Case Study: TeraLumen

The term ‘cancer’ can be daunting for many. According to an estimate by the Indian Council of
Medical Research (ICMR), there will be a 12% rise in cancer cases in India in the next five years. And almost 1.3 million new cancer cases came up in India in 2020.

Alarmed by the rising prevalence of cancer in India and the paucity of effective diagnostic options, Dr. Jyotirmayee Dash, who has a Ph.D. in Terahertz technology from the Council of Scientific and Industrial Research-Central Electronics Engineering Research Institute (CSIR-CEERI), decided to use her expertise to develop high-tech, cost-effective systems for critical healthcare issues such as cancer diagnosis in India. This is how the idea to start TeraLumen Solutions Pvt. Ltd. was born.

The Company

Dr. Jyotirmayee Dash, Dr. Shaumik Ray and a dedicated team of researchers founded India’s first Terahertz company, TeraLumen Solutions Pvt. Ltd., in 2019. The company has been mentored and supported by industry experts Dr. Bala Pesala and Dr. Shyam Sundar Mandayam, who have extensive expertise in technology. The team aims to develop cutting-edge technological systems for medical diagnostics, mainly focusing on cancer margin detection. The company’s top goals include developing compact Terahertz systems to make the technology accessible at an affordable cost and providing customized solutions for accurate cancer margin diagnosis.

The Problem Statement

Determined to make the best use of Terahertz technology in the healthcare sector, Dr. Jyotirmayee met with numerous doctors, pathologists, and oncosurgeons from Rajiv Gandhi Cancer Institute, New Delhi, Dr. Mehta’s hospital Chennai, MSMF Bangalore and AIIMS Jodhpur. Working with them, she tried to identify pressing patient issues and ways of alleviating them with the use of technology. She and her team identified the following issues in the oncology sector:

  • Cancer surgery is the most fundamental protocol in almost all cancer cases, and accurate cancer margin detection during surgery is crucial.
  • Real-time cancer margin detection is one of the main challenges during surgical oncology procedures—failure to achieve precise surgical margin results in an increased risk of cancer recurrence.
  • Around 25% to 30% of cancer surgeries fail primarily due to inaccurate cancer margin detection, leading to increased morbidity rates, further surgery, and delay in recovery.
  • The gold standard margin assessment technique, histopathology assessment, is generally very complicated and time-consuming (takes 5-7 days).
  • Frozen Section Analysis (FSA), another margin assessment technique, is faster but can still take up to an hour of surgery time.

Thus, the medical professionals felt the need for an intraoperative device that could provide rapid and accurate cancer margin detection.

The Challenges in Creating a Solution

From the very beginning, Dr. Jyotirmayee knew that she would have to face numerous challenges to build a hi-tech product to address the critical issue of cancer margin detection. For one, since Terahertz technology is still in a nascent stage in India, her team depended on expensive options from Europe and America.

Another major challenge was to make the system compact. This required reducing the optics and developing the electronic control unit while negating electromagnetic interference effects and also ensuring at the same time that the performance of the system was not compromised.

The entire team then had to focus on developing the complete software for data acquisition and the graphical user interface development. Tackling these challenges separately and then integrating everything to build the prototype took months of intense work.

Team TeraLumen

The Solution

After successfully tackling the preliminary challenges, the team at TeraLumen are now focused on developing the first Artificial Intelligence (AI) enabled Terahertz-based intraoperative device in India for real-time cancer margin detection. This system is:

  • Compact
  • Non-invasive
  • Cost-effective
  • Portable
  • Easily deployable in surgical rooms

TeraLumen uses non-ionizing technology in the system, making it effective for medical diagnostic applications. Furthermore, the fully-automated software can carry out the imaging rapidly and in real-time with minimal human intervention. This technology will help diagnose cancer margin with very high accuracy and demonstrate imaging of the tissue excised after the surgical procedure. The entire system is designed to guide the oncosurgeons and pathologists in making informed decisions during cancer surgeries and achieving better clinical outcomes.

The Competitive Edge

At present, the standard gold technique is histopathology assessment, a process that takes several days to complete. Even though the approach is accurate, it is labour-intensive and time-consuming. Another commonly used method is frozen section analysis which could take up to an hour to diagnose. This method is expensive and generates significant artefacts, especially in fatty tissues. A few other products, such as MarginProbe, MassSpec Pen, and iKnife, are also set to enter the market, but these products are invasive and expensive.

TeraLumen’s Terahertz-based intraoperative device effectively challenges the shortcomings of the competitors. This system:

  • Gives rapid, real-time results
  • Is non-invasive
  • Is fully automated
  • Does not need chemical staining of tissues
  • It does not need expert analysis by pathologists
  • It is more cost-effective than the competitors (40% reduced cost)
  • Provides accurate cancer margin detection

This system has been validated with more than 50 multicentric breast cancer tissue samples at TeraLumen. It can effectively differentiate between cancerous and normal tissues with more than 85% sensitivity and approximately 90% accuracy.

Social Impact of the Product

Dr. Jyotirmayee envisions the creation of a product that will have a significant social impact, and TeraLumen’s product promises to deliver the same. The wide usage of the product can benefit the society in numerous ways:

  • The potential for rapid diagnosis will reduce the load of the oncologists and enable them to attend to a more significant number of patients diagnosed with cancer.
  • The product currently targets the diagnosis of breast, oral cavity, lip, and head and neck cancer, accounting for around 28% of all cancers. Margin analysis is highly critical in these cases.
  • Due to its high accuracy, the device will help reduce the number of second surgeries, thereby providing better patient outcomes. It will benefit more than 0.12 million patients per year.
  • The widespread usage of the device can offer a total cost-benefit to the entire country estimated at around Rs. 750 crores to Rs. 1,500 crores in a year.

How has MSMF Helped TeraLumen?

Dr. Jyotirmayee lauds MSMF for their support as an incubator and for getting the TeraLumen team connected to renowned oncosurgeons to carry out their clinical validation. This association is expected to accelerate its entry into the market.

TeraLumen's Vision for the Future

The TeraLumen team looks forward to developing compact medical diagnostic systems for intraoperative cancer margin detection, which can save millions of lives and have a significant social impact. As the first Terahertz technology company from India, they aim to reach a global standing in innovation at par with international competitors.

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