Tiresias: Enthusiasm uncurbed

“What is now proved was once only imagined.”

William Blake

My friends,

Well, last week, Tiresias mentioned that he thought Prof Farah kept his cards close to his chest. And he certainly does. Tiresias must confess that this week’s announcement surprised Tiresias somewhat. Tiresias expected, and is still expecting and expecting confidently, that there will be announcements on clinical progress, most likely in breast surgery, FDA and oral cancer surgery, and undoubtedly some corporate activity. Tiresias had not realised that improvements in the technology were underway as well. Now some may not think that the announcement of new InVue platform, the new improved higher resolution confocal laser (CLE) handheld microscope is a big deal. Au contraire, Tiresias thinks it's a very big deal indeed. The announcement that the resolution InVue is 0.5 microns is the big deal. You see, the best optical microscopes now in use in pathology today, after 430 years of development since is invention, has at best 0.2 microns resolution. Now, please think about this, just from the simple analysis of the power of our microscope and what other improvement may be in order and what other features CLE microscopy has which Tiresias has waxed lyrically on previously.

Just as a small aside, for his friends who aren't very familiar with micro anatomical pathology, what else does this mean? What does a resolution of 0.5 microns mean? A micron is one thousandth of a millimetre. A hair is somewhere in the order of 50 microns in diameter. InVue resolution of 0.5 microns means that the InVue microscope can separate two points which are 0.5 microns apart in other words 0.005 millimetres apart. Farah indicated that this resolution is 1000X of the best MRI or CT resolution. In Tiresias’s opinion he is somewhat understating the relative power of InVue. To understand the clinical power of InVue, Tiresias would like to show the real advance entailed in the new development. A breast cancer cell, and this may vary, but on average, is about 15 to 16 microns in size. A nucleus of the cell, and normal cell is about 6 microns. The malignancy or otherwise of a cell is largely seen in the nucleus although the cytoplasm and its structures are also useful. This capacity of InVue to resolve 0.5 microns is no longer just cellular imaging, it is subcellular imaging, and this too changes everything. It is comparable to the best laboratory microscopy, but unlike traditional histopathology, this is real -time, in vivo, in operating theatre, live instant pathology. But as Tiresias has said before, it is not only just about these factors that makes this a revolutionary technology. We do no need to discuss all of the other aspects of CLE technology, such as resolution at depth, and thus 3D microscopy. What really excites Tiresias is the in-vivo application of machine learning/ AI which is under way. Tiresias considers that this too may be portentous. Let us therefore look for some developments on this front too. What Farah mentioned, which should have piqued our interest that all this will be on The Cloud, meaning that pathology will be available, instantaneously anywhere in the world. Tiresias wanted to consider a possible parallel that could best explain the impact of our technology for medicine and for us the shareholders, and the best parallel, in Tiresias’s opinion, is Pro Medicus. Optiscan is at the cusp of doing for pathology what Pro Medicus has done in radiology, except much bigger.

My friends, sometimes Tiresias may seem to be too excited and perhaps some of his friends might think he should “curb his enthusiasm”. But as a song from Tiresias’s past, which comes to mind and which some may recall; “…it’s not easy to be calm, when you’ve found something going on.”

Until next week