Pie Medical Imaging

What Pie Medical Imaging does

Pie Medical Imaging B.V. (Maastricht, Netherlands) develops and commercializes cardiovascular image analysis software for hospitals, catheterization laboratories, and academic medical centers. Founded in 1982 and operating as a fully owned subsidiary of the Esaote Group, the company sells two principal product lines: CAAS (Cardiovascular Angiographic Analysis Systems) for coronary and vascular quantification, vFFR physiological assessment, IVUS/OCT co-registration, stent enhancement, and ventricular analysis; and 3mensio for multi-modality pre-operative planning of structural heart interventions (TAVR, TMVR, TMVr, PPVI, TTVR, LAAO). The portfolio also includes CAAS Qardia (web-based echocardiography analysis) and CAAS MR Solutions (cardiac MRI analysis including 4D Flow), giving the company coverage across all major cardiovascular imaging modalities.

The underlying technology combines proprietary algorithms with semi-automated and automated workflows—CAAS vFFR builds a 3D coronary reconstruction from two standard angiograms and aortic pressure to compute fractional flow reserve without a pressure wire, while 3mensio provides automatic segmentation, valve sizing, and neo-LVOT assessment. The CAAS MR 4D Flow automated valve tracking reduces analysis time from 25 to 14 minutes versus manual methods, and CAAS Qardia 2.2 (April 2026) introduced one-click LVEF/LV Strain analysis and view-classifier automation. Regulatory clearances include FDA 510(k) (USA), CE Mark (Europe), and PMDA (Japan).

Revenue is generated primarily through enterprise site licensing (quote-based, not publicly disclosed) on an annual subscription cadence, complemented by professional services via PMI Academy training and technical support. Distribution combines direct field sales, OEM embedding through Siemens Healthineers' Cios Alpha, and regional partnerships (Meril Life for India). Customers are interventional cardiologists, structural heart interventionalists, cardiac MRI specialists, echocardiographers, and cardiovascular researchers at healthcare institutions worldwide.

Name

Pie Medical Imaging

Legal name

Pie Medical Imaging B.V.

Website

https://piemedicalimaging.com

Company type

Private

Founded year

1982

Operating status

Operating

Short description

Pie Medical Imaging develops cardiovascular image analysis software (CAAS and 3mensio product lines) used by interventional cardiologists, structural heart specialists, and radiologists at hospitals and academic medical centers globally.

Ownership category

akta.pro rank

Product category

Cardiovascular Medical Imaging Software

NAICS

Software Publishers (51321)

SIC

Surgical & Medical Instruments & Apparatus (3841)

akta.pro primary industry

Radiology AI, CAD & Advanced Visualization Software (HLAHABAJ)

akta.pro secondary industries

Non-Invasive Cardiac Imaging (Echo/CT/MRI/Nuclear) (HLAKABAE), AI Orchestration & Imaging Analytics Platforms (Model Management/Triage) (HLACALAG)

Keywords

• Cardiovascular imaging software
• Cardiac image analysis
• Structural heart planning
• Angiography analysis software
• Echocardiography analysis

Headquarters

HQ city

Maastricht

HQ country

Netherlands

HQ region

Europe

Offices2 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Personnel, Marketing or Sales, Operations, Infrastructure

Revenue model

1. Software Licenses and Subscriptions: Pie Medical Imaging sells enterprise medical imaging software licenses, likely as perpetual licenses with maintenance/subscription contracts (typical for medical device software). Software is installed on hospital servers with client access, as evidenced by the client-server architecture of CAAS Qardia and the browser-based CAAS Workstation 9.3.
2. Professional Services and Training: Training and support services provided to clinical users, as evidenced by PMI Academy (academy.piemedicalimaging.com) and dedicated support desk. Support includes DICOM image consultation and product training.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels6 records

Core offering

Pie Medical Imaging develops and commercializes enterprise cardiovascular image analysis software under the CAAS and 3mensio product lines. Its solutions cover quantitative coronary and vascular analysis (QCA/QVA), angiography-based fractional flow reserve (vFFR), cardiac MRI analysis (including 4D Flow), echocardiography analysis, and pre-procedural planning for structural heart interventions. The software is sold primarily to hospitals, catheterization labs, and academic medical centers for use by interventional cardiologists, radiologists, and cardiac surgeons.

Product overview

Pie Medical Imaging provides cardiovascular image analysis solutions through two main product lines: CAAS and 3mensio. CAAS Workstation is the core platform for intravascular imaging analysis, featuring modules for quantitative coronary analysis (QCA), vascular analysis (QVA), ventricular analysis (LVA/RVA), intravascular imaging co-registration (IV-LINQ), stent enhancement, and vFFR physiological assessment. CAAS Qardia is a web browser-based echocardiography analysis solution. Caas MR Solutions covers cardiac MRI analysis with 4D flow, functional, tissue characterization, 2D flow, and strain workflows. 3mensio Structural Heart is a multimodality platform supporting pre-operative planning across all structural heart procedures including aortic, mitral, pulmonary, and tricuspid valve interventions, as well as left atrial appendage occlusion. The company operates as a subsidiary of the Esaote Group.

Differentiator

Problem solved

Functional benefit

Brands

• CAAS: Cardiovascular Angiographic Analysis Systems - flagship software platform for coronary and peripheral artery quantification, ventricular analysis, stent visualization, and vFFR calculation.
• 3mensio
• CAAS MR Solutions
• CAAS Qardia

Products and services

• CAAS Workstation Core cardiovascular image analysis workstation for quantification of coronary and peripheral arteries, ventricular analysis, enhanced stent visualization, and vFFR calculation. Co-registers angiography with IVUS and OCT pullbacks. Used by interventional cardiologists and clinical researchers in cathlabs and research institutions.
• 3mensio Structural Heart Multimodality software platform for pre-operative planning of structural heart interventions including TAVR, TMVR/TMVr, PPVI, TTVR/TTVr, and LAA occlusion procedures. Uses MSCT and 3D TEE data for device sizing, neo-LVOT assessment, and virtual device simulation. Used by structural heart interventionalists and cardiac surgeons at tertiary care centers.
• CAAS Qardia Web browser-based complete analysis and reporting solution for 2D transthoracic echocardiography studies, featuring AI-driven workflows, automated measurements, myocardial strain analysis, left atrial strain analysis, and volumetric assessment. Uses client-server architecture requiring no local installation. Used by echocardiographers and cardiologists for routine echo reporting workflows.
• CAAS MR Solutions Cardiac MR imaging analysis suite covering 4D Flow analysis, functional analysis, tissue characterization, 2D flow quantification, and strain analysis. Supports analysis of cardiac function, valvular hemodynamics, shunts, congenital heart disease, wall shear stress, and strain parameters. Used by cardiac MRI specialists and radiologists in clinical and research settings.

Quantifiable outcome

• FAST III trial (2,235 patients): Identical 1-year MACE rates (composite of all-cause death, MI, or revascularization) between vFFR-guided and FFR-guided groups, confirming non-inferiority of angiography-based vFFR.
• +4 more outcomes

Named customers10 records

Segments6 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability9 records

Feature8 records

Partnerships

Five partnerships are on record, tiered core and regional.

• Siemens HealthineerscoreStrategic or Co-development Partner · 29 March 2026Siemens Healthineers co-funded the FAST III clinical trial (alongside Pie Medical Imaging) and provides access to its Digital Ecosystem for embedding PMI software (CAAS QVA, StentEnhancer) in Siemens Cios Alpha mobile C-arm systems. Doris Pommi, Head of Cardiovascular Care at Siemens Healthineers, publicly endorsed FAST III results. The companies have a multi-year collaboration spanning clinical evidence generation and commercial distribution.
• Cardialysis (Rotterdam, The Netherlands)coreImplementation/ SI/ Consulting Partner · 3 June 2024Cardialysis provides trial services for the FAST III trial including trial management and Core Laboratory activities. As the core laboratory for the trial, Cardialysis ensures standardized analysis of imaging data across all participating centers.
• European Cardiovascular Research Institute (ECRI)coreStrategic or Co-development Partner · 16 August 2021ECRI is the formal sponsor of the FAST III clinical trial. ECRI initiated, designed, and oversees the multicenter randomized trial comparing vFFR-guided vs. FFR-guided coronary revascularization in 2,235 patients across 37 centers in 7 European countries. ECRI's role as sponsor is essential to the clinical validation of CAAS vFFR.
• Meril LiferegionalChannel Partner/ Reseller/ Distributor · 1 March 2021Meril Life, an India-based global medical device company with operations in 100+ countries, serves as the official distributor for 3mensio Structural Heart products in India. The partnership is intended to expand 3mensio access in India and increase service, support, and customer care in the region.
• Esaote GroupcoreOthersPie Medical Imaging is a fully owned subsidiary of the Esaote Group, a leader in the biomedical equipment sector. The Esaote Group encompasses Pie Medical Imaging along with ultrasound and biomedical equipment businesses. Note: Esaote Group is listed as the Data Controller in some contexts related to Esaote's privacy compliance, indicating full corporate ownership.

Scale indicators5 records

Recent moves7 records

Expansion highlights6 records

Emerging players

• Artrya: Artrya applies deep learning to coronary CT angiography for plaque and physiology assessment. As an AI-native emerging player focused on CCTA, it is a partial competitor to Pie Medical Imaging's vFFR via a different imaging modality (CT vs angiography) targeting similar lesion-assessment use cases.
• Cleerly: Cleerly provides AI-driven coronary CT analysis for plaque characterization and stenosis assessment, addressing the same non-invasive coronary physiology market that CAAS vFFR targets. It competes for CCTA-driven cardiology decision-making workflows.

Others

• Edwards Lifesciences / Medtronic (structural heart device makers): Edwards and Medtronic are dominant structural-heart device manufacturers (TAVR/SAPIEN, TMVR) whose products are planned and validated using Pie Medical Imaging's 3mensio platform. They are ecosystem participants — clinical-trial partners and procedural stakeholders — rather than direct software competitors.
• Ziehm Imaging / Philips (2D-3D C-arm fusion, structural heart): Ziehm Imaging provides mobile C-arms with intra-procedural 3D imaging used in structural heart interventions. They are an enabling/integrated imaging vendor adjacent to Pie Medical Imaging's 3mensio structural-heart planning workflows, sharing cathlab and OR integration touchpoints.

Broad incumbents

• GE HealthCare (EchoPAC / AW Workspace): GE HealthCare provides EchoPAC for echocardiography strain/quantification and AW Workplace/MUSE for cardiovascular imaging IT. It competes with CAAS Qardia on echo analysis and with broader GE cardiology offerings against Pie Medical Imaging's cathlab and MR solutions.
• Philips (Cardiovascular Suite / IntelliSpace Portal): Philips offers a comprehensive cardiovascular imaging portfolio via IntelliSpace Portal and HeartNavigator for structural-heart planning, including TomTec-derived analysis modules. As a larger incumbent it competes on breadth and integration, though Pie Medical Imaging differentiates on specialization and QCA-grade validation.
• Siemens Healthineers (syngo.via): Siemens Healthineers distributes Pie Medical Imaging's CAAS QVA and StentEnhancer embedded in its Cios Alpha C-arm via its Digital Ecosystem and co-funded FAST III. Beyond the partnership, Siemens' syngo.via cardiovascular suite competes broadly with PMI's image-analysis stack in the cardiology ecosystem.

Direct peers

• HeartFlow: HeartFlow develops FFR-CT, a non-invasive fractional flow reserve technology using coronary CT rather than angiography. It is the most direct competitor to Pie Medical Imaging's CAAS vFFR, both targeting non-invasive physiological lesion assessment in the cathlab decision workflow.
• Medis Medical Imaging Systems: Medis markets QAngio (QCA/QVA) and QFR (a wire-free FFR analysis software) — directly overlapping Pie Medical Imaging's CAAS Workstation QCA, QVA, and vFFR modules in interventional cardiology quantification and physiology assessment.
• Circle Cardiovascular Imaging: Circle CVI provides cvi42, a leading cardiac MR/CT post-processing platform used at academic medical centers globally. It directly competes with Pie Medical Imaging's CAAS MR Solutions for CMR analysis (function, strain, 4D Flow) and with 3mensio for CT-based structural-heart planning.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks7 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/pie-medical-imaging

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Pie Medical Imaging