WEBVTT 00:00:00.000 --> 00:00:19.440 Music. 00:00:19.945 --> 00:00:23.485 Hello and welcome everybody. This is Joe from StartupRate.io, 00:00:23.625 --> 00:00:29.365 your startup podcast and YouTube blog from Germany, bringing you yet another interview today. 00:00:29.625 --> 00:00:32.525 Today, I do have Giuseppe here with me. Hey, how are you doing? 00:00:33.325 --> 00:00:37.965 Hi, Jan. Nice to meet you. Thank you for having me here. It's totally my pleasure. 00:00:38.045 --> 00:00:39.185 A little disclaimer here. 00:00:39.405 --> 00:00:42.985 Today, we do the first interview on my new computer. 00:00:42.985 --> 00:00:48.445 I was building StartupRate.io on a laptop that was first produced in 2015, 00:00:48.745 --> 00:00:55.725 and now I upgraded it seriously to a computer together with a friend who actually 00:00:55.725 --> 00:00:57.565 called the computer only the beast. 00:00:57.805 --> 00:01:01.425 So let's see how this is performing and if everything works. 00:01:01.825 --> 00:01:08.305 I actually have not all the cables yet, so that means I'm working only on one monitor, but I'm sure. 00:01:08.465 --> 00:01:12.325 I keep my fingers crossed so that everything goes well. 00:01:14.085 --> 00:01:19.865 Yeah, in Germany, thumbs press, but we do both that and everything will be totally fine. 00:01:20.065 --> 00:01:24.685 Today's episode is sponsored by StartupRaven.com, the fastest and most efficient 00:01:24.685 --> 00:01:29.825 way to find new investors, startups to connect and cooperation partners. 00:01:30.485 --> 00:01:34.485 Giuseppe, you are an Italian living in Munich. 00:01:34.665 --> 00:01:40.385 Funny note here, I've heard a lot of people from Munich referring to it as the 00:01:40.385 --> 00:01:42.065 most northern city of Italy. 00:01:42.985 --> 00:01:46.265 Yeah, exactly. So Munich is seen as the most northern city of Italy. 00:01:46.385 --> 00:01:51.505 It's because of the climate, because of the... No, it's really nice to be here. 00:01:51.605 --> 00:01:53.465 It's very close to Italy, as you know. 00:01:53.825 --> 00:01:58.345 And the atmosphere, the way of living is quite similar. 00:01:59.045 --> 00:02:02.345 And except the food. So the food we had to import. 00:02:05.085 --> 00:02:08.025 So you're not a fan of Weisswurst for breakfast? 00:02:08.645 --> 00:02:13.605 Not really. Maybe once a year I have Weisswurst. But then I go back to my Italian 00:02:13.605 --> 00:02:17.125 dishes, gnocchi and tagliatelle. 00:02:17.365 --> 00:02:20.485 And, you know, we have good food. We have a big variety there. 00:02:21.145 --> 00:02:24.945 I have to admit that they both have a certain place in my life, 00:02:24.985 --> 00:02:28.605 but actually don't tell anybody. But I prefer Weisswurst for dinner. 00:02:29.385 --> 00:02:34.505 Okay, don't tell anybody. This would be a crime in Bavaria. So don't do that. 00:02:36.505 --> 00:02:42.085 Exactly. Giuseppe, you are today here because we will talk about a serious topic, 00:02:42.285 --> 00:02:45.885 diagnosing tumors, speeding up this diagnostics. 00:02:46.165 --> 00:02:50.565 You are from a company called Viva Scope. 00:02:50.785 --> 00:02:54.325 Can you tell us a little bit about this company and the history? 00:02:54.405 --> 00:03:00.265 Because when we talked before, you told me about a very, very interesting setup here. 00:03:00.385 --> 00:03:07.485 So you're not necessarily a startup anymore. You do your R&D in Rochester, upstate New York. 00:03:07.565 --> 00:03:12.825 You're headquartered in Munich, and you have production facilities in Europe and the US. 00:03:12.965 --> 00:03:16.265 So can you walk us a little bit through all that stuff? 00:03:16.990 --> 00:03:19.690 Yeah so the whole story i mean i'm i'm now 00:03:19.690 --> 00:03:23.030 19 years with the company quite a long of time and 00:03:23.030 --> 00:03:28.070 but it started even before and it started with the in vivo application so today 00:03:28.070 --> 00:03:33.910 we will not hear a lot about in vivo diagnostic and xvivo diagnostic in vivo 00:03:33.910 --> 00:03:39.730 diagnostic was the first area of application and it's quite interesting how 00:03:39.730 --> 00:03:42.790 it started they developed the product which was 00:03:42.870 --> 00:03:45.750 supposed to check the effect of hair removal, 00:03:45.970 --> 00:03:48.570 which is a pure aesthetic application. 00:03:49.930 --> 00:03:55.430 And they wanted to see how good the quality is when you remove hair, how good the cut is. 00:03:55.710 --> 00:04:01.310 And then they realized, wow, we can see much more in the skin. We can see cells. 00:04:01.490 --> 00:04:05.650 We can see different layers in the skin. What can we do with this information? 00:04:06.050 --> 00:04:11.730 And then they started to investigate. And by now, we can use this in vivo technology, 00:04:12.150 --> 00:04:19.650 which had its origin in aesthetic, to diagnose very accurate skin diseases in 00:04:19.650 --> 00:04:21.850 vivo before cutting out anything. 00:04:22.450 --> 00:04:27.890 Okay, this is how it started. The other technology we are offering is ex vivo. 00:04:28.110 --> 00:04:30.050 This is I have to remove tissue. 00:04:30.650 --> 00:04:35.550 And here I want to have a very fast diagnosis. This is a bit the history. 00:04:35.550 --> 00:04:40.710 We may get into the background because we're talking today about diagnosing 00:04:40.710 --> 00:04:44.050 cancer, especially skin cancer. And... 00:04:45.581 --> 00:04:50.861 Everybody was thinking, fast diagnosis, you get a good diagnosis anyways. 00:04:51.181 --> 00:04:57.501 But actually, guys, listen, when you get tissue removed, you want to have the 00:04:57.501 --> 00:05:01.461 results as fast as possible to know if it's in cancer or not. 00:05:01.601 --> 00:05:04.741 Right now, how long can it take to get the diagnosis? 00:05:05.261 --> 00:05:10.261 It takes, unfortunately, quite long, 10 days up to three weeks. 00:05:10.961 --> 00:05:16.321 And this is far too long. I'm not a doctor. I have a commercial background, 00:05:16.581 --> 00:05:23.361 but I was quite shocked when I started in this area to see how long it takes to get a result. 00:05:23.601 --> 00:05:29.301 So today I can order whatever I want digitally on the Internet. 00:05:29.421 --> 00:05:33.681 I can get it the next day. But if I want to know if I have a tumor or not, 00:05:33.781 --> 00:05:35.241 I need to wait so long time. 00:05:35.941 --> 00:05:39.161 And then I started to try to understand why is this? 00:05:39.341 --> 00:05:43.661 What's the reason for that? On the other side, when we talk about skin cancer, 00:05:43.781 --> 00:05:49.801 so we're going to talk today about in vivo application means skin and all diseases 00:05:49.801 --> 00:05:53.601 around skin and the ex vivo application with the other device. 00:05:54.341 --> 00:06:01.681 It's all type of tumors from prostate cancer to breast cancer, lung cancer and so on. 00:06:02.161 --> 00:06:08.801 In the area of skin, there is an over excision rate. Let's say there is a lot 00:06:08.801 --> 00:06:12.061 of biopsies done which are not necessary. 00:06:12.421 --> 00:06:17.881 So over 60% of this removal are done because there is a suspect. 00:06:18.221 --> 00:06:22.701 But, you know, skin, I can look with my eyes. I can use a lens. 00:06:23.081 --> 00:06:26.381 But I always stay at the surface. I see the top of the iceberg. 00:06:26.641 --> 00:06:30.881 I don't know what's below, what's happening. How big is the iceberg? Going to crash or not? 00:06:31.281 --> 00:06:36.081 So it's the same for skin cancer. And so we have the difficulties to understand, 00:06:36.281 --> 00:06:40.261 or the dermatologists have the difficulty to understand what's happening below. 00:06:40.681 --> 00:06:47.041 Before risking to get a melanoma, they just remove it. But then after two weeks, you get the result. 00:06:48.129 --> 00:06:54.089 Was nothing, was a benign lesion. So in the in vivo area, we want to avoid that 00:06:54.089 --> 00:06:59.289 too much biopsies are taken and benign lesions are sent to the laboratory. 00:06:59.889 --> 00:07:07.869 This is the aim for the in vivo. Ex vivo, we want to know immediately what is there. 00:07:08.309 --> 00:07:13.909 In the best case, this is our target, which we're managing, when the patient 00:07:13.909 --> 00:07:15.429 is there in the hospital. 00:07:16.849 --> 00:07:21.609 That's very important. You're talking about unnecessary biopsies. 00:07:21.669 --> 00:07:27.529 We may tell our audience the doctor is not really able to tell from just looking 00:07:27.529 --> 00:07:31.249 at it if it's cancers or not. 00:07:31.449 --> 00:07:37.029 So that means there needs to be some tissue removed, sent into a certain laboratory, 00:07:37.349 --> 00:07:42.389 and then really thoroughly cut under a microscope. 00:07:42.529 --> 00:07:47.309 And they have specialists to look at it. And I do believe that's the process 00:07:47.309 --> 00:07:49.649 when you guys come in, right? 00:07:49.849 --> 00:08:00.109 Yeah, exactly. So every tumor in the world needs to be judged by this doctor called pathologist. 00:08:00.349 --> 00:08:05.569 The pathologist is the only one which can tell if a tumor is there, 00:08:05.669 --> 00:08:08.189 independent of its skin or the other types of tumors. 00:08:08.969 --> 00:08:14.889 The process, the base of his judgment is an image. 00:08:15.489 --> 00:08:19.669 And the image is now achieved by a process called histology. 00:08:20.869 --> 00:08:27.169 Unfortunately, this process called histology to get the image is today in 2024, 00:08:27.649 --> 00:08:31.349 an analogue procedure, so tissue is removed. 00:08:32.439 --> 00:08:39.379 There are three types of these procedures. So the most common one was the paraffin section. 00:08:39.639 --> 00:08:41.619 I don't know how deep I should enter into these details. 00:08:41.999 --> 00:08:46.079 Paraffin section is one of these. It takes minimum 24 hours. 00:08:46.319 --> 00:08:50.279 Here they take the tissue, they embed in paraffin, they cut it in slices, 00:08:50.359 --> 00:08:51.879 and then they put it into chemicals. 00:08:51.919 --> 00:08:56.479 And then 24 hours later, they have an image, which is on a glass slide, 00:08:56.599 --> 00:08:58.939 and the pathologist is looking at it. 00:08:59.899 --> 00:09:04.219 Since ever there was the wish to have a faster way of doing diagnosis, 00:09:04.439 --> 00:09:07.259 of doing histology, of getting these images. 00:09:07.679 --> 00:09:14.219 And in 1894 the so-called frozen section was invented. 00:09:14.579 --> 00:09:21.059 Here we have the advantage that it takes less time, but the tissue is frozen, 00:09:21.279 --> 00:09:26.219 cut into slices, analog, and then put into chemicals. 00:09:26.539 --> 00:09:29.679 This freezing up the tissue creates some problems. 00:09:30.719 --> 00:09:35.839 It creates artifacts and every time I cut something and I put it into paraffin 00:09:35.839 --> 00:09:40.099 or frozen, I lose the tissue, I lose the probe because it's dead. 00:09:40.339 --> 00:09:42.179 I cannot use it for further investigations. 00:09:43.739 --> 00:09:49.419 And this is the problem of the current system. It's still made in an analog way. 00:09:49.879 --> 00:09:56.519 What we do is, we do it digitally. In vivo we image the skin in a digital way 00:09:56.519 --> 00:10:01.139 and we see what's going on, if there's a need of excising or not. 00:10:01.479 --> 00:10:06.919 Ex vivo we have a tissue which we just put on the machine, we scan it and we 00:10:06.919 --> 00:10:13.839 get an image like the pathologist knows today, this kind of H&E like image it's called. 00:10:15.614 --> 00:10:24.694 Big advantage time i preserve the tissue i can act much faster than than with the analog system. 00:10:25.614 --> 00:10:29.434 And we're talking here about minutes so it's 00:10:29.434 --> 00:10:32.354 not a small change that you improve by 00:10:32.354 --> 00:10:35.834 a bit it's from weeks to minutes 00:10:35.834 --> 00:10:41.134 and that's that's a big big improvement the 00:10:41.134 --> 00:10:44.574 other problem we have today is that worldwide we 00:10:44.574 --> 00:10:47.674 have 20 million cases of 00:10:47.674 --> 00:10:50.474 cancer which need to 00:10:50.474 --> 00:10:53.434 be diagnosed by whom you learn the lesson 00:10:53.434 --> 00:10:56.834 all the tests by the pathologists 00:10:56.834 --> 00:11:00.014 so did the number of cases 00:11:00.014 --> 00:11:03.254 is increasing in a drastic way we're expecting in 00:11:03.254 --> 00:11:06.154 2040 30 million it's not saying me is 00:11:06.154 --> 00:11:12.794 the WHO saying this and on this this number of pathologists which are able to 00:11:12.794 --> 00:11:19.714 make a diagnose I would expect also a big increase but here's the problem worldwide 00:11:19.714 --> 00:11:24.134 we have 84,000 pathologists, 00:11:24.874 --> 00:11:27.734 covering 90% of the 00:11:27.734 --> 00:11:30.454 cancer cases yeah this is a 00:11:30.454 --> 00:11:36.554 far too low number and the tendency is decreased in number of pathologists and 00:11:36.554 --> 00:11:43.254 not increased in number of pathologists it's a huge problem yeah so when we 00:11:43.254 --> 00:11:45.014 have more and more cancer cases 00:11:45.014 --> 00:11:49.694 less and less pathologists who's gonna diagnose all these cases means. 00:11:51.056 --> 00:11:54.636 If i'm lucky i get my result after i don't know how many months if 00:11:54.636 --> 00:11:58.476 i'm not lucky i will die before i get my diagnosis and 00:11:58.476 --> 00:12:01.336 here we need to change things we need 00:12:01.336 --> 00:12:04.596 to make the process much efficient much 00:12:04.596 --> 00:12:08.516 more efficient i cannot bake pathologists but 00:12:08.516 --> 00:12:11.676 i can make this analog process in a 00:12:11.676 --> 00:12:16.336 digital way cutting down the time and reducing 00:12:16.336 --> 00:12:23.096 or let's say reducing the time needed to get to the diagnose to get to the image 00:12:23.096 --> 00:12:30.416 yeah we may add here that of course for everybody who had ever a biopsy done 00:12:30.416 --> 00:12:36.136 and it was not yet determined if it's cancer or not this is quite a stressful full time. 00:12:36.276 --> 00:12:41.736 But we should also emphasize that this could give you a week's head start in 00:12:41.736 --> 00:12:46.956 the best case to start your treatment, which may at the end have a decisive 00:12:46.956 --> 00:12:48.436 impact on your treatment. 00:12:48.676 --> 00:12:51.596 So that's where you guys are really coming in. 00:12:52.276 --> 00:12:58.556 It's amazing. Just to tell you a story, I was last week in Rome at our reference 00:12:58.556 --> 00:13:00.416 center, Unicampus Biomedical, 00:13:00.736 --> 00:13:06.236 with a fantastic pathologist, Ana Crescenzi, she's a wonderful, progressive doctor, 00:13:06.476 --> 00:13:12.416 and I assisted to a procedure, so we had a patient, suspect of pancreas, 00:13:12.436 --> 00:13:14.916 you know, pancreas is very, very aggressive, 00:13:15.156 --> 00:13:22.316 we have a mortality of 95% in this area, he came in, then Professor Di Matteo 00:13:22.316 --> 00:13:29.396 used the endoscope, so he took anaesthesia, of course, endoscopic examination, 00:13:29.756 --> 00:13:31.196 we took a biopsy. 00:13:32.276 --> 00:13:35.056 Which are liquid biopsies in this case, not firm. 00:13:35.576 --> 00:13:40.696 And then immediately they brought it to the machine. They scanned the probe. 00:13:40.876 --> 00:13:42.796 And within three minutes, we 00:13:42.796 --> 00:13:47.816 saw that, number one, what they took out of the body is of good quality. 00:13:48.016 --> 00:13:50.696 That's also a challenge when I cannot see this immediately. 00:13:51.216 --> 00:13:56.436 And number two, we saw that it's an aggressive tumor. 00:13:58.856 --> 00:14:04.756 So very bad for the patient. Normally now, this probe would have gone to the 00:14:04.756 --> 00:14:09.356 laboratory, after two weeks he would get his result, and then there's another 00:14:09.356 --> 00:14:13.316 process called molecular analysis in order to know what kind of treatment you need. 00:14:13.796 --> 00:14:17.216 It would have taken four weeks until he can start the treatment. 00:14:17.636 --> 00:14:23.416 On this day, I was quite flashed because I saw there's an aggressive tumor. 00:14:23.916 --> 00:14:26.096 She then took the probe. 00:14:27.416 --> 00:14:33.576 And scraped a bit of the cells into another container and put it in another device. 00:14:34.036 --> 00:14:37.396 And the molecular analysis was done within three hours. 00:14:37.636 --> 00:14:47.596 So within one day, this patient got his analysis, aggressive type of pancreas 00:14:47.596 --> 00:14:51.496 tumor, and he got also the, 00:14:52.216 --> 00:14:57.816 therapy he needs the information that is needed to start the therapy this is 00:14:57.816 --> 00:15:03.596 a revolution this is a change of paradigm it's like when they invented the plane not a car, 00:15:04.376 --> 00:15:12.476 it's changing completely the workflow cutting down the time from weeks in this 00:15:12.476 --> 00:15:18.396 case four weeks to one day and for me this is emotional yeah this is very because 00:15:18.396 --> 00:15:20.756 everybody which has a case in the family, 00:15:21.496 --> 00:15:27.956 uh can understand what the problem is there are many people out there don't even know about this. 00:15:28.776 --> 00:15:33.976 Time needed to get the diagnosis they trust the system the system is relying 00:15:33.976 --> 00:15:38.556 on an analog system but i don't want to wait 10 days do you want to wait 10 00:15:38.556 --> 00:15:40.576 days if you have a suspect of pancreas, 00:15:41.336 --> 00:15:47.936 or lung biopsy no no i don't i wouldn't want to wait that long this is this 00:15:47.936 --> 00:15:54.076 is incredible that we We don't know and we realize once we are affected or once 00:15:54.076 --> 00:15:58.616 our beloved are affected or friends are affected, we realize, wow. 00:15:59.816 --> 00:16:03.456 And there is an urgency because the situation is not getting better, it's getting worse. 00:16:03.716 --> 00:16:10.996 So it's not saying us, the prediction of cancer is increasing in a drastic way. 00:16:11.096 --> 00:16:15.936 And the guys which can say, tell you there's a cancer are decreasing. 00:16:15.936 --> 00:16:22.596 There are 40% over 55% down the way of retirement. 00:16:23.036 --> 00:16:28.076 The workload is increasingly high of the remaining people. 00:16:28.296 --> 00:16:35.656 And especially in Germany, I just read yesterday, it's one pathologist per 48,000 00:16:35.656 --> 00:16:40.536 inhabitants, means the worst value in Europe, in Germany. 00:16:41.476 --> 00:16:49.016 I would expect not Germany. So there's even worse situation in this country. 00:16:49.949 --> 00:16:55.369 But in general, we have some differences in the distribution. 00:16:55.629 --> 00:16:58.569 But in general, worldwide, we have a big problem. 00:16:59.309 --> 00:17:03.929 I see. And when you've been talking about this biopsy, by the way, 00:17:03.969 --> 00:17:10.169 liquid biopsy is just that you don't extract tissue, but liquid. So simple as it gets. 00:17:12.009 --> 00:17:18.029 So today, there's the tendency, which is good, to be less and less invasive. 00:17:18.029 --> 00:17:23.129 So in the former times, they took big chunks out of your body. 00:17:23.249 --> 00:17:29.109 They had a big probe, big tissue in order to make the process. 00:17:29.389 --> 00:17:34.509 Today, when I have suspect of lung cancer or pancreas or thyroid, 00:17:34.729 --> 00:17:41.309 they try to go with a nice needle and take some sample, very little sample. 00:17:41.309 --> 00:17:47.629 So imagine this system, this analog system, which was built based on big chunks, 00:17:47.809 --> 00:17:53.229 has to now handle these small little samples. And this is quite impossible. 00:17:53.469 --> 00:18:00.549 There's no other way to do a fast diagnosis with this analog technology. 00:18:02.569 --> 00:18:07.629 It takes time. It needs to go to the laboratory. The patient goes home. So there's a process. 00:18:07.789 --> 00:18:12.289 After two weeks, they find out the biopsy was not good. 00:18:12.349 --> 00:18:15.789 Please come back, which is the worst, worst case. We have to do it again. 00:18:16.069 --> 00:18:23.629 Or after 10 days, we did the process and you have unfortunately two more we need to treat you. 00:18:23.969 --> 00:18:32.449 So for us, as we use it like a scanner, it's very easy to have liquid biopsies 00:18:32.449 --> 00:18:34.709 or small fragments of biopsies. 00:18:34.709 --> 00:18:39.189 So we see that in the market, or let's say in this area, 00:18:39.948 --> 00:18:45.828 There's an increasing number of small and liquid biopsies, which is good for us. 00:18:46.028 --> 00:18:52.728 But the more we have this minimal invasive biopsies, the more that the current system is challenged. 00:18:52.988 --> 00:18:58.108 So we have the advantage of you put it on the scanner, you scan it and then 00:18:58.108 --> 00:19:01.208 whatever it is, whatever size it is, we can see it immediately. 00:19:01.448 --> 00:19:02.768 So this is another big advantage. 00:19:03.848 --> 00:19:09.068 And there's a funny story. Sorry, how did we get there? How did Anna Glashensky get there? 00:19:09.768 --> 00:19:14.448 We went for Neurology Congress in Rome before COVID. 00:19:14.988 --> 00:19:20.088 And then we did the Congress. We all flew home. And then COVID started. 00:19:20.348 --> 00:19:22.608 And we had no access to this machine anymore. 00:19:23.088 --> 00:19:28.428 And Anna was in this hospital. And she also at the same time got a little sponge, 00:19:28.568 --> 00:19:32.608 a little matrix in order to bind this little and liquid biopsies. 00:19:32.808 --> 00:19:38.428 So thanks to COVID, she had the time. and to test this solution and to find 00:19:38.428 --> 00:19:42.348 out that there is a new way of having a fast evaluation in a digital way. 00:19:42.428 --> 00:19:46.568 So this is also some positive aspect of COVID. 00:19:47.428 --> 00:19:53.008 So these two years where she had the machine, she managed to develop all this 00:19:53.008 --> 00:19:54.328 application, which is fantastic. 00:19:55.585 --> 00:20:01.845 When you've been talking about getting faster digitally, the first thing that 00:20:01.845 --> 00:20:08.205 came to mind, hey, you got less and less pathologists and everybody is talking about AI right now. 00:20:08.205 --> 00:20:15.565 Now, I do totally understand that there are much higher levels of certainty, of trust, of testing, 00:20:15.845 --> 00:20:20.905 of processes that need to be done before you could even think about introducing 00:20:20.905 --> 00:20:26.145 even an AI-assisted diagnosis for pathologists here. 00:20:27.365 --> 00:20:31.105 My question would be, are you guys already working on stuff like that? 00:20:31.325 --> 00:20:36.545 Yeah, we need to. I mean, it's obvious. We will not change the number of pathologists so quickly. 00:20:37.385 --> 00:20:42.345 If it's not a political change, a push, but even so, if somebody would decide 00:20:42.345 --> 00:20:47.565 today to invest in the promotion or let's say in the education of new pathologists, 00:20:47.805 --> 00:20:50.305 then it would take years. 00:20:50.885 --> 00:20:57.305 We will need AI because even we make the process fast and digital, 00:20:57.645 --> 00:21:03.605 we need to support the pathologists in the daily work. 00:21:03.605 --> 00:21:08.445 Thanks to the fact that we do it digitally, we have now the possibility with 00:21:08.445 --> 00:21:11.165 the digital image to feed AI system. 00:21:11.505 --> 00:21:21.405 We did this with our partner university and Professor Hartmann from the LMU in Munich for BCCs. 00:21:21.465 --> 00:21:27.645 It's the most current skin cancer, the so-called white skin cancer. 00:21:27.765 --> 00:21:33.105 The black skin cancer is called melanoma. And she won with our device, 00:21:33.245 --> 00:21:37.305 with the software, the first prize, the German Medical Award. 00:21:37.405 --> 00:21:38.845 So it was a nice moment for us. 00:21:39.685 --> 00:21:46.065 But this is only the beginning. We have now also developed together with another 00:21:46.065 --> 00:21:49.965 company an AI judging the sample. 00:21:50.105 --> 00:21:53.345 So I want to know if I take with my endoscope out of the body, 00:21:53.465 --> 00:21:55.925 the biopsy is good of quality or not. 00:21:56.285 --> 00:21:59.665 And here AI can help us immediately to check the adequacy. 00:22:00.225 --> 00:22:08.285 The next step would be to check adequacy and to make a kind of preliminary diagnosis 00:22:08.285 --> 00:22:14.445 to support the pathologist or to indicate where the area are. 00:22:14.585 --> 00:22:17.805 You could see very nicely where are the cells which are important. 00:22:18.025 --> 00:22:19.945 Are they there? Are they enough? 00:22:20.845 --> 00:22:26.125 So, when we talk about biopsy, it's important to have a good, 00:22:26.125 --> 00:22:34.045 adequate probe, means enough cells that I can use to do all the consecutive examination. 00:22:34.625 --> 00:22:40.145 The first one is histology to understand I have tumor, I have no tumor. 00:22:40.956 --> 00:22:46.496 Is it aggressive or not? The second one which they adopt is the immunohistochemistry 00:22:46.496 --> 00:22:49.316 to better understand the typology of the tumor. 00:22:49.496 --> 00:22:54.956 And the third one is the molecular analysis to know which therapy is fitting 00:22:54.956 --> 00:22:58.916 to you or to me, Giuseppe, or to my sister. 00:22:59.096 --> 00:23:03.396 So we are all different. So we need individual so-called medicine. 00:23:03.676 --> 00:23:06.116 We need to have individual treatment. 00:23:06.456 --> 00:23:09.376 Not everybody can have the same treatment. 00:23:09.576 --> 00:23:12.556 It's impossible. it's not efficient it can be 00:23:12.556 --> 00:23:15.736 good the most efficient treatments the doctors 00:23:15.736 --> 00:23:19.756 are talking about you have a certain molecular composition 00:23:19.756 --> 00:23:24.716 of tumor and then they have treatments they call it a key it fits in luck and 00:23:24.716 --> 00:23:28.896 then they can really efficiently treat it that's what you're talking about individual 00:23:28.896 --> 00:23:36.036 medicine right yeah yeah so we need for every individual I'm receptive to type A, 00:23:36.216 --> 00:23:40.196 you're receptive to type B because of the DNA, 00:23:40.396 --> 00:23:46.016 and then you need the drug made for type A or made for type B. 00:23:46.296 --> 00:23:51.996 So what Anna told me was very interesting is today, when you do the normal way, 00:23:52.116 --> 00:23:57.536 you have a suspect of lung cancer, for example, you go make the investigation, 00:23:57.816 --> 00:24:00.736 the imaging, then they take the biopsy, goes to the laboratory, 00:24:00.876 --> 00:24:05.256 and they see it's an aggressive tumor, they have to do a molecular analysis, 00:24:05.396 --> 00:24:08.476 and it takes four weeks, four to five weeks. 00:24:08.956 --> 00:24:13.796 So what do they do with the patient in between? They cannot wait five weeks 00:24:13.796 --> 00:24:15.596 doing nothing. They start, 00:24:16.380 --> 00:24:19.780 a general treatment which has a cost for the system. 00:24:20.760 --> 00:24:27.500 Imagine one month of treatment for lung cancer is 60 000 euros in cost. 00:24:27.800 --> 00:24:33.700 So they just start a general treatment to do something in the hope it's good 00:24:33.700 --> 00:24:40.060 until the specific result comes where they can use the right drug. 00:24:40.440 --> 00:24:44.540 The problem is that you cannot stop after four weeks the general treatment. 00:24:44.660 --> 00:24:48.200 You need to finish the cycle, she explained to me. You have to finish until 00:24:48.200 --> 00:24:54.840 this is then ready, and you can then start, in some cases, after six weeks the 00:24:54.840 --> 00:24:57.140 specific treatment, which is crazy. 00:24:58.900 --> 00:25:05.020 We lose time. We spend resources on a drug which doesn't make sense, 00:25:05.700 --> 00:25:10.820 and then we put in danger the life of the patient. 00:25:10.820 --> 00:25:14.680 She said some patients cannot wait all this time and they just die. 00:25:15.300 --> 00:25:17.140 It sounds terrible. 00:25:18.020 --> 00:25:23.880 I say this, but if you think about your relatives, to say he died because it 00:25:23.880 --> 00:25:25.540 took too long to get the diagnosis. 00:25:26.100 --> 00:25:30.180 How crazy is that? This is really something very serious. 00:25:31.520 --> 00:25:36.020 Independent that you're working in this field, but it's just crazy to say he 00:25:36.020 --> 00:25:40.700 died without knowing what he had. or he died because it took too long to get the diagnosis. 00:25:40.860 --> 00:25:46.600 So there's an urgent need because of many reasons to improve the system, 00:25:46.740 --> 00:25:54.940 to digitalize the system, to have digital images which can be seen remotely and not on site. 00:25:55.580 --> 00:25:58.820 There are some countries where the pathologist is driving by car. 00:25:58.980 --> 00:26:02.980 By car he's driving to a clinic to assist during a surgery process. 00:26:03.620 --> 00:26:14.140 How crazy, I don't have to say it's nonsense, so it's a waste of resources which we don't have. 00:26:16.251 --> 00:26:23.411 You guys are really making an effort to shorten the diagnosis and establish 00:26:23.411 --> 00:26:27.611 even a better diagnosis with helping with remote. 00:26:27.871 --> 00:26:31.911 So my understanding is in the future, there will be options for remote. 00:26:32.031 --> 00:26:34.091 In the future, there will be options for AI. 00:26:34.811 --> 00:26:40.171 Are you also looking for, before we get into a little bit into the future, 00:26:40.311 --> 00:26:43.451 where are you guys currently available? 00:26:43.451 --> 00:26:46.991 Because as we already said, you have the headquarter in Munich, 00:26:47.131 --> 00:26:51.651 you have R&D in upstate New York at the Great Lakes. Have you been there? 00:26:51.791 --> 00:26:53.991 Oh, yeah. Did you wear warm socks? 00:26:54.811 --> 00:26:58.971 In the wintertime, wintertime is quite tough in Rochester. 00:26:59.211 --> 00:27:02.351 I think due to the climate changes, also a bit changed there. 00:27:02.351 --> 00:27:13.151 But I remember flying to Rochester from Newark by this little propeller plane and a stormy night. 00:27:13.551 --> 00:27:18.491 And I see only the runway from the, you know, the cockpit was open, the door was open. 00:27:18.571 --> 00:27:22.251 You could see the snow and the plane, and he was like doing like this. 00:27:22.351 --> 00:27:25.251 And at the last minute doing like this, you know, was crazy. 00:27:25.391 --> 00:27:31.311 But summertime, Finger Lakes, wineries, really fantastic. One time I had the 00:27:31.311 --> 00:27:39.691 luck to fly via Toronto, I took the car and I passed Niagara Falls and then I drove on to Rochester. 00:27:40.291 --> 00:27:44.471 So beautiful, beautiful area, especially the Finger Lakes is fantastic. 00:27:44.691 --> 00:27:46.091 I love it. I love it very much. 00:27:47.431 --> 00:27:54.031 This is a nice, nice area. I would assume you guys are vivoscopes currently 00:27:54.031 --> 00:27:59.211 available in Europe, meaning the European Union and the United States. 00:27:59.211 --> 00:28:02.491 Anywhere else we just started in india uh 00:28:02.491 --> 00:28:05.591 it was um an idea which came 00:28:05.591 --> 00:28:08.711 into my mind why not india it's 1.4 billion people 00:28:08.711 --> 00:28:14.431 and we hired indian colleagues which we appreciate very much and we did our 00:28:14.431 --> 00:28:20.511 first demo tour and uh after the first demo tour that this i think the indians 00:28:20.511 --> 00:28:25.291 are really amazing yeah they got so excited so progressive doctors and they 00:28:25.291 --> 00:28:26.591 have a big problem they have even 00:28:26.731 --> 00:28:33.331 higher workload than we have and it immediately ordered four devices now after one month. 00:28:33.471 --> 00:28:36.531 So this is for me, it's wow, they're fast, they're clever. 00:28:38.111 --> 00:28:44.611 We need to learn a bit of the speed and dynamic of Indian people. 00:28:45.451 --> 00:28:49.831 In Europe, we have 50 centers by now. 00:28:51.166 --> 00:28:56.926 The latest one is really made me happy is a pediatric center in Ancona means 00:28:56.926 --> 00:29:03.986 for babies and children because I didn't also not know that sometimes when you 00:29:03.986 --> 00:29:06.346 have this Hirschsprung disease is called, 00:29:06.466 --> 00:29:12.446 you need to do a kind of surgery and the babies are put under anesthesia for quite a long time. 00:29:12.546 --> 00:29:17.226 So we could reduce the time for anesthesia by two hours, which is immense. 00:29:17.226 --> 00:29:22.206 So, this makes a big difference for the babies. 00:29:22.366 --> 00:29:25.166 So, I think this is a fantastic application. 00:29:25.686 --> 00:29:32.586 And I just got the news that the first oral lecture was accepted to the World 00:29:32.586 --> 00:29:34.546 Congress for Patriotic Oncology. 00:29:35.866 --> 00:29:41.826 I think we all wanted our babies, our children, are feeling well and that they get the best treatment. 00:29:43.246 --> 00:29:50.326 Yeah, we have 50 centers throughout Europe. We have roughly five now in U.S. 00:29:50.346 --> 00:29:54.186 U.S. is quite tough with the regulation. 00:29:54.526 --> 00:29:59.406 You need to prove by big studies that you are allowed to do this. 00:29:59.466 --> 00:30:01.826 So we have Mandy Anderson, Memorial St. 00:30:01.906 --> 00:30:08.106 Catherine, New York, with fantastic scientists and doctors. 00:30:09.446 --> 00:30:14.466 Professor Krishnamurti Savitri, she's a pathologist, very, very progressive. 00:30:15.166 --> 00:30:22.686 Manu Jain pathologist. So it's nice to see how these pathologists are pushing the technology. 00:30:23.026 --> 00:30:28.786 So it's nice because pathologists are used to this analog process, 00:30:28.946 --> 00:30:31.806 but they saw and understood that this is a help for them. 00:30:31.886 --> 00:30:34.286 It's a relief. They can sit at big monitors. 00:30:34.586 --> 00:30:40.486 They can judge the sample from the office or from home. And it's not a threat. 00:30:40.646 --> 00:30:43.646 We're just changing the way of doing 00:30:43.646 --> 00:30:47.326 histology we do it digital and funny 00:30:47.326 --> 00:30:50.606 enough when I started my first job at the Japanese company 00:30:50.606 --> 00:30:53.366 at the time we were the first introducing the digital 00:30:53.366 --> 00:30:59.146 camera so before we used the camera with the film so we made pictures we took 00:30:59.146 --> 00:31:03.966 the film out we said it to laboratory waited to get the results and now it's 00:31:03.966 --> 00:31:12.286 basically the same also in this field in a much more important field the pathology histopathology, 00:31:12.446 --> 00:31:15.166 yeah, the diagnosis area. 00:31:15.486 --> 00:31:20.866 And so it's nice, it's nice to have this, this kind of repeating of the history 00:31:20.866 --> 00:31:22.206 in a higher level, let's say. 00:31:22.446 --> 00:31:27.866 I see. Um, are you guys looking currently for somebody to join your journey? 00:31:27.946 --> 00:31:32.126 So are you looking for talented people? We're looking at getting more and more 00:31:32.126 --> 00:31:34.546 important, we need, of course, it's kind of a. 00:31:36.132 --> 00:31:38.872 Challenging you need to know a lot uh as i 00:31:38.872 --> 00:31:42.012 mentioned i i studied uh mba uh but 00:31:42.012 --> 00:31:45.472 uh i had to learn a lot about skin tumors what 00:31:45.472 --> 00:31:48.892 is a melanoma what is the basis cell carcinoma tinea keratosis inflammatory 00:31:48.892 --> 00:31:54.572 diseases what is the prostate cancer why they take 18 biopsies out of your prostate 00:31:54.572 --> 00:32:00.792 to know if you have prostate cancer breast breast core biopsy fine needle needle 00:32:00.792 --> 00:32:02.572 biopsy, fine needle aspiration, 00:32:03.112 --> 00:32:05.432 lung, how do they do this? 00:32:05.572 --> 00:32:10.532 So it's a lot. It's really a lot to learn, but it's a fantastic way to combine 00:32:10.532 --> 00:32:17.852 your job with something really makes sense, which helps in a tremendous way. 00:32:18.252 --> 00:32:23.632 It helps to improve and to get fast results. And it helps you. 00:32:25.012 --> 00:32:32.492 It helps me when I'm affected. And the probability to get the cancer is unfortunately increasing. 00:32:32.812 --> 00:32:37.292 So we have to think about if it happens, where do I go? 00:32:37.452 --> 00:32:43.972 Do I go to a center offering old type or do I go to a center offering digital, 00:32:44.092 --> 00:32:46.412 new, progressive approach? 00:32:47.712 --> 00:32:51.832 And on the one side, we're looking for talented people. 00:32:52.112 --> 00:32:56.832 Of course, we are a middle-sized company. We are not Siemens, 00:32:56.932 --> 00:33:00.752 we are not General Electric, so it takes more time, it takes more resources, 00:33:00.912 --> 00:33:05.392 and let's say we need then to just do it all by ourselves. 00:33:05.732 --> 00:33:11.872 Thanks God we won many grants last year, which allow us or supports us, 00:33:12.032 --> 00:33:18.532 but you know, medicine is a very slow moving object. 00:33:18.532 --> 00:33:23.012 Checked to change things takes long time. 00:33:24.612 --> 00:33:33.572 Yeah, I do understand that some of it is just to reduce the risk of of potential misdiagnosis. 00:33:33.772 --> 00:33:36.832 Are you guys are also open to talk to new investors? 00:33:38.032 --> 00:33:44.972 Of course, always. I mean, I was, I am a firm believer of collaborations, 00:33:45.292 --> 00:33:49.012 in terms of combining different technologies together, 00:33:49.252 --> 00:33:53.172 in terms of bringing people with knowledge inside, 00:33:53.412 --> 00:33:58.152 in terms of bringing resources to speed up the process because as I mentioned, 00:33:58.332 --> 00:34:03.792 it's an urgent, urgent problem and the more power we have to change things, 00:34:04.012 --> 00:34:09.492 the more, let's say, the more we have the chance to also save people. 00:34:09.492 --> 00:34:14.452 Yeah, we're talking about people's life, that's definitely an issue. 00:34:15.859 --> 00:34:21.619 And we now have a lot of big companies knocking at the door. I'm quite happy. 00:34:22.979 --> 00:34:29.659 And I'm looking forward to these new collaborations. But our doors are open for more. 00:34:32.379 --> 00:34:36.259 Giuseppe, it was really great having you as a guest. You could totally tell 00:34:36.259 --> 00:34:39.659 you are an Italian the way you've been talking. 00:34:39.759 --> 00:34:45.099 I like it when I do have a guest who has really an interesting and important 00:34:45.099 --> 00:34:46.839 topic and can talk a lot about it. 00:34:47.299 --> 00:34:51.039 We're now running almost at thirty five minutes recording time here. 00:34:51.159 --> 00:34:53.739 So I'd like to say thank you. Milagros. 00:34:54.339 --> 00:34:55.899 That's a little bit of a veto. 00:34:56.599 --> 00:35:01.399 I hope I hope it was a bit interesting. I tend to not stop. 00:35:01.599 --> 00:35:04.679 I was want to stop. So thank you so much. 00:35:04.759 --> 00:35:08.939 It was great to talk about this problem and possible solutions. 00:35:08.939 --> 00:35:17.539 And I wish you a fantastic day and week ciao ciao ciao, 00:35:22.399 --> 00:35:32.059 that's all folks find more news, streams events and interviews at www.startuprad.io 00:35:32.059 --> 00:35:34.639 remember sharing is caring. 00:35:35.600 --> 00:35:49.717 Music.