System development for image-guided therapy (IGT), or image-guided interventions (IGI), continues to be an area of active interest across academic, industry groups This is an emerging field that is growing rapidly: major academic institutions, medical device manufacturers have produced IGT technologies that are in routine clinical use, dozens of high-impact publications are published in well regarded journals each year, and several small companies have successfully commercialized sophisticated IGT systems In meetings between IGT investigators over the last two years, a consensus has emerged that several key areas must be addressed collaboratively by the community to reach the next level of impact, efficiency in IGT research, development to improve patient care These meetings culminated in a two-day workshop that brought together several academic, industrial leaders in the field today The goals of the workshop were to identify gaps in the engineering infrastructure available to IGT researchers, develop the role of research funding agencies, the recently established US-based National Center for Image Guided Therapy (NCIGT), and ultimately to facilitate the transfer of technology among research centers that are sponsored by the National Institutes of Health (NIH) Workshop discussions spanned many of the current challenges in the development, deployment of new IGT systems Key challenges were identified in a number of areas, including: validation standards; workflows, use-cases, and application requirements; component reusability;, device interface standards This report elaborates on these key points, proposes research challenges that are to be addressed by a joint effort between academic, industry, and NIH participants