Karim Karim Professor early detection lung cancer

Sina Ghanbarzadeh (left) and Karim S. Karim of startup company KA Imaging work in a lab at Waterloo Engineering.

A digital X-ray imager developed by a Waterloo Engineering startup is being tested on cancer patients with lung nodules in a pilot study at Grand River Hospital in Kitchener.

The new technology is faster and cheaper than traditional CT scans, and has the potential to detect lung cancer earlier and with less radiation exposure.

The system was developed by KA Imaging, a Kitchener company founded in 2015 by Waterloo Engineering professor Karim S. Karim and graduates Amol Karnick and Sina Ghanbarzadeh.

Their low-cost, portable, multi-energy X-ray detectors – flat panels that essentially act as the film in the process – produce much clearer images than standard X-rays by differentiating soft tissue from bone.

The detectors can produce at least three separate images – one showing only bone, one showing only soft tissue and one showing both – instead of just one with existing X-ray machines.

Karim, an electrical and computer engineering professor at Waterloo, says that capability, together with the system’s low cost and low radiation levels, could help save lives by enabling widespread screening for early detection of lung cancer.

CT scans are typically used only for high-risk patients because of radiation concerns and standard X-rays aren’t accurate enough for diagnostic purposes.

“If a cancer lesion is located in the apex of a lung and bone obscures it, it can’t hide anymore,” Karim says. “If an abnormality is hiding behind the heart, we can see it nice and clearly.”

early detection of lung cancer

Sample images of chest X-rays made with new technology that can differentiate soft tissue from bone.

The study at Grand River Hospital (GRH), which will involve up to 30 patients with existing lung nodules, is comparing the quality of images from CT scans and the company’s prototype X-ray imager.

“The human side of this work is so important,” says Dr. Vikram Venkatesh, a radiologist who is leading the study. “We cannot make advancements in patient care without first working with them to trial new technologies.”

Patients are getting X-rays using the new panel, which is installed on one of the hospital’s existing X-ray machines, on the same day as their scheduled CT scans.

“We are excited to partner with KA Imaging to trial this innovative technology at Grand River Hospital,” says Tina Mah, the vice president of research and innovation. “Our mandate is to advance exceptional care and we continue to be leaders in our community by trialing new technologies, like this multi-energy X-ray, in partnership with our patients.”

Lung cancer claims about 180,000 lives a year in North America, in part because the disease often isn’t detected until its late stages.

Karim’s hope is that X-ray machines retrofitted with the new detectors will make it safe, economical and effective to routinely screen people over a certain age, dramatically boosting lung cancer survival rates due to early detection in the same way mammograms have impacted breast cancer.

“Nothing like that exists now,” he says.

The panels – 17 inches square and less than an inch thick – could also improve X-ray images for screening and diagnosis of tuberculosis, pneumonia, bone cancers, bone fractures and numerous other conditions.

In addition, the data-rich images they produce are ideal for analysis by artificial intelligence (AI) software.

KA Imaging, which has 24 employees, was launched with support from the Waterloo Commercialization Office (WatCo) at the University of Waterloo.

Its initial prototype was developed with funding from Grand Challenges Canada, the Ontario Centres of Excellence and the Fight Against Cancer Innovation Trust.

The company recently received Health Canada approval to extend the trial to patients suspected of having lung cancer as well as those who have already been diagnosed. It expects to launch a commercial version of its X-ray technology in mid-2019.

“Partnering with Grand River Hospital is a tremendous opportunity to trial this innovation at home in the Waterloo Region,” says Karnick, president and CEO of KA Imaging. “We look forward to continuing our partnership with GRH, working together to improve patient care in our region.”

Watch for more information on the recent Grand River Hospital announcement