One of the most successful centers of medical device innovation, Israel is wrestling with that success and adopting new models to build on it. TriVentures, a new firm that is part incubator, part VC fund, is focusing on companies at the very earliest stages of development. At the other end of the spectrum, Ofer Hi-Tech is looking to roll up companies and create the next Kyphon.

Among imaging modalities used to guide surgery, magnetic resonance imaging (MRI) is growing at the fastest rate. According to “"US Markets for Imaged-Guided Surgery Products,"” published in November 2007 by Medtech Insight, MRI systems used in surgery or interventional procedures accounted for 12.5% of the $1.24 billion in surgical interventional imaging sales in the US in 2006, and procedure volumes are expected to grow at a compound annual rate of 9.2% through the year 2011. While it's obvious that the diagnostic imaging giants are positioned to enjoy the growth in emerging applications of MRI, start-ups can profit too.

In terms of medical applications magnetic resonance imaging could serve, the modality is still underused, and that means a large, untapped growth opportunity for the entrenched large manufacturers that dominate the industry with an installed base of capital equipment. Small companies have a role to play as well, with adjunctive technologies that serve the large players, or in niches too small for the multi-billion dollar players to notice.

Intraoperative imaging using MRI brings real-time imaging into the neurosurgical suite, complementing other methods of helping neurosurgeons visualize their operating fields. Neurosurgical interest seems high, but with the technology new and extremely expensive, adoption rates are at a crawl. Two big players, Siemens and GE, are in the market. Now, Odin Medical, an Israeli start-up, is offering a lower cost, but less powerful system that it says is more practical and adequate for neurosurgeon's needs. A new deal with Medtronic's Surgical Navigation Technologies division should help drive sales.