Electronic Health Reporter

By Ran Polikane, founder, Nanox.

The digital age has of course brought tremendous advances to healthcare, but one area in particular has lagged: medical imaging. The sad truth is that two-thirds of the world’s population still has no regular access to medical imaging. In many cases, even those who do have access to the technology still must wait weeks or months for medical scanners to become available. This means that diagnostic results often arrive too late and people do not get treated in a timely manner, sometimes with fatal consequences.

Early detection by medical imaging (or lack thereof) is perhaps the most important factor in the nearly 8.8 million lives lost each year to cancer, according to the World Health Organization. When detected early using medical imaging systems like CT scanners, cancer has a 70 percent to 99 percent survival rate, according to Marshfield Clinic Health System Foundation.

Not all of the limitations in medical imaging are technological, and it is important to note there are simply not enough radiologists and diagnostics experts being trained in this field currently. Even in developed countries like the United Kingdom, there is a serious shortage of senior radiologists; while the workload of scan interpretation has increased by 30 percent in the U.K. since 2012, the number of radiologists has increased by just 15 percent.

But, a key technological impediment is causing what I believe to be the real reason behind the disparity in medical imaging: price. For example, CT scanners can cost $3 million, even before the high cost of maintenance is figured in. This cost is well beyond the means of most healthcare systems in the world, and most countries can only afford a few medical imaging systems to service their entire citizenry. Because of this, even in a highly developed country like the U.S., some insurance companies will only cover a medical imaging procedure, such as a mammogram, every two years, not every year. So imagine how hard it is for people in developing countries to get the timely medical imaging they need.

Fortunately, however, the holdup in medical technology is relatively straightforward, and it lies at the heart of the science underpinning almost all medical imaging technology, from CT scans to MRIs. It is the source of the X-rays, which has remained unchanged since their discovery more than a century ago in 1895 by the German physicist Wilhelm Röntgen, who simply labeled this newfound ray “X,” standing for unknown. The name stuck. 

Behind even our most advanced X-ray equipment is the same analog bulb little changed from Röntgen’s era. It looks like a big lightbulb — although far more expensive, about $150,000 to $200,000 each — and similarly needs to be replaced frequently. Also like the common lightbulb, but at a much more extreme scale, these X-ray bulbs produce huge amounts of heat.

In fact, a part of the reason for the rotating inside a CT-scan is to dissipate this heat, as it would otherwise melt through the machine at more than a thousand degrees Celsius. That spinning reaches somewhere in the neighborhood of 13 G forces, meaning the machine needs to be built with the precision of fighter jets — a primary reason only a handful of companies in the entire world are qualified to make them.

The fundamental analog nature of X-ray devices is why, despite advances on the frontend thanks to the digital era, we take a step back to the 19th century the moment the X-ray turns on. Thankfully, however, I am sure it won’t always be this way; there is an enormously exciting new advance under development, which I am proud to say I am spearheading in conjunction with some of the brightest minds in physics. This technology is called ‘cold-cathodes’ — a source of X-ray that works at room temperature and can be from a device as small as the silicon chips in your computers. Instead of using heat to generate X-rays, cold cathodes use an electric field to draw out the electrons that eventually become X-rays (I am skipping a step or two for the sake of simplicity, but this the key difference). 

Cold-cathode technology has tantalized with its potential for several years, but my company, Nanox, believes we have found the key to mass production with a different process, which was originally intended for flatscreen TVs. We are converting it to far more impactful uses. The intended result would work very much like a “tricorder” on the Star Trek series: small, producing far less radiation than current methods, and most importantly, readily accessible to almost every country and village, no matter how far flung.

What if we could democratize medical imaging? What if we could provide at least one medical screening for every person on the planet every year? Through their ubiquity, cold-cathode X-ray machines could save lives with early detection, making healthcare more affordable and accessible to all people globally. Bringing the X-ray into the digital era is a critical step in achieving true democratization of healthcare. As an entrepreneur, I can’t think of anything more rewarding than that.