Unlocking the Future of Disease Prediction through Breakthrough Imaging with Dr. Codi and Valerie Gharagouzloo

2023-12-23 | https://www.youtube.com/watch?v=6g94BkscIog Transcript YouTube English auto-captions. [Music] [Applause] hey guys this is Dr Mike Wang welcome to another edition of bootstrap MD this is the podcast for physician and healthc Care entrepreneurs you know I I've been I've been saying for years you know if you have a a uh an idea a product a service that you think could be beneficial to mankind you should be shouting out to the heaven you just can't keep it on to yourself and that's what happened with this couple uh the company is called imagixs it's a startup company was founded in 2018 where they're bringing to Market a revolutionary longevity techn techology for early detection of diseases decades in advance through MRIs the company's technology uses a new way to acquire data from existing MRI scanners and Hardware improving MRIs by 10x and enabling new physiologic measurements that describe the cellular vascular environment representing a potential breakthrough for early diseases of many age related diseases early detection of many age related diseases such as Alzheimer's disease and related diena it was founded by my following guest a French American couple who met in France in 2007 married in 2010 have two children uh the The Physician or the doctor is Dr gar guzu who's invented and developed a breakthrough quantitative IM imaging technology during his PhD in bioengineering at Northeastern University with postto research fellowship at Harvard Affiliated Massachusetts General Hospital in Boston Valerie his wife was inspired uh or inspired Cody to launch his startup to bring his Tech from bench to to bedside so that was my introduction for you folks but I don't think I did it justice I want to Welcome to the program Dr Cody and VI gargler how are you doing we're doing great thank you much yeah fantastic thank you thank you well again that was a mouthful you know you have so many extraordinary achievements but I want to I want to hear it from from you and uh Dr Cody I'd like to start with you tell me about kind of your background and what kind of LED you to this journey in in a journey that actually uh came out uh what they you describe as a faith love and science yeah so my background you know my undergraduates in physics and and uh you know mechanical and nuclear engineering so I've always been fascinated with nuclear physics um and uh and at the same time you know I've wanted to do something that helps people um in health care um and so I got a master's in biophotonics which is essentially Imaging with light light matter interactions a lot of um laser Technologies and you know you can image uh you know within a millimeter of tissue it's mainly cellular work so there's applications there but I really wanted to get into medical imagy so we could get into the human body um and then what I really noticed was among the different modalities that are available in medical imaging MRI stands out as the modality that you know can image inside the body high resolution soft tissue right U but the the sort of uh you know long-standing drawback of MRI has been the qualitative nature of the Imaging so you get these images that are really appropriate for visual interpretation but there are no numbers that quantify the physiology um so it's really more about looking at the individual level at anatomical details um and so I started out my PhD just reading papers 12 hours a day for six months and sort of theorized a new way to do MRI um and then I sat down at an MRI scan and did a lot of small animal work for for about six years um yeah and so that's kind how I got started so uh Valerie how did you get into the picture here and maybe tell us of your background sure so I'm a lawyer of backround I'm originally from France follow C to the United State went back to law school became became anatomy in New York my backround is more into international human rights immigration uh I was a lawyer entrepr uh with my own practice uh based in Boston Massachusetts um so I was you know we've been married for more than 10 years K spoke about his science like every single day and it took me six years to understand the importance of this technology um because it's you know I mean based on nuclear physics I it's a very intensive like scientifically uh and when I understood I was like this is amazing you know I I wish we had that at the hospital so uh what you know inspired me to tell Cody we need to you know create a company it was really like the desire to translate from the bench you know from the lab to the bedside and bring it to people at the hospital now that that that Journey or that the convincing of start of a company probably wasn't easy you know most in in most you know PhD students who then become graduates usually work for some big expensive Fortune 500 company you know um you said you were at the time just kind of working with some some some studies on on on on animals how did that transition I mean you had this idea was it like you know should I tell my Superior about this is it is there something that they can integrate tell tell me about that process yeah so when I did my post talk at Mass General Hospital uh for a couple years um I you know transitioned from uh mice and rats to monkeys and humans still doing you know rat work but especially in genetically modified models um but you know we by the end of uh my my term there we were able to get the first images of the human brain um and then um so sort of demonstrated the proof of concept you know we got these stunning images and when my postdoctoral fellowship ended uh we decided to you know because of uh thanks to Valerie's courage here we uh we decided to have a startup and fortunately we were funded early on by physician investors um you know the leader of that group is an orthopedic surgeon that founded a hospital and so that was really we couldn't have got started without them is Dr Mike too is the same name Dr Mike we have lot of Mike suppor that's good that's good that's a good name to follow there but yeah we were I think we were really blessed to have you know the right type of support like early on uh with Angel Investors Physicians who understood the importance of the technology for the medical field and um yeah we were really blessed in that sense and it was really early on like I would say precede almost because Cody had to finish like his Publications and you know scientific uh yeah Publications um and uh he was still filing patents so it was was really early on yeah yeah so as you know here at bootst MD we have our audience is is filled with entrepreneurs who maybe you know started their business maybe going through that journey and you know have gone through some have gone through that process of you know raising funds uh you know you know getting their their their slide decks ready and and presenting how is that that that for you because it you know it doesn't sound like or maybe it does did you have a background in in entrepreneurship with like family members or or or or like I mean well could I mean you know you have all type of Entrepreneurship right P he studied uh at 13 years old he was parking cars in his yard uh you know it was at his first you know and selling maybe sodas you know as as that yeah that's for the K State home football game so but I I do want to say a special thanks to uh my uh loim partner Chas Le you um because he really mentored us a lot he's a business uh you know lawyer uh business Consulting and business lawyer and I think I learned so much from him as as a lawyer but as well um he mentored us a lot at the beginning when we started the company to understand all those things you know like about founding a company and what do you need to look for and uh so yeah we had definitely his support and mentorship yeah and I think you know I mean you know we were in Boston and Cambridge Massachusetts so we were in quite an innovation ecosystem at the Cambridge Innovation Center so I was able to meet a lot of different Founders and see what kind of uh Technologies were being commercialized what type of products people were commercializing and um you know I really realized how important our technology was there similar to you know going to Scientific conferences right so ismrm is of the MRI conference so I'm an MRI physicist and you know it was when I was starting to go to those conferences that I really realized how important that our technology was um and so I think similarly on the sort of um as an entrepreneur kind of comparing you know Technologies understanding the importance of it there in terms of commercialization you know sort of a zero to one technology right and quite Paradigm shifting so um kind of made me feel good and kind of reinforce the the idea that yeah this needs to get out there we have commercial ons this and and we were part of like an ecosystem of Entrepreneurship um at the impact Hub at the cic Cambridge in Boston so every day we talk to entrepreneurs and it it was really um you know encouraging um very supportive and collaborative environment uh so I really this really helped us to get started as a doctor I wasn't used to asking for help especially when it came to subjects outside of medicine but then I found physician coaches.com in an instant I found hundreds of experts to help me in all aspects of Life on areas I was afraid to ask dealing with burnout starting a side gig money management even help with my marriage and the best part nearly all experts are Physicians themselves after reading their profile and a quick chat I'm I knew I found the right Mentor for me at physician coaches.com help from professional colleagues is just a click [Music] away so you know there's the entrepreneurship Journey you know seems to be never ending and uh I like again kind of take you back to those those those early days uh you know you're uh you where were you in the process of you know going out and and seeking investors you know important important uh uh you know term in in entrepreneurship is having the MVP right the minimum viable product but when you were going out to these investors and you said you you you um successfully got some uh your early investors were mostly Physicians um you where were you in the process did you already have it all kind of fleshed out was it still an idea you know in your head uh you know and maybe just talking about that because if it's still an idea it's kind of difficult no matter how persuasive you can be to for them to start putting their money where where where their their mouth is so maybe talk about those kind of early days and maybe what was the the one thing that that led them to say you know you know I really believe in what you're doing Cody uh and I want to be part of it yeah I mean we had uh convincing biomarker data you know that was published in small animals um we have those images and what they look like and it's a really novel way to make vascular images and they look incredible um and then uh because I was able to do the sort of first inum studies at Mass General Hospital uh we had beautiful looking images of the brain um and so I think that's part of you know sort of having that prototype I think was critical um to get the investment uh and at the same time that initial investment was really geared towards uh more prototyping right so we kind of had you know one kind of working uh prototype to get some images but now we need to sort of refine it and so we we took that money and went and worked with academic collaborators who you know to sort of stretch the dollar as far as we could right so found the best in the field um started working with you know Peter Larsson who's a professor at UCSF that really uh you know from ism remm is where I met this guy and he's an incredible uh imager uh and and so we worked there with him and got sort of went from alpha to Beta uh version um later on we we uh you know licensed a specific sequence so we have po sequence that we license from W Madison with another professor there um and so uh so we had a MVP in mind and we're essentially building it and raised the funds to build it um yeah I want to add is the importance of relationships you know like um we were introduced so I I think when I mean when investors you know invest at such an early stage they need to believe in the team they need to believe in the you know in the founders um so I mean again we were blessed to have you know the introduction um I think relationship are fundamentals because when you understand the person and you know what drives them you know and that they're not gonna give up they really passionate uh about bringing this technology to the market that's where you know people are you know not only believe in the technology the potential but as well in the strength of the team to really achieve you know the goals um so yeah I think it was a good combination um and and you know I mean I think there is a timing Factor too like um um things have evolved a lot in five years but I remember when you know Cody started to work on Alzheimer's research project um at that time you know know we had feedback from experts that did don't recognize the value of the vascular um you know aspect of the disease progression this has evolved like you know in the past two or three years I guess um and and now we do have the support you know from from expert in that field so I think in terms of timing how technology fits well with what we know in the field you know um in the medical field um and people understand you know the value that can bring um um and just to had one more thing one one more thought for um you know to to think about is that our goal is really to um change a parading of care to switch from Curative to preventative so that's what we working on um you know in terms of long-term Vision so it's really like a breakthrough platform technologies that we building I think this be good opportunity to actually kind of dive into the technology I think I I I I I listen to to an interview you did uh talking about MRI and kind of the state of MRI and I think and then you can correct me I think you said that there it hasn't changed that much it's still in in the Stone Age maybe you want to elaborate and and and talk about how your technology is is transforming uh and and making a a giant paradigm shift in into what we're currently looking at ye yeah and I want to add to your question that why M ohigh because Cody is actually an Imaging expert why did you show MRI for your PhD yeah I mean right so again so you know okay so in in medical imaging I mean you really have a modalities right you've got CT which which is great but you know there's radiation exposure you're not really you know looking at tissue per say you're looking more at like bone and high density things um you can use iodine contrast and you can try to get some information there but uh but it's not appropriate necessarily for interrogating soft tissue right uh you've got positron emission tomography which is uh really great for quantification you know fomar type uh sensitivity but uh what you're really looking at there is you know specific targeting of your agent to some Moi right and so if you want to look at an amalloy plaque or a tow you know protein or something very specific there's you know nothing better than PET Imaging but if you want to characterize tissue sort of in a more abstract way like you know quantifying the vasculature of the tissue um it's not you know quite appropriate ultrasound is is great but you know Limited in resolution and um you know and so MRI just stands out right and um and and so uh so so that's why that's sort of why I I picked MRI and then uh why I say that it's sort of not changed a lot is because you know well first of all what I really care about is that you have a technology that clinician can use and you get some useful information for that patient right and so far what we see with MRI biomarkers is it works great at the group level you know uh if you want to look at for example blood brain barrier leakage you can use galenium based contrast agent Imaging with dce MRI Dynamic contrast enhanced MRI you can see group level statistics um you can see blood brain barrier leakage that's how we know now that for example people with mild cognitive impairment have bloodb brain barrier leakage um now uh those Tech you know there's fmri you can do all kinds of things some of it you know doesn't necessarily have a direct physiological significance per se like default mode Network and so on um but even if you're doing like task-based fmri where you know you have to have some repetitive task to get the signal out for um you know so it's just everything's sort of limited uh you're not really able to get individual level significant results that are useful in the clinic the one thing that I see that you know and even with arterial spin labeling we're looking at blood flow that's a powerful technique but again it's not quite sensitive enough to be used by clinicians got a low SNR um you know long scan times and again you know errors in the inside of the brain and you're just not able to get that individual level significant measurement you know DTI and so on um the one measurement that I've seen time and time again that sort of works is the size of brain regions you know the anatomical delineation of brain regions but by the time brain regions are sort of shrinking I think that's a little bit too late you know that significance for the individual level it's like deep into Alzheimer's we want you know uh let's say before somebody has cognitive impairment you see something right so that anatomical shrinking of brain regions is quite limited you can look at vascular related features like white matter hyperintensities right so you know there's some ischemic burden there but trying to use those you know as biomarkers they're moving around they're changing in size you can't quantify the esic burdent and so again we're limited right now in MRI with for the individual level measurements for uh you know essentially just looking visually at these MRI images by a trained radiologist and picking things out you know some kind of anatomical feature maybe some kind of something that screams at you like a gross abnormality um and um I want to add that a lot of like the add on on MRI or lot of like AI company are developing out there to um to have a faster uh time of acquisition on the MRI machine or to have like um you know maybe faster diagnosis uh we def from that because the technology is based on quantum physics so it's a deep Tech and what's going to change is like the acquisition is different so um C did you want to explain a little bit yeah I mean yeah just so you know everyone can be clear kind of what it is we're doing so it's a different approach to Imaging much like arterial spin labeling or DTI or flare Imaging all these different modalities that are used to it it's a different physical approach to data acquisition that gives you some different type of image in MRI so we have MRI which is quantitative Ultra short time to Echo contrast enhanced MRI and it's another flavor of MRI um the objective of that Imaging approach is to create essentially a 3D Volume where the signal can be Quantified by basic fundamental equations so the spoiled gradient Echo equation so we get this quantitative sort of Imaging signal in this volume of interest and before uh you know so but then what we do is we enhance the vascular compartment with contrast agent we don't use gatala uh for different reasons one it's sort of toxic right now we know it accumulates in the brain of healthy people it's not for preventative Diagnostics um also it's got a short uh blood halflife so it's being excreted sort of rapidly from the blood um and so we do use an iron supplement so we use pherom oxol it's approved for iron anemia it's been around for over 20 years now it's generically available um and it's a nano particle formulation so it stays inside the blood unless it's like very leaky for example blood brain barrier um and and so we can use that quantitative signal in that intravascular contrast to get these positive contrast images that are sort of very very beautiful higher resolution better than these galenium images as judged by Radiologists and um and then quantify the partial volume of blood in each volume element that's filled with blood so we can say you know we see those beautiful vessels but then also Al in those areas where it's just you know 5% blood we can say is it 5% blood is it 6% blood you know should it be 6% but now it's a schemi and so it's 3% like so we quantify that and then what we can do is we can use that quantitative measurement of for example blood volume and do it in a functional way so we can look at the vasodilatory response and so we do that with a hypercapnic challenge so for example the patient will breathe in 5% CO2 95% air that's going to make all the blood vessels dilate and so we can measure me those Dynamics we can measure the actual vascular Reserve which is essentially how much can those vessels dilate because CO2 is such a potent vasod dilator and then we can put back on the air and look at the Dynamics of things sort of coming back to normal and so we can do the structure which is the small vessel density the function which is those vascular Dynamics and the leakage for example blood brain barrier leakage so structure function and leakage and so those are the type of quantitative measurements we make at the individual level that each box will in space uh this has been great so let's talk about as you know there are a lot of Physicians who may be listening to this anywhere from primary care physicians like myself radiologist neurologists uh let's talk about the clinical applications um um you we T we briefly discussed about like Alzheimer's disease and more as a tool and and and you're evaluating in terms of prevention let's discuss this um what what are the clinical applications of your technology yeah so you know Alzheimer's disease is sort of near and dear to my heart right so I was for example the um you know the co-chair of the Alzheimer's Association business Consortium for a couple years just finished that term um a lot of my research has been in neurology especially in genetically modified animals for Alzheimer's disease so um in terms of early detection you know what we've seen in the small animals uh you know for example on an apoe4 genetically Knockin animal model was that very early on before there's any manifestation of cognitive impairment for example a 20y old human equivalent in these ap4 genetically modified rats we see increases in small vessal density right so with neurodegenerative disease you know you think you wanna you're gonna find some decrease in the small vessel density you're GNA get you know all that brain shrinking and things but all that happens much later on so we were able to map out with super high significance right individual level stuff that early on and more than half of the brain of these animals they've got an increase in small vessel density so that means that there's some kind of chronic problem that the brain is now compensating for that metabolic dysfunction by doing that and then we we have applications in neurology so like you know Alzheimer's is one Parkinson stroke um like um like rare disease as well like so like you know a lot of application in neurology but not limited to neology because the technology will work in any type you know in all the organs um so there application in cardiology as well the application in cancer um for inflammation as well and we can also um image in and around um stain stainless steel uh vascular implant as well so what we've been doing is that we've been as well applying for Grants um as non you know non-dilutive Equity funding to pursue those different application um it takes a lot of time because we have to like you know develop collaborations uh you know with different hospitals with different experts uh apply for funding um so right now we're more like developed in in the Alzheimer's uh you know sector but the idea is to have you know to develop all those applications uh traumatic brain injuries as well is is one of the applications um you know it's it's really like a longevity technology in the sense that it's um you know in in terms of um impact it has a lot of different applications in neurology cancer uh cardology and and and other you know disease but um because we're able to detect you know like um change in the vascular um the idea is to really like detect disease like decades in advance so what we you know one of the reason why actually we relocated to Orlando is to work with a leader in preventative Diagnostics so it's a private Clinic um and the idea is to offer like full body MRI scans you know with how technology um they also use different type of techniques and between you know blood biomarkers how technology different AI like you know see if um you know how we can help to detect disease you know so like if you know that you are you you might have a stroke you know then you go to see your doctor and you know see if there are things that you can Implement to stay healthy you know so the idea is really like to um to help uh change Medical Care where people will be able to see the doctor maybe in their 20s you know and detect those disease like decades in advance so they go see the doctor but not when they are sick really when to have a preventative treatment plan you know and and I you know we believe that we um we can achieve that um so in a way we are a piece of the pual of longevity um because we can help with those really Advanced Diagnostic add individual level for precision medicine but we can also help you know um the farmer like biotechs in with how end promps to um measure the efficacity of their novel drugs um you know especially anti-aging drugs right right right yeah go ahead it's a I mean it's so those are the sort of the vision and sort of long-term play right um and and so you know we do have biomarkers of aging and if there's any you know deviation in the vascular structure function or leakage such as in Alzheimer's um you know or or other diseases we can see that in the short term I mean so now we we finally have opened up a uh regulatory pathway by working with you know some of these big MRI manufacturers and so now um we can get our pole sequence software cleared um and then we're we're bringing to Market our vascular Imaging solution it'll be uh available within a couple of years um and uh and so then it'll be everywhere and so first we're you know because there's the 10x better M and there's all those Precision medicine Imaging biomarkers for all these diseases so we're raising money um to go to market with just the vascular imaging technology um and focusing in on patients who are contraindicated to gatal Lin so every year there's 40 million MRI scans in the US 20 million with gatal lium and patients who have chronic kidney disease uh if they have CKD stage four or five they're absolutely contraindicated to gatala uh but if they you know the 37 Millions Americans who have CKD it'd be better as well if they you know uh didn't get the gatal lium even if they have stages one to three and so we know that there's at least one million scans that are not undergone because of contraindication and concern for you know nephrogenic systemic fibrosis and these type of things so we want to first start into that market and then sort of open up into the more you know larger market sort of you know for anybody who doesn't want Gatlin because it is a 10x better scan so that's sort of our go to market is just the vascular Imaging solution um the second part of our business model if I can should I share that is yeah I mean you know but uh we can provide more information we can provide more information but um we have a really excellent strategy here and and excellent Partners as well and then and then that's that sort of two-year approach right just the vascular Imaging solution and sort of getting into Beach head markets and expanding and then in parallel again we're we're going after these uh biomarker based Solutions through non-dilutive funding and that will be you know in the future our Focus where we really expanded the really even larger markets um you know somebody gets hit in the head they got a concussion a TBI you got suspected uh you know cognitive impairment there's so many different applications then and really huge markets with unmet needs that were're you know we're following up even now through non-diluted funding yeah yeah this this is really exciting and just talking about you know just going back to your example about you know Alzheimer's right you know we just yeah they're having cognitive decline and yes the MRI shows that there is a decrease in in in in brain matter but then what are you going to do so we know that in Alzheimer's there is abnormal blood you know vas you know vascular CH and that's probably the time to start ear having early intervention versus just like seeing it so and again you know with your example of the g g gum uh you know uh effects on on the on the on renal vasculature and chronic kidne disease obviously there is millions of people who are not current do not have the ability to to use that so very exciting and and again you shared us all the different conditions um and um for those who are listening to this and maybe they're looking for to learn more about your company perhaps uh may be interested in maybe investing as you had mentioned that as well what's the best place where they can go and find out more about about imag imagos sixs yeah so we've got imos.com so that's the the website you can email me at Cody Codi imagin tic.com and Valerie v a l r i attic.com um you know you can reach out to us on LinkedIn as well we're we're sort of active there and and just imag imagin atic stand for Imaging Diagnostics Imaging plus Diagnostics I know like the Imagine is kind of fun because imagination but it it it's it's that's just a bonus I think it's um Imaging plus Diagnostics I I I love the name I love I love the name uh uh Cody and Valerie again it's been a pleasure to to learn about you to meet you and learn more about your technology um maybe if you give give us like one last advice to maybe the the entrepreneur or the wantrepreneur out there who's in healthc care uh who's got an idea maybe had seen some things that they're currently doing and wants to move forward but they're not quite sure any advice for that for that person for me I mean like reach out you know like talk to people um new tribe that's my best advice and it took us a long time actually because you know we didn't really know how to define ourselves um so we understood that we Weare deep Tech uh compared to like you know just digital health or we not as well a metch because we don't have any hardware um we're not a biotech because we don't propose you know Therapeutics we help biotech we their Therapeutics um but yeah we uh you know after we understood like we are deep Tech we longevity Tech uh we reach out to the different you know ecosystem and I'll say you know don't stay isolated like join a a program an incubator just get started you know get started and make some connections and I know that there are some programs as well where they match you with potential co-founders so like if you're a physician and you want to you know match with someone with a background in business or computer science um you know go to those like events and the you know ecosystem events because that's how you're going to meet you know your idal team and co-founders wonderful Cody any any words from you uh no I think I think Valerie is amazing I think her I think that's why I think it's more about who yeah one last maybe shout out for idos program for yeah so I mean there are some you know um you know there are some programs such as I was in Ido talls program called raise the round right and there's all kinds of different different entrepreneurs in there and they teach you you know how to build the deck um how to reach out to people how you know um you know what do you say how do you so from A to Z sort of in fundraising and so there are places to learn those skills and they are skills and um and you need some kind of uh crash course on it so that's I would definitely recommend os's raise the round uh course I thought that was really helpful plus you start to meet other entrepreneurs and there as well um and that and it's really and maybe that was the most important thing from that group for me was just the people themselves and the encouragement yeah there was a Facebook group WhatsApp group um and and I remember when we got started it was so hard to expend the technology in 10 seconds you know so heo is the one who said but you know you have a deep T platform technology it will take more than 10 second for you because sometimes you have you know expectation from what people tell you um but it's not applying to you you might be the exception compared to the rule and we learned that with youo yeah oh wonderful and then I might add too it does it does help that you're in a area I mean I know with zoom and everything we're getting connected it does help that you're in an area where you know startups are around you've got entrepreneurship I was in an incubator here in in San Diego as well and it's kind of it's kind of being around you know to be able to Network and and learn from from from these folks had mentioned that as well and we moved an area as well with has you know it's like a health um cluster here in L Nona Medical City uh we we co-working members of The gadwal Innovation centers so it's really you know they are they always organized conference about the health health health sector uh you know the future of health so we actually took um when we started we took a a picture we posted on Linkin and behind on the background is like reaging the future of houseal I mean you know we come to work and we know what you know that really remind us you know what we are working for you know and uh so I think you know Finding Your tribe you know whether it's your office space co-working space or virtual group um it's really important well Dr codin and Valerie thank you again imag gnostics well we'll put out the links uh if anybody wants to reach out to you we'll have that in the show notes as well thank you for a time we'll let you get back to the lab back back to work and and keep fighting the good fight thank you so much and thank you for listen saying as always as entrepreneurs you're going to have your ups and downs do something a little each day to get you closer to your goals and [Music] forward