Nidhi Mathur and Geeta Manjunath, co-founders of Niramai. The field of cancer diagnosis is constantly evolving and changing, but diagnosticians still struggle to keep up with demand. Examining images and data is time-consuming and relies on the judgment and skills of highly specialized experts. Here, artificial intelligence (AI) – or deep learning – can save vast amounts of time and give much more accurate results, according to Geetha Manjunath, the cofounder of health tech startup Niramai. In India, where incidences of breast cancer are rising, Niramai is using machine learning algorithms, big data analytics and thermal image processing to improve breast cancer diagnosis. The company's screening tool is said to be able to detect breast cancer based on subtle abnormalities that cells display as the disease begins to take hold. “Most available screening tests can detect tumors in breasts, but more than 60% of them are harmless,” says Manjunath. “Our screening tool looks for tissue abnormality and identifies only lumps that may be cancerous.” Given that healthcare tech in India is a $30 billion opportunity, it’s no surprise that entrepreneurs like Manjunath are diving into the sector. Last April, Niramai raised $1 million in seed funding and has started making inroads into breast cancer treatment in the country, saving lives and money, and offering an alternative to mammography. The Bengaluru-based startup has been using this funding, Manjunath says, to strengthen its intellectual property portfolio and expand operations. Although questions remain about the day-to-day reality of integrating sophisticated AI software with hospital IT systems, which are already criticized for being outdated, using the technology to diagnose breast cancer has huge benefits in a country that has one of the lowest doctor-patient ratios in the world. While it may not outright replace mammography any time soon, it is increasingly finding acceptance with hospitals, and the business has begun to gain traction, although not yet turned a profit. “Currently, Niramai is working with hospitals and diagnostic labs in three states in India, and plans to expand this year to other parts of the country,” says Manjunath, adding that it aims to extend the reach of its breast cancer screening tool around the world, including Singapore, Japan, Malaysia and the U.S. “Our plan is to expand beyond India by the middle of next year.” “As a deep technology company, product innovation is our core strength. However, we already have some early revenues coming in. We hope to be profitable in about two years,” she adds. India's breast cancer crisis In India, breast cancer is the most common cancer in women, with rate as high as 25.8 per 100,000 women and mortality 12.7 per 100,000 women. According to a study, lack of early diagnosis of breast cancer may kill 76,000 Indian women a year by 2020. Worse still, India has a low survival rate for breast cancer, with just 66.1% women diagnosed with the disease between 2010 and 2014 surviving. “Now, we have a tool to speed up diagnostics and save more lives by enabling early detection,” says Manjunath, who started Niramai with Nidhi Mathur in 2016 after four years of research. The radiation-free, painless, contact-free device addresses most of the problems that conventional mammograms grapple with by reducing overdiagnosis and false positives. “Since it doesn't involve touching a patient, it is more acceptable to women who shy away from clinical screening,” she adds. Niramai's screening tool uses machine learning and thermal imaging to detect cancerous tumors. Cost-effective solution In India, cost is just one of the many factors that discourage women from undergoing breast cancer screening. The device, which was awarded six U.S. patents for its AI and ML algorithms, is affordable, says Manjunath, and that gives them their unique selling point. “A woman can get her breast scan done with our tool for only $22. The cost will fall further as volumes pick up.” By comparison, a digital mammography costs around $54. In the coming years, Manjunath expects small diagnostic centers to incorporate the screening tool that requires minimal skills to operate into their clinical practice across the country making breast cancer detection accessible to every woman, dramatically change efficiency, and save money into the bargain. Meanwhile, to grasp new opportunities, and find ways to increase the number of people who can benefit from its tool, the startup is also collaborating with non-profits and governmental agencies to introduce its technology into rural towns by organizing screening camps at a low cost. “We provide them an end-to-end solution, including hardware, installation, training, automated analysis and report generation,” says Manjunath. Business growth In India, there's huge potential for AI to help improve medical diagnosis, and investors are pouring into the field. According to a report by the Center for Internet and Society, investment in AI in the healthcare sector is estimated to add $957 billion to the economy by 2035. “From the $5.5 billion raised by global digital healthcare companies in the July-September 2017 quarter, at least 16 Indian healthcare IT companies received funding,” the report stated. According to Manish Singhal, founding partner of pi Ventures, an AI and IoT focused early stage venture fund that invested in Niramai, healthcare and AI are “made for each other” in emerging markets like India. “In India, there's a massive mismatch in supply and demand. Training enough doctors and other staff to meet this demand will take decades,” adds Singhal. “However, with AI, one can build smart diagnostics that can aid doctors in making more accurate and faster decisions.”
Indian start-up Niramai is using AI to improve breast cancer detection, and has raised $1m in seed funding to develop machine learning, algorithms, big data analytics and thermal image processing to improve diagnosis. More than 60% of abnormalities currently found are harmless, but Niramai’s technology only identifies potentially cancerous ones. The company is working with hospitals and labs in six Indian states, but plans expansion in India and elsewhere. Its technology has been awarded three US patents, and its scan costs $22 against $54 for digital mammography.