose of the Foundation Development Adoption Millions of Lives Improved
    42. 42. Overview Founded 2006  Catalyst to accelerate the development and adoption of FUS Charlottesville based, global impact Tax exempt, high performance, entrepreneurial  Market driven, action and results oriented Essence of activities  Foster collaboration  Knowledge: create, aggregate, share Model  Venture philanthropy, social entrepreneurship  Private funding bridges gap between research & treatment
    43. 43. Unique, Hybrid Organization Device: platform technology Variety of clinical indicators Fulfill multiple roles Focused Ultrasound Foundation Medical & Scientific Society Manufacturers Trade Association Patient Advocacy Organization Patient Support Organization Research & Education Foundation
    44. 44. Vision Focused Ultrasound     Improve quality of life and longevity Millions of patients worldwide Serious medical disorders Shortest time possible
    45. 45. Mission Accelerate development of new applications     Fulfill unmet critical medical need Superior to best current therapies Reimbursable Widely available as standard of care Accelerate adoption as standard of care
    46. 46. Culture Patient centric  Uncompromisingly, passionately, obsessively committed to rapidly improving quality of life Catalytic, small, nimble, potent  Reputation, contagious enthusiasm and energy  Instill in others enthusiasm and energy to precipitate change Entrepreneurial  Create reality from imagined future through human action  Accomplishments exceed assets available Pioneering  Pursuit of excellence  Hard work, risk taking, innovation
    47. 47. Strategic Focus It's all about the patients: saving time, saving lives  Litmus test of actions and expenditures
    48. 48. Positioning, Nexus of Organizations Academic research sites Venture capital, Patients Academic private equity Treatment facilities research sites Private philanthropy Disease specific foundations Industry Insurers NIH Private Disease specific Venture capital, private equity philanthropy foundations Industry Insurers FDA Patients Patient advocacy organizations Patient advocacy Medical societies organizations Treatment facilities Medical societies FDA NIH Physicians, Physicians, numerous specialties numerous specialties
    49. 49. Currency and Incentives Reputation: trusted, independent, unbiased, 3rd party Contagious passion and enthusiasm Information Funding
    50. 50. Activities Influence direction Foster collaboration Change behavior and policy Create knowledge: clinical evidence, best practices & standards Cultivate the next generation Convene the community Collect and disseminate information Increase awareness: communications Overcome barriers
    51. 51. Influence Direction Define areas of clinical benefit Prioritize indications Market oriented approach  Segment to achieve natural advantage  Pick battles  Rapid success
    52. 52. Foster Collaboration Rapidly achieve a critical mass of effort and knowledge Approach  Stimulate innovation  Leverage intellectual capital  Coordinate activities, avoid duplication
    53. 53. Change Behavior & Policy Amalgamate stakeholders into a cohesive ecosystem  Patient centric  Sense of urgency
    54. 54. Develop Evidence of Safety, Efficacy Organize, conduct and fund research Niche: translational, application > discovery  Preclinical, clinical, technical  High risk, early stage, broad impact Iconoclastic model  Collaboration vs. individual glory  Patient centric vs. investigator centric  Commercially successful products vs. publications, grants, promotion Programs, tightly managed, milestone driven  External award: investigator initiated • Competitive, peer reviewed  Internal, Foundation initiated • Brain, liver • Contracts with academia, industry
    55. 55. Establish Best Practices, Set Standards Research, training, patient care Centers of Excellence: multidisciplinary luminary sites  Showcase for technology  Venue for collaboration Partnership of academia, industry and the Foundation
    56. 56. Centers of Excellence UVA Focused Ultrasound Center  Partnership     University of Virginia Commonwealth of VA FUS Foundation InSightec and GE Institute for Cancer Research, London  Partnership  Royal Marsden Hospital  FUS Foundation  Philips Medical
    57. 57. Cultivate the Next Generation Educate clinicians and scientists Fund fellowships and internships
    58. 58. Convene the Community Organize and fund meetings, symposia, workshops  Exchange knowledge and ideas  Foster collaborations and partnerships Foundation Organized Foundation Supported
    59. 59. Collect and Disseminate Knowledge Website Newsletter Journal Collaborative Network Social Media
    60. 60. Website – fusfoundation.org Encyclopedia of Focused Ultrasound Source of information  Comprehensive  Trusted  Up to date
    61. 61. Newsletter Published monthly
    62. 62. Journal Online, open access, peer reviewed Partnership with International Society for Therapeutic Ultrasound
    63. 63. Collaborative Network Inventory, updated quarterly on website     Laboratory research sites, investigators and projects Clinical research sites Commercial treatment sites Manufacturers
    64. 64. Social Media facebook.com/focusedultrasound @FUSFoundation
    65. 65. Increase Awareness: Communications Inform stakeholders, heat up environment, advance field Awareness events Media relations
    66. 66. Media Relations
    67. 67. Media Relations (cont.)
    68. 68. Media Relations (cont.)
    69. 69. Overcome Barriers Regulatory: partner with FDA, bridge not a barrier  Pathway for new indications: preclinical & clinical studies Reimbursement: obtain coverage & payment  Evidence of safety, efficacy, cost  Patient advocacy  Physician advocacy
    70. 70. Strategy Leverage capital: Cofunding and funding, indirect costs, royalties Best in class management practices  Transparency, accountability  Continuous quality improvement, policies, procedures, systems Align vision, mission, strategy, organization, culture, resources Prime the pump  Engage Foundations, Government, Industry, VC's  Assume functions of Foundation
    71. 71. Organization Flat: flexible, responsive to market and technology shifts 17 Athletes, A-players     Unbounded, highly intelligent, highly educated Healthcare professionals with over 140 years of experience 3 Ph.D.'s, 3 M.B.A.'s, 2 M.D.'s Interns Organized in teams
    72. 72. Portfolio of Programs Research Collaborative network Educational fellowships Meetings, symposia, workshops Centers of Excellence Regulatory Reimbursement Communications Website Newsletter Online, open-source journal Accelerate development and adoption
    73. 73. Board of Directors…active, engaged, passionate Neal F. Kassell, M.D. Edward D. Miller, M.D. Chairman, Focused Ultrasound Foundation Professor, Department of Neurosurgery, University of Virginia Former CEO, Johns Hopkins Medicine Dorothy N. Batten Frederic H. Moll, M.D. Former Director, Landmark Communications Co-founder, Intuitive Surgical Co-founder and Executive Chairman, Hansen Medical S. Morry Blumenfeld, Ph.D. Steve H. Rusckowski Founding Partner, Meditech Advisors Management CEO, Quest Diagnostics Former CEO, Philips Healthcare Eugene V. Fife Lodewijk J.R. de Vink Founding Principal, Vawter Capital Founding Partner, Blackstone Health Care Partners John R. Grisham Andrew C. von Eschenbach, M.D. Author Daniel P. Jordan, Ph.D. President Emeritus, Thomas Jefferson Foundation, Inc. President, Samaritan Health Initiatives
    74. 74. Academic and Corporate Relationships S. Morry Blumenfeld, Ph.D.  InSightec, Shareholder Neal F. Kassell, M.D.  InSightec, Shareholder  UVA, Faculty Member Andrew C. von Eschenbach, M.D.  Histosonics, Director and Shareholder
    75. 75. Council Purpose  Harness goodwill, increase awareness Members  Passionate, enthusiastic advocates • • • • • • • • • • • • Jane P. Batten (Co-chair) Charles H. Seilheimer, Jr. (Co-chair) John B. Adams, Jr. Ellen Block Edgar M. Bronfman, Sr. Thomas N. & Nancy J. Chewning Norwood & Marguerite Davis Diane Heller Cecelia S. Howell Dean L. Kamen Robert Khayat, Ph.D. Shirley Lin, Ph.D. • • • • • • • • • • • • Amanda Megargel Michael Milken Paula Newcomb Wyndham G. Robertson Mary Lou Seilheimer Alice H. Siegel Aaron Stern, M.D., Ph.D. Howard & Fredi Stevenson Jack Syer The Honorable Nicholas F. Taubman Kitchie Tolleson Linda K. Zecher
    76. 76. Resources – Financial Capital Committed to date $54 million     62% from Individuals 24% from Corporations/Organizations 10% from Government 3% from Foundations Next 3 years: invest additional $25 million      Research Fellowships Centers of Excellence Regulatory & Reimbursement Symposium, Website, Newsletter, Journal
    77. 77. Fund Raising Model Patients are impatient Target venture philanthropists     Rapid decisions Results oriented Staying power Substantial capacity (value every dollar, every donor)
    78. 78. Value Proposition Once in a lifetime opportunity  Investment with extraordinary return  Social not economic Big idea, compelling story, noble cause Perfect timing Best in class management practices
    79. 79. Results – Accelerating Adoption Magic moment in evolution  Opportunity to make a difference Early stage  Small investment = large impact No major theoretical or technical barriers  Development > Discovery Brute force application of $ enormous progress
    80. 80. Accelerating Development and Adoption 2026 +$20 2024 +$35 2022 +$50 million 2020 +$65million 2028 2030 +$5 2013 Development Adoption Millions of Lives Improved
    81. 81. It’s all about the patients It‟s all about the patients: Saving time, Saving lives Saving time, Saving lives
    82. 82. Focused Ultrasound Manufacturers Acublate SJTU SUNTEC
    83. 83. Research and Commercial Treatment Sites 140+ Research sites 380+ Commercial treatment sites
    84. 84. 87
    85. 85. 88
    86. 86. 89
    87. 87. 90
    88. 88. 91
    89. 89. 92
    90. 90. 93
    91. 91. 94
    92. 92. Global Development Landscape 2 Reimbursement FDA 14 2 2 Other Approvals Pivotal Pilot Anecdotal Preclinical 14 4 Q3 2013 Conceptual
    93. 93. Dissolve Bloodclots: Sonothrombolysis 1/4
    94. 94. Dissolve Bloodclots: Sonothrombolysis 2/4
    95. 95. Dissolve Bloodclots: Sonothrombolysis 3/4
    96. 96. Dissolve Bloodclots: Sonothrombolysis 4/4
    97. 97. Procedure: Targeting Structures to be avoided Region to be treated
    98. 98. Procedure: Planning Automatic planning
    99. 99. Procedure: Treatment Temperature measurement
    100. 100. Procedure: Guidance Move to next target
    101. 101. Procedure: Confirmation Pre treatment Treatment plan Post treatment
    102. 102. Internship Program Back to Activities Slide Back to Organization Slide
    103. 103. Procedure: Targeting Structures to be avoided Region to be treated 1/4
    104. 104. Procedure: Planning Automatic planning Manual adjustment 2/4
    105. 105. Procedure: Treatment Real time guidance Temperature measurement Adjust treatment parameters 3/4
    106. 106. Procedure: Confirmation Confirmation of effectiveness Retreat if necessary 4/4
    107. 107. Pre-treatment 1/5
    108. 108. Targeting 2/5
    109. 109. Planning 3/5
    110. 110. Post-treatment Confirmation 5/5
    111. 111. Sonication size
    112. 112. Unique Accelerate development of device Platform technology  Multiple mechanisms of action  Variety of medical disorders 116
    113. 113. Patient Support Organization Advocacy Group: Grass Roots  Increase Awareness • Patients • Physicians • Insurers Facilitate Reimbursement Fibroid Relief: Prototype FR Website – 71,000 visitors since January 2009 117
    114. 114. Team Mark Adcock Rachel Browning Matt Eames, Ph.D. Jessica Foley, Ph.D. Arik Hananel, M.D., M.B.A, BsCs Melissa Healy Sara Horton Heather Huff-Simonin, M.B.A. Robin Jones Neal Kassell, M.D. Susan Klees Pamela Minetti, M.B.A. Dave Moore, M.Sc. Jill Roberts Whitney Robertson Mary Rose Serafini John Snell, Ph.D. Interns 118
    115. 115. Potential Impact, Urgent Need Cumulative adoption Without the Foundation With the Foundation 2000 2010 2020 Millions of People 2030
    116. 116. Use of Funds       Research Meetings, Symposia, Workshops Fellowships Centers of Excellence Reimbursement Initiative Core Programs $9 million $1 million $1 million $1 million $1 million $7 million 120
    117. 117. Research  External Awards $2 million  Parkinson‟s Disease $2.4 million  Brain Tumors $850,000  Pancreatic Cancer $250,000  Liver Cancer $250,000  Breast Cancer $600,000  Stroke $600,000  Epilepsy $500,000  Brain Technology $800,000  Back Pain $500,000 $9 million 121
    118. 118. Management Practices Highest standards, not-for-profit, for profit  Best practices: policies, processes, systems  Continuous Quality Improvement  People Strategic Plan  Reviewed and updated frequently  Acting > studying and planning Culture  Entrepreneurial, market driven, results oriented  Patient centric: It‟s all about the patients Operating plan and program management  Updated annually, quarterly, weekly 1/3 122
    119. 119. Management Practices Governance     Articles of incorporation, bylaws Board of Directors; represent all stakeholders Audit & compensation committees Legal review Finance      Monthly reporting with audit committee review External audit of annual financials and 990 Annual 501(c)(3) tax status review Prudent investment policy Comprehensive insurance coverage 2/3 123
    120. 120. Management Practices People      Philosophy: „A‟ players, athletes Quarterly performance review against objectives Biannual external compensation review Structured hiring/termination process Employee handbook Research awards and contracts     Contracting: legal and sponsored program expertise Peer reviewed: research advisory committee Competitive: program funding committee Monitoring: milestones, progress reports, payments IT Infrastructure  Backups, security, redundancy 3/3 124
    121. 121. Use of Funds        Research Fellowships Centers of Excellence Communications Reimbursement Miscellaneous Development $9.6 million $1.4 million $4.1 million $3.6 million $1.8 million $400,000 $2.2 million $23 million 125
    122. 122. Individual Donors (updated 9/19/12) Anonymous Bob and Glorie Bailie Baker Construction Group Aimee and Frank Batten, Jr. Foundation D.N. Batten Foundation Frank* and Jane Batten Mr. and Mrs. David A. Beach Anson and Debra Beard The Bernstein Law Firm, LLC Ms. Lois Berry Birdsall Family Fund Ellen and Ronald Block Family Foundation Dr. and Mrs. S. Morry Blumenfeld Rich and Roxanne Booth Charles R. Bronfman Edgar M. Bronfman and Jan Aronson Peter and Nancy Brooks Scott Byron and Company, Inc. Phebe Cambata The Caruthers Foundation Mr. and Mrs. Norton E. Cater Mr. and Mrs. John Chamales Roy R. Charles Charitable Trust Derwood and Johanna Chase Tom and Nancy Chewning Christian Broadcasting Network, Inc. Moffett and Dupre Cochran Mr. and Mrs. Victor M. Dandridge, Jr. Mr. and Mrs. Terrence D. Daniels Mr. and Mrs. John Stewart Darrell Mrs. Margareta C.H. Douglas* Mrs. Francis Dulaney Joan and Barry Elman Mr. and Mrs. Albert D. Ernest Fibroid Foundation Eugene V. Fife Family Foundation Bruce D. Fisher Margaret and Thomas Flynn Penny and John Freund Mr. and Mrs. Donald Geller Struthers and Frederick Gignoux Mark and Judy Giles Leslie and Richard Gilliam Mr. and Mrs. Donald Goldsmith Ms. Audrey Gould Julann Griffin Marge and Joe Grills Mr. and Mrs. Eugene R. Hack, Jr. 1/3 126
    123. 123. Individual Donors (updated 9/19/12) Jim and Sue Haden Carolyn Hadesman and Family John A. Hartford Foundation, Inc. Matching Gift Program The Hassenfeld Foundation Diane and David* Heller Herndon Foundation Mary Buford and Frederick P. Hitz The Joseph M. and Lisa B. Hogan Charitable Fund Ulrike Hoffmann-Burchardi and Dirk Willes Horton Foundation Fund in CACF The Horwich Family Foundation Mr. and Mrs. Robert M. Huff Chad D. Inman Dean Johnson Mr. Thomas N.P. Johnson, III Lou and Dan Jordan Drs. Neal and Lee Kassell Marcia and Jonathan Kean The Keeley Family Foundation The Kellogg Organization, Inc. Mr. and Mrs. Donald A. King, Jr. Mr. and Mrs. Douglas M. Kinney Mr. James B. Klutznick Mrs. Delores J. Kuberka Mr. and Mrs. Fritz R. Kundrun Diana Levin Lawrence and Carol Levy Dr. Stanley H. Levy John L. Lewis, IV Mr. and Mrs. Harvey L. Lindsay, Jr. Terry J. Lockhart Mr. and Mrs. John Lucey St. Luke‟s Hospital John and Dudley MacFarlane Chrisanne Mannion Paul and Diane Manning Jill Kiersky and Andrew Marcus Mr. and Mrs. Donald Mazzoni Janice McArdle Cancer Research Foundation Patrick McCarthy Melville Foundation Methodist Hospital Milken Family Fund Mitford Children‟s Foundation Frederic Moll Mr. and Mrs. Victor A. Morgenstern Thos. Nelson Jr. Initiative of the Community Foundation Serving Richmond and Central Virginia Paula and Rob Newcomb Dick and Judy Nunley 2/3 127
    124. 124. Individual Donors (updated 9/19/12) Joy Marie Polefrone Prince Charitable Trusts Dr. M.G. Pat Robertson The Robertson Foundation Wyndam Robertson Mr. and Mrs. Thomas C. Rodeno Felicia W. Rogan Madison Rogers Harry and Ady Rosenberg Mr. and Mrs. Charles M. Rotgin Steve and Deborah Rusckowski Mr. Raymond L. Rusnak Cari and Michael Sacks The Adler Schermer Foundation Valerie Beth Schwartz Foundation Mr. and Mrs. Charles H. Seilheimer, Jr. Linda Rae Sher Rick and Sherry Sharp, The Community Foundation Serving Richmond and Central Virginia Dr. James A. Shield, Jr. Alice H. Siegel Mr. and Mrs. Thomas A. Silberman Jane-Ashley and Peter Skinner Albert H. Small The Eddie and Jo Allison Smith Family Foundation, Inc. Oscar F. Smith/Marjorie Smith Charles Charitable Fund of the Community Serving Richmond and Central Virginia Robert H. Smith Family Foundation Mr. and Mrs. Francis M. Stanis Barbara and Cyrus Sweet III Virginia and John Syer Fay Davis Taylor In Memory of Bertrand L. Taylor III Sandra Thomas Jane Tolleson Ms. Cecile Trop Sarah Beck and Wojtek Uzdelewicz Eleanor Cameron Van Clief Foundation Mrs. Faith Van Clief Sheri Waddell Mr. and Mrs. Herbert S. Wander Mark Warner and Lisa Collis The Watterson Foundation R. Ted and Sheila Weschler Custis Westham Fund of the Community Foundation Serving Richmond and Central Virginia Jane Woldenberg Family Foundation Laurie and Bruce Zessar Michael Zoller Family Philanthropic Fund 3/3 128
    125. 125. Corporate Donors and Sponsors Abbott Laboratories Cooley Godward Kronish Crutchfield Corporation EDAP Elbit Elekta GE Healthcare IGT Imasonic InSightec International Society for Therapeutic Ultrasound (ISTU) JJA Instruments JP Morgan The Kellogg Organization, Inc. Meditech Advisors Methodist Hospital Microsoft Ogilvy Public Relations Philips Healthcare Siemens St. Luke‟s Hospital Supersonic Imagine Theraclion University of Virginia Varian Medical Systems Foundation 129
    126. 126. Process, complicated and inefficient Patient advocacy Evidence, safety, efficacy, cost Technology R&D IP generation and protection Design, engine ering, manufacturing Pre-clinical proof of concept Regulatory approval Marketing, sales, support Training and credentialing Insurance reimbursement Physician and Scientist education Physician advocacy
    127. 127. Uterine Fibroids before treatment planning post-treatment Approved: FDA 2004, CE: 2003
    128. 128. Pain Palliation of Bone Metastases Patient with osteolytic breast cancer metastasis at right iliac bone Pain score of 5.5 before treatment reduced to 0 at 3M follow up CT Before Treatment Note: At 3M new bone formation and thickening of cortical layer in treatment area
    129. 129. Prostate Cancer - Transrectal
    130. 130. Prostate Cancer - Transurethral
    131. 131. Breast Cancer Pre-treatment Two weeks post treatment
    132. 132. Liver Tumors post treatment dose maps (in blue) and post treatment T1W C
    133. 133. Facet Rhizotomy Focused ultrasound energy treats in the same locations as RF ablation
    134. 134. Neuropathic Pain – Zurich Research
    135. 135. Brain Tumors Accumulated thermal dose at end of treatment Diffusion weighted image immediately after treatment T1w contrast enhanced image immediately after treatment
    136. 136. Capsulotomy for OCD 140
    137. 137. Focused Ultrasound Foundation FUSF

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