Why are synthetic intelligence, gadget gaining knowledge of and neural networks drawing the eye of the maximum extraordinary scientists, sharpest marketers and billions of dollars in funding? It’s simple, virtually. AI can exchange the sector and most cancers studies is one of the clearest examples of just what a vital function this technology goes to play in one of the longest medical battles in human history.
Even in India, over one million new cases had been pronounced remaining yr of most cancers and in line with statistics launched with the aid of Global Cancer Observatory (GCO), out of over 1.15 Mn new cancer cases pronounced in India in 2018, extra than 10% or over 162K were breast most cancers instances. The number of deaths caused by breast most cancers in 2018, in India, turned into over 87K, which indicates the severity of the issue facing Indian healthcare companies in detecting and treating the growing incidence of breast most cancers cases in India.
Breast cancer is the largest cause of most cancers deaths in girls nowadays. According to WHO, one in every 12 girls is vulnerable to a breast abnormality. Indian girls have handiest about 50% hazard of survival, that is why early prognosis is extraordinarily essential to decrease mortality fees.
The present day technologies, that aren't appropriate for frequent screening and feature portability troubles, do not work on women below 45 years of age. Today ninety% of the ladies on a global scale stumble on breast cancer by way of hand; they by chance find a lump after which visit the medical doctor. This late detection can be averted with excellent technological intervention. Here is in which NIRAMAI has stepped in, the use of technology and AI/ML algorithms to assist ladies hit upon breast most cancers at an early level, giving them a higher danger of surviving the disease.
From Tragedy To Saving Lives: The Story Of NIRAMAI
Established in July 2016, NIRAMAI turned into co-based by using Dr Geetha Manjunath and Nidhi Mathur. With a Ph.D. From the Indian Institute of Science and has over 25 years of know-how in the IT innovation at Hewlett Packard Labs and Xerox Research, Dr Manjunath turned into well versed in how technological know-how and era can paintings collectively. Mathur were a senior product manager at Xerox Research and changed into answerable for locating product-marketplace in shape for generation studies being conducted on the corporation. As such, she was also up to date on what era is catching on inside the market. The duo made a brilliant healthy.
Dr Manjunath additionally had a stint at Xerox Research as a senior director, in which she researched more than one use cases of AI, and that’s when tragedy struck as she misplaced two young cousins to breast cancer. This heartbreaking incident have become the catalyst for her to start working on technology that assist intervene and save lives. In that country of mind, amidst a discussion with every other colleague, she learnt about thermography and its ability to locate abnormalities early.
With a small studies crew, Dr Manjunath commenced analysing thermal images of most cancers patients. Going a step in addition, she postulated to use this on everyday ladies who do not have signs, thereby permitting early detection. With the help of the team, she deployed AI algorithms to address early detection. With early promising results, Dr Manjunath decided to try this full time and created NIRAMAI with Mathur, as well as crew contributors Himanshu Madhu and Siva Teja Kakileti.
Simplifying Cancer Detection To Boost Survival
While it feels like an ancient Sanskrit word, NIRAMAI in reality stands for “Non-Invasive Risk Assessment with MAchine Intelligence”. The non-touch method screens for breast abnormalities. According to the enterprise, it is the simplest privateness-conscious automatic solution that can discover early-level breast most cancers. The affected person is made to calm down in a room for 10-15 mins before the real screening takes location. The manner takes much less than five minutes. The NIRAMAI answer is based totally on thermography, in which a thermal device is placed 3 feet in the front of the patient, which captures 5 thermal snap shots. These pix are then routinely analysed by using NIRAMAI’s software device, which sends the analysis report to a senior radiologist for certification.
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The center of NIRAMAI solution is Thermalytix, the laptop-aided diagnostic engine that is powered by artificial intelligence and device getting to know fashions. The solution makes use of a excessive-decision thermal sensing device and a cloud-hosted analytics solution for analysing the thermal pics, checking it towards its database of effective and terrible reports. Its SaaS answer uses huge information analytics, synthetic intelligence and device mastering for breast cancer screening.
Why Thermalytix Is Better Than Mammography
According to Dr Manjunath, despite the fact that mammography is the defacto general for breast most cancers screening, it has sure obstacles together with low sensitivity for ladies below 45 years of age. Since it is X-ray based totally, the test can't be done extra than as soon as in years. It is also not inexpensive for lots women.
Thermalytix is radiation-loose, and works on women of all age corporations, on the other hand. “Given that it is transportable and coffee-price, the answer makes most cancers screening greater on hand and low cost to all, Thermalytix has been shown to come across very small tumours as small as four mm,” Dr Manjunath tells CFT.
Though Thermalytix can be carried out to several varieties of different diseases, NIRAMAI’s focus is on breast fitness at this level. In the future, the company will move past breast most cancers screening to wellknown breast fitness and prognosis and analysis of different breast sicknesses. Earlier this yr, the FDA within the US issued a warning about using thermography instead for mammography. So how is Thermalytix different from thermography?
Thermography is a way wherein heat radiated from the body is captured. Due to the excessive metabolic activity of cancer cells, greater warmth is radiated from the affected area. This may be visualised as an abnormality in thermographic photographs.
Dr Manjunath explains that the use of Thermalytix for breast cancer screening is sincerely FDA-authorized as an adjunct modality and has been utilized by medical doctors round the arena. The recent FDA caution turned into to dissuade misuse of thermography by way of some clinics that claimed it as a standalone modality. Manual interpretation of thermal photos may be very complicated as the radiologist wishes to look at millions of color information points to determine if a subject is ordinary or now not.
Thermalytix, on the other hand, makes use of device analysis, instead of guide interpretation, to generate a quantitative thermal analysis report. In addition to thermal pix, NIRAMAI’s Thermalytix has a unique set of rules to discover and extract blood vessel structures from the photographs that help in figuring out deep-seated tumours, that are in any other case neglected in thermography.
“We additionally use many different demographic information from the affected person for our prediction. We have clinical courses that show good accuracy of the approach, similar or maybe higher than the cutting-edge general of care. Still, Thermalytix record can be reviewed by using a physician to decide whether or not someone is malignant and requires similarly followup. It is an aid to the physician,” provides Dr Manjunath.
NIRAMAI is presently advertising the Thermalytix-primarily based most cancers screening answer only in India and has the regulatory clearances for it. The thermal imaging device is already approved by way of america FDA as properly. The employer is operating on an FDA utility to post its scientific evaluation effects and get a clearance for Thermalytix software program for the US and different markets with comparable guidelines.
Moreover, Thermalytix is not confined to breast cancer, that is why NIRAMAI is banking at the achievement of this utility earlier than taking it to different illnesses. As an experimental research mission, NIRAMAI is likewise working on the usage of Thermalytix era to fight the unfold of river blindness. It is an contamination caused by a parasite referred to as parasitic computer virus Onchocerca volvulus transmitted by means of the bite of an infected Simulium blackfly, inflicting skin sicknesses and even blindness.
The stay grownup worms of Onchocerciasis are detected via using Thermalytix. As it is a non-invasive technique, it is anticipated to help examine the efficacy of latest tablets being evolved to govern river blindness via killing the adult worms. The Bill & Melinda Gates Foundation has supplied funding aid to NIRAMAI on this new endeavour and also get right of entry to to medical experts in Ghana who understand this ailment properly.
The other predominant tool that NIRAMAI works with is SMILE (short for Software with Machine Intelligence for Life Enhancement). It is a web interface for the NIRAMAI-certified technician to add demographic records about the affected person along side the subject’s thermal images. This is processed to examine the concern’s breast fitness situation. Their answer automatically generates a document list certain precise parameters received from patient thermal pix and additionally recommends a breast fitness score.
Dr Manjunath says NIRAMAI presently imports its thermal hardware from Sweden. “However, our answer can paintings with any true thermal imaging tool that satisfies our imaging specifications. There are some carriers in India too with whom we're running to peer in the event that they may be our destiny companions.”
Clinical Trial By Fire
As India has one of the most stringent clinical studies regulatory environments inside the world, going for walks the vital scientific trials could were a time-consuming and laborious technique for NIRAMAI. Dr Manjunath is of the same opinion that it maximum actually become.
“In India, like several processes, just taking off a scientific trial takes a whole lot of time as there are strict procedures and processes involved.”
She explains that is vital to attain a clearance from the Independent Ethics Committee, that's a collection of experts from one of a kind fields who review the proposed protocol of the trial and ensure the validity of the method to test the claims made, as well as ensure that no damage may be triggered to the sufferers within the procedure and so forth. Patient recruitment additionally takes time as frequently girls are hesitant to partake in a trial, although it’s a harmless and private process.
“Conducting scientific trials on an AI-based product is a continual system. Since we hold evolving the AI model and continue to enhance the accuracy or applicability of the answer to many other subcategories of sicknesses or different diseases, medical trials are very a great deal as the organizational want for AI-based fitness tech groups,” she adds.
NIRAMAI carried out trials at Narayana Hrudayalaya and HCG Oncology. It has also employed an unbiased expert CRO, who ensured proper scientific tips for the trial. Other hospitals have proven interest inside the trials too, Dr Manjunath tells us and NIRAMAI is in specific stages of the process in a couple of different places. “In parallel, we do retrospective trials, and as and when we get desirable results we launch the version to manufacturing and pass it to our business pipeline.”
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Further, NIRAMAI has regulatory clearance from the Ministry of Health and Family Welfare, India, Drug Control General of India (DCGI), and Central Drugs Standard Control Organisation (CDSCO) for the overall Thermalytix answer. It additionally has permission to behavior screening exams in authorities hospitals in Bengaluru as well as a few different states.
NIRAMAI: Breaking Gridlocks And Glass Ceilings
Every new beginning faces a few challenges, and so did NIRAMAI. The first and biggest project faced turned into raising finances to shop for high-resolution thermal sensors and start extreme experimentation.
NIRAMAI observed a partner in pi Ventures, an AI-focussed fund, which believed inside the technology and the team and determined to lead the seed spherical, with co-funding from Axilor Ventures and Ankur Capital.
“The next project changed into to persuade hospitals and docs to attempt the answer. Though the hospitals and the doctors noticed that the generation had advantages, NIRAMAI needed to show that their answers truely worked. They set up randomised clinical trials to evaluate their consequences with the cutting-edge wellknown of care,” says Dr Manjunath.
Talking approximately the modern-day challenges that the healthtech startup continues to be suffering with, she states that obtaining a structure in vicinity with the intention to decorate its scalability quotient and reach out to more hospitals remains a bit of a challenge. The key aspect of this project is the time involved in convincing the medical doctors. Although NIRAMAI currently has six international guides showcasing the workability of its technique, every reputed health practitioner desires to conduct a trial before utilization.
Mindset is also a key difficulty that NIRAMAI faces. Although breast most cancers cognizance is regularly growing in India, the number of women who come forward for preventative screening is minimal.
“Change within the mind-set to well-being verses sickness is the need of the hour.”
Currently, NIRAMAI has over 30 installations at hospitals and diagnostic centres throughout 10 Indian cities. It has performed screenings for over 12K girls and organised over 50 worker well being camps. It additionally companions with NGOs and cancer societies to behavior unfastened screening camps for the underprivileged.
Focus On Driving Acceptance, Not Revenue
Apart from the courses and patents, NIRAMAI has additionally received numerous national and international awards. It has obtained help and popularity from Biotechnology Industry Research Assistance Council (BIRAC), Startup Karnataka, Accenture, Philips, Google and Amazon as one of the pinnacle startups in its domain.
NIRAMAI has also gained the Best Preventive Insurance Idea award in Milan and the Gold prize in Hack Osaka 2019 International opposition held in Japan. It is likewise the simplest Indian corporation listed within the 2019 COHORT of AI 100 startups within the world by using worldwide commercial enterprise records intelligence platform CB Insights. Last yr, NIRAMAI was recognised as one of the 42 most progressive Indian startups of 2018 by CFT’s 42Next listing.
Talking about the organisation’s revenue streams, Dr Manjunath states that its primary revenue stream is from its managed breast health solution for hospitals and diagnostic centres. It also has a screening operations wing in which it conducts corporate camps with in line with-day hire fees.
And when asked about sales projection for FY 2019-20, Manjunath said the focal point is on creating extra recognition for AI solution in disorder detection. “Having proven early revenues, our cutting-edge recognition is to power recognition within the clinical network and get international regulatory clearances – no longer a lot at the sales as a minimum for the next few quarters.”
Road Ahead For NIRAMAI And Healthtech
Starting with $1 Mn in seed budget raised via Pi Ventures, Ankur Capital, Axilor Ventures, 500 Startups, and Flipkart cofounder Binny Bansal in 2017, NIRAMAI moved forward to elevate $6 Mn in Series A investment earlier this year from Dream Incubator, Beenext and existing traders. At the instant the corporation’s awareness is on commercial enterprise enlargement, which it has already efficiently kicked off over the last 12 months.
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From most effective one installation in Bengaluru remaining year, NIRAMAI has grown to have a presence in ten towns throughout India. This year, it plans to amplify to more towns. It is likewise trying to associate with numerous corporates, diagnostic centres, hospitals, NGOs, government hospitals and more for installations and engaging in screenings.
In order to ease its sales pipeline, the organization is likewise seeking to companion with a longtime medical device distributor. “We now have a vivid group of 20+ innovators and an able management crew. We are presently focussing on hiring the pinnacle control a good way to construct their group for enlargement. We are running on hiring an Engineering Director and Chief Medical Officer,” Dr Manjunath adds.
In India, NIRAMAI competes with some of most cancers-centric fitness-tech startups together with Zumutor Biologics INC, Mitra Biotech, OncoStem Diagnostics, Sascan, Exocan, and Onward Health, amongst others. However, Dr Manjunath believes NIRAMAI stands out from the opposition — maximum gadgets hit upon lumps however all lumps are not cancerous, thereby resulting in a number of fake positives.
