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A Speckle of Hope: A UT Austin Project’s Journey Through & Beyond Texas Health Catalyst

April 8, 2019

Shreya Thiagarajan, a University of Texas at Austin undergraduate student in the College of Natural Sciences, writes for Texas Health Catalyst through Dell Medical School's Health Leadership Apprentice program.

Deep in the heart of Central Texas brews a new imaging technique that may change how we perform cerebrovascular surgery. For a practice that encapsulates high-stakes procedures such as tumor extraction, vascular malformation repair and aneurysm clipping, neurosurgery has a complication rate believed to hover around 15%.

The University of Texas at Austin’s Andrew Dunn, Ph.D., and his team of biomedical engineering researchers hopes to lower this statistic: The lab is currently studying neurosurgical applications of laser speckle contrast imaging. Speckle imaging allows visualization of blood flow in real time by analyzing interference patterns created from the scattering of light in a given medium, namely blood. Surgeons typically inject a dye called ICG to visualize blood vessels during neurosurgical procedures. The dye has several disadvantages, ranging from a short time window for visualization to side effects such as renal failure in some patients. The team’s novel technology can eliminate the use of ICG by replacing it with noninvasive and real-time visualization with speckle imaging.

It was midway through his doctoral program in applied physics that David Miller, Ph.D., realized his interest in health care and began transitioning into more clinical aspects of physics and engineering research. After he joined the team, they reached out to neurosurgeon Ramsey Ashour, M.D., chief of cerebrovascular surgery at Ascension Seton Brain and Spine Institute and an assistant professor at Dell Medical School. A UT Austin graduate, Ashour was excited about the opportunity to engage in translational research and develop collaborations with the biomedical engineering department. He met with Dunn’s team and discussed the types of procedures for which speckle imaging would be ideal. Thus began a longstanding collaboration between the neurosurgeon and the biomedical engineering lab.

Following a pilot study in late 2017, Dunn’s team — including Miller, Ashour and Paul Toprac, Ph.D., whose background in augmented-reality technology and business brought him to the team — applied to the Texas Health Catalyst program at Dell Medical School in hopes of taking speckle imaging to the commercialization stage for neurosurgical applications. The program selected their project to receive a consulting award through a highly competitive vetting process.

As anesthesiologist and Dell Medical School assistant professor Tony Manuel, M.D., was reviewing applications for Texas Health Catalyst, program director Nishi Viswanathan asked him if he was interested in being connected with the team. He was assigned to the team as an adviser as part of the consulting award along with Eric Mayes, Ph.D., CEO of Endomag, an imaging technology company. The advisers coached Dunn and Miller on the applications of speckle technology in health care. Manuel advised them to explore the value of this “game changer” that could be applied to more than just neurovascular technology. A health care provider himself, Manuel redirected the business focus of the team from thinking only about hospitals toward targeting medical device companies at an early stage.

Texas Health Catalyst assisted the researchers in pitching their idea to a panel of clinicians and industry that returned critical feedback. While the lab originally planned on designing augmented-reality goggles for neurosurgeons to wear during procedures, their focus shifted to imaging after conversing with the expert reviewers about the practicality and marketability of their former idea in the near term.

“Texas Health Catalyst was immensely helpful in launching the whole idea and the entrepreneurship side,” Miller explained. “We had two mentors who were useful in figuring out what it means to identify the unmet clinical need and how to adapt our idea to fit that.”

Because the Dunn lab already had funding from the National Institutes of Health, Texas Health Catalyst decided to augment the project. Nick Bryan, M.D., Dell Medical School’s chair of diagnostics, and Anthony Rodriguez from TVA Medical were brought in to help the team optimize their clinical study. Several aspects were discussed including study design, what data to capture and how to leverage strategic partnerships and craft a commercialization strategy.

Additionally, since the team did not have a solid regulatory roadmap, the program awarded them funding for a regulatory consultant to discuss what the FDA wanted to see in their proposal and set up a presubmission meeting with the FDA. Texas Health Catalyst was also able to connect the team with Wilson Sonsini Goodrich & Rosati, a law firm that sponsored startup creation. Mayes, the team’s Catalyst adviser, introduced them to Len Pagliaro, Ph.D., CEO of a spinout company. The program also connected the team to a major medical device company manufacturer that Viswanathan said “would be a great strategic partner for the future.”

Miller said he has enjoyed Dell Medical School’s openness to collaboration and the program’s focus on connecting science with commercialization strategy. “The past year has been a crash course in regulatory hurdles, clinical trials and ethics,” he said. “I’m taking classes on the business side of things, but learning about it in the classroom and living them are two very different things.”

Ashour shared a similar sentiment, noting that the interactions and experiences he’s had through this program have affirmed the reason he came here and are unique compared to traditional, established medical institutions. He said the program is “a promise of the medical school … that I, as an individual, and many people recognized and saw over a decade ago. Seeing it be realized and to participate is a dream come true.”

Manuel encourages other clinicians to get involved in Texas Health Catalyst because the clinical perspective “is really valuable.” He praised the program as a gateway to try new things and help other companies and hopes that health care evolves into an ecosystem where these partnerships become the norm. “It’s this back and forth collaboration [that helps] advance the field,” he said.

The Catalyst team and its partners continue to meet with awardees, including the speckle imaging team, regularly to find out what exactly they need to move to the next milestone. “Early stage ventures have different challenges at every stage, and we are available to provide the right support at the right time to move things forward,” Viswanathan said.

Viswanathan emphasized that Texas Health Catalyst is different from a typical startup accelerator because the support begins even before the application stage and is sustained for years after a project goes through the program. “We provide some seed funding, but our primary aim is to support UT Austin’s translational researcher community with clinical and industry expertise,” she said. “By facilitating a viable pathway to the clinic, we can add real value to the health of the community, which ties into Dell Medical School’s vision.”

The Texas Health Catalyst program has helped facilitate the translation of speckle technology for blood flow imaging through its connections to both clinicians and commercialization experts. A spinout company, Dynamic Light, led by CEO Len Pagliaro, Ph.D., is currently commercializing this innovative technology. Tony Manuel, M.D., continues to be involved in an advisory role. The team is now conducting their second clinical study where the speckle technology will be evaluated against the current standard of care. The company recently raised its seed round (which was oversubscribed) and is open to discussions with strategic partners and potential Series A investors. Please email Texas Health Catalyst for an introduction. More info about Dynamic Light can be found on its website.