Today, if a hematologist wanted to delve into the exact organization and structure of your blood cells, he would probably need a microscope in a lab. Scopio, an Israel-based startup that just closed a $50 million Series C round, argues that soon much of that work could be done with nothing more than a laptop.
Founded in 2015, Scopio is an imaging company that aims to reinvent a common blood test, a peripheral blood smear. Essentially, that’s a test where a doctor, who usually wants to understand an abnormality in blood cell counts, literally looks at your blood cells. That process involves placing a smear of blood on a microscope slide and examining the shape, size, and structure of certain cells with a well-trained eye.
Scopio has developed a scanner called Scopio100x that is able to image that whole blood sample while still retaining the ability to achieve 100x magnification. The result is a zoomable, digital image that CEO and founder Itai Hayut argues enables remote peripheral blood smears and lowers the cost of these procedures in the first place. Once samples are scanned in the lab, they can be reviewed by hematologists working everywhere.
You can zoom in on one of the images here.
“We’ve seen lines of people in hematology labs leaning over microscopes, in some cases using a manual clicker to count cells,” Hayut told TechCrunch. “We thought this was just a perfect example of how computer vision tools can help the experts and get better results much faster.”
Peripheral swabs are part of a range of different assessments that can be used to identify blood diseases. But these days, in most cases, they are not the first-line option.
If your doctor is concerned that you may have a bleeding disorder, he or she may order a complete blood count first. Those tests are done almost completely autonomously: An analyzer counts different levels of blood cells in your body and gives the doctor a rough idea of how much of each type of cell is present.
If those tests show abnormalities, a doctor may want to see the samples for themselves. In that case, they will perform a peripheral blood test to examine cell size and structure and look for indicators of a specific disease.
There is some evidence that the peripheral blood smear landscape has some major pain points. For example, some articles argue that manual sample review doesn’t often add much to physicians’ diagnostic dataset. A paper published in 2020 in Diagnostic pathologyfound, for example, that only 23 percent of the 515 peripheral blood smears ordered at three medical centers added clinical value.
That paper doesn’t necessarily mean the technique itself is foreign; the authors do add that efforts to make the process more efficient are likely justified.
Numerous other papers confirm that the peripheral blood smear is unlikely to be left out. About 15 percent of analyzer tests are still referred to hematologists for a blood smear to confirm the findings. And, on a less scientific note, some researchers see the ability to diagnose blood cells as something of an art.
In short, it seems that for now we still need to manually look at blood cells to confirm diagnoses. And other companies have already looked at developing imaging tools that could make that manual review faster and more automated. For example, two major companies in this space are already Cellavision and Sysmex, systems that are responsible for the majority of peer-reviewed studies in this space, according to a 2019 review paper.
In some ways, the fact that this technology already exists works in Scopio’s favor, as research is already suggesting that cell imaging systems have benefits, and scientists are already familiar with it. Indeed, these systems allow for remote monitoring (although about 10-20 percent of samples still require personal confirmation), reduce eye strain, can reduce labor costs, make it easy to archive and retrieve blood films, and make good educational resources. .
Hayut argues that Scopio can represent the next generation of this technology, because the company seems to have found a niche in that world: the existing imaging technology does not offer the whole slide†
To achieve a higher magnification, the width of the image is compromised. Think what it’s like to zoom in on something with a camera lens: the field of view gets smaller. In this case, that means only parts of the slide are scanned and displayed, Hayut said. Independently published articles have confirmed this idea.
“Scopio is the first company in the world to break the trade-off between field of view and resolution,” Hayut said. In short, they managed to capture the entire slide and still achieve magnification of up to 100x, in line with what is needed to make a peripheral blood smear.
The ability to scan the entire slide leads to the second half of Scopio’s pitch: those “two orders of magnitude” more visualized and digitized cells means more applications can be developed around it. Essentially, Hayut said this will enable new algorithms to learn more about the peripheral blood smear in the first place.
Scopio, like some of the other major players in this field, has invested in getting FDA approval for certain clinical decision-making algorithms. (Think of this as assistive software that helps a hematologist differentiate between cell types).
In October 2020, the FDA approved a clinical support system from Scopio that classifies cells and allows a hematologist to review those automatic classifications through the 510(k) new device pathway. (It gained approval this way because the classification process was essentially similar to an equivalent already on the market).
The company also recently completed a clinical trial of an application designed to help technicians evaluate bone marrow aspirate – samples commonly used to scan for conditions such as leukemia, multiple myeloma or anemia. The data from that study has yet to be published, but the company plans to file for FDA approval in March of another clinical decision support system focused on bone marrow aspirate analysis.
As for the Series C funds, the company has a single focus: commercial delivery. The company plans to expand its commercial team in Europe and the US and try to penetrate clinical labs (Scopio’s core customer).
This Series C round brings Scopio’s total funding to $85 million. The round was led by OurCrowd and an undisclosed strategic investor. It includes new investors Mizrahi-Tefahot Bank Invest, Ilex Medical and existing investors Olive Tree Ventures and Aurum Ventures.