Could this ‘Skype for microscopes’ change the game for cancer diagnosis in the developing world?

When Lou Auguste went to Haiti in 2010 after a massive earthquake killed more than 160,000 people there, he expected to stay only for a short while. Instead, he was there for more than a year, aiding first responders and clinicians.

“There’s not much to prepare you for an experience like that,” said Auguste, who is Haitian-American.
Among the devastation he witnessed in Haiti, one challenge stood out to him. The island of nearly 10 million people only had four pathologists available to diagnose infectious diseases, such as cholera, that were breaking out among survivors of the earthquake. Getting lab results often required a six-hour drive across the country, Auguste said, and it could take three to five months to receive a diagnosis.
That sparked the idea for Auguste’s company, Alexapath. Alexapath enables images of microscopic slides to be shared on the web through a low-cost kit that connects the microscope to a smartphone. Alexapath’s technology allows doctors to send lab images to pathologists for faster disease identification. The standard equipment that allows clinicians to share lab slides typically costs more than $30,000, Auguste said, which puts it out of reach for many clinics and hospitals in developing countries, as well as many small towns and rural areas in the U.S. By contrast, Alexapath’s kit costs only $2,000.

Auguste launched Alexapath in 2015 after a stint in London, where he launched a company that developed television remote-control technology for the blind and visually-impaired, and later for children. Originally from Fresh Meadows, Queens, he came back to New York upon winning a competition for U.K.-based startups, but his company at the time, CookieSmart, folded after a corporate partnership fell through. That freed him to work on his passion project, Alexapath.
The company was soon selected for the NYU Tandon School of Engineering’s incubator program, where Auguste met his cofounders, mechanical engineer Dhaval Palsana and electrical engineer Shishir Kumar Malav. (We first met Auguste at NYU Engineering’s Research Expo last year.) The company won a hardware contest hosted by the American Society of Mechanical Engineers last year, landing $17,000. Now based in NYU’s Dumbo office, Alexapath was one of the companies that hosted Brooklyn Tech Triangle interns this summer.
Auguste describes Alexapath’s system as a “Skype for microscopes.” The user mounts a smartphone onto the microscope, then takes a panoramic video by using a joystick-esque controller to pan across the slide. Then, the video is sent to Alexapath’s web app, which processes the video to create a detailed image of the slide. Clinicians then use the web platform to send and receive images for evaluation.
The first locale Auguste seeks to tackle with his company’s technology is India, which has the highest rate of cervical cancer in the world. Earlier this year, the company received a $200,000 grant from the United States–India Science & Technology Endowment Fund, or USISTEF, to conduct field testing for cervical cancer screening in Bangalore, India. The company will begin running the trial in January, in conjunction with Cancer Care India, an NGO that runs rural clinics in the country, and Kidwai Memorial Hospital, based in Bangalore. Doctors at Cancer Care India’s clinics will send lab images using Alexapath’s technology to Kidwai Memorial, which will make diagnoses and return the results back to the clinic.
Alexapath’s business partner for the grant in India is Aindra, a Bangalore-based company that has developed artificial intelligence technology to pre-screen slides for abnormalities. By screening out normal images, pathologists have to look through fewer slides themselves, which speeds up the diagnosis process. The catch is, of course, that the detection process needs to be accurate; a false negative result could prove to be fatal. That’s what the field testing process is designed to gauge.

#NYUEntrepreneur AlexaPath is disrupting microscopic imaging w/ its smartphone 📱mWSI technology 🔬#NYU pic.twitter.com/5FmKL5C7VD

— NYU Entrepreneur (@NYUEntrepreneur) May 6, 2016

In addition to its work in India, Alexapath works with Justinien Hospital in Cap-Haïtien, Haiti, for cancer screening, and it is set to begin a study of its technology next month with Northwell Health in Long Island. The company’s work has personal ties for all three cofounders: Palsana and Malav are from India, and Auguste’s family is from Haiti. One of Auguste’s uncles, an engineer, was killed in the 2010 earthquake, and his family also lost a house and a pharmacy it owned.
“It’s one of those life-changing experiences that puts things in perspective,” Auguste said.
With Alexapath, Auguste sees both a huge market opportunity and a chance to help save lives. India, for instance, is home to more than 500 million women, whom Alexapath hopes to help with its cervical cancer screening trial. Auguste plans to begin selling Alexapath’s product there once field testing begins next year, then begin the process for FDA approval in the U.S. once that trial concludes. In the future, he hopes to work with the Department of Defense on infectious disease control projects and to address a wider range of diseases. Zika infections, for instance, are outside the company’s scope, since viruses can’t be detected by standard microscopes.
“We would love to help out with that, but it requires genetic testing,” Auguste said. “We’re looking to expand upon the things we can diagnose.”