A three-dimensional image of a beating heart rotates on the computer monitor in Professor of Radiology Ernest Garcia’s first-floor office at Emory Hospital.
On another screen, color-coded virtual “slices” of the heart show the distribution of blood flow while the patient is at rest and during exercise. The area of the cardiac muscle with inadequate blood flow shows up as a black void.
This patient is very sick, says Garcia, and is in immediate danger of a myocardial infarction, more commonly known as a heart attack—a diagnosis the computer has made in just a few seconds using cutting-edge nuclear medicine software called the Emory Cardiac Toolbox.
“This is a collection of tools we’ve developed over thirty years,” says Garcia, who came to Emory from Cedars-Sinai Medical Center in Los Angeles in 1985. “In the beginning, whoever developed a new medical software program would just give it away for free.”
But in the late 1980s, the Food and Drug Administration stepped in to regulate medical software as a “medical device.” 
“People needed to charge for the software they created and then stand behind it,” says Garcia. “This needed to be done formally.” 
Garcia and his collaborators, including researchers at Cedars-Sinai and Georgia Tech, gained a copyright and began licensing the Emory Cardiac Toolbox program. Initially, they licensed the rights to large companies like G.E., Siemens, Philips, and Toshiba. But in 1999, they founded their own start-up company, Atlanta-based Syntermed, which sublicenses the software to the larger companies as well as selling it directly to users. The future of medical software, Garcia believes, will involve purchasing it on a pay-per-use basis directly from the Internet.
While much of Garcia’s research has been supported by the National Institutes of Health and the Georgia Research Alliance, Syntermed brings in more than $1.5 million a year in revenue—20 percent of which comes back into Garcia’s lab and is used to fund projects and augment researchers’ salaries.
Despite the mountains of extra paperwork it requires, bringing research into the marketplace is “contagious,” says Garcia, who serves as Syntermed’s chief scientific advisor.
“Some of my colleagues feel that you denigrate research when you commercialize it—that you are no longer a true scientist. I feel exactly the opposite. A lot of funding is being spent on research that never amounts to anything,” he says. “Our invention should be translated to help the health of the public. If it does that, it’s going to be successful as a product.”
With 10,000 licenses sold, the Emory Cardiac Toolbox is one of the most widely applied forms of cardiac imaging around the world. “Once you feel the satisfaction of walking into a little hospital in China or Italy and they are running your software to help a patient,” says Garcia, “it makes the effort worthwhile.”—M.J.L.


© 2005 Emory University