| Infovalley Group Chief Executive Mathavan Chandran poses at his office in Kuala Lumpur, June 24, 2013. |
By Jeremy Wagstaff
SINGAPORE |
He believes his so-called digital autopsy could
largely displace the centuries-old traditional knife-bound one, speeding
up investigations, reducing the stress on grieving families and placating religious sensibilities.
He is confident
there's money in what he calls his Autopsy as a Service, and hopes to
launch the first of at least 18 digital autopsy facilities in Britain in
October, working closely with local authorities.
Around 70 million people die each year, says
Chandran, and around a tenth of those deaths are medico-legal cases that
require an autopsy. "That's a huge number, so we're of the view that
this is a major line of services that is shaping up around the world,"
he said in an interview.
The poor common perception of autopsies has
undermined their commercial appeal. "Unfortunately, because the process
of the post-mortem is seen as gruesome, one tends to ignore that," says
Chandran.
Humans have been cutting each other open for at
least 3,000 years to learn more about death, but the autopsy has never
been widely embraced outside TV crime dramas. Surgeons in 18th century
Britain, for example, robbed graves for corpses to dissect, some even
commissioning murders when supplies dried up.
By the 1950s, the autopsy was at its zenith,
with pathologists performing post-mortems on more than 60 percent of
those who died in the United States and Europe - helping uncover more
than 80 major, and perhaps thousands of minor, medical conditions.
But the number of autopsies has fallen steadily:
Today, fewer than 20 percent of deaths in Britain are followed by
autopsy, and most of these are ordered by coroners in cases where the
cause of death is unclear or disputed.
The fall has been blamed on a growing distaste
for a procedure regarded by some as crude and outdated - a feeling
fanned by the public discovery in Britain in 1999 that medical
institutions had been retaining organs and tissue after post-mortems for
decades.
| Digital Autopsy forensic application, a three-dimensional capabilities to view and dissect inside and outside of the digital body in high definition visuals, on a multi touch screen representing a digital mortuary table at the INFOVALLEY office in Kuala Lumpur June 5, 2013. |
DIGITAL MAKEOVER
Chandran, 45, wants to change all this by simply connecting his company iGene's 3D imaging software
to any standard medical CT or MRI scanner. An expert can then inspect
the virtual cadaver in 3D, removing layers of cloth, skin and bone with a
mouse or by gestures on a tabletop touchscreen.
The advantages, Chandran says, are considerable.
The digital evidence remains intact and can be
reviewed; experts can more easily spot and identify fracture, foreign
objects such as bullets, and the tips of knife wounds; and grieving
families can swiftly learn how their loved ones died and without having
to cut open the body.
iGene isn't the first to run a scanner over a corpse. Radiology has been used on skulls for 30 years, and Israel
first introduced the concept of a virtual autopsy in 1994. The U.S.
military started conducting CT scans of all soldiers killed in Iraq and Afghanistan in 2004 in addition to traditional autopsies.
The results have been encouraging. Researchers
from University College London concluded that in fetuses and individuals
aged 16 and younger, a minimally invasive autopsy incorporating an MRI
scan identified the same cause of death as 90 percent of traditional
autopsies.
| A staff member carries out a CT scan on a corpse at a mortuary at Hospital Kuala Lumpur in Kuala Lumpur July 3, 2013. |
COMMERCIALISE
But iGene is, Chandran says, the first to
package the process and offer it commercially as a suite of services
that stretches from the moment of death to the delivery of a post-mortem
report.
His company provides a software
suite that uses existing medical scanners from the likes of Siemens,
General Electric, Toshiba and Philips. These form the heart of iGene's
digital autopsy facilities which the company plans to build close to UK
mortuaries. The first will open in October in the northern English city
of Sheffield.
A spokesperson for Sheffield City Council confirmed it was working with iGene on such a centre, but declined to give details. Chandran says his company will spend around $77
million to build and run the facilities and will make its money from
those cases where a coroner demands a post-mortem. About 200,000 deaths
require autopsies each year in Britain, he said.
Next of kin will be given the option of a
classical autopsy, paid for by the state, or a digital autopsy, costing
about 500 pounds ($780) and paid for by the family.
SKEPTICS
Not everyone believes the digital autopsy is
ready for prime time. Some question whether it can spot some diseases.
And even a pioneer like Guy Rutty, chief forensic pathologist at the
University of Leicester and the first to use CT images as evidence in a
criminal trial, says that while demand may be growing there are limits
to what a digital autopsy can do - particularly determining where and in
some cases when a patient died.
Chandran and his team are undeterred. They say the digital autopsy facility combines with other non-invasive diagnostic tools such as angiography and toxicology.
Pramod Bagali, chief operations officer of
iGene's parent company InfoValley, says the system is "a complementary
method, not a complete replacement" to traditional autopsies, but could
handle 70 percent of routine cases. The others could be done digitally
to start with and then a decision could be made about whether to open up
the body. "It's not replacing one flawed system with another," he says.
Crucially, iGene offers a business
model that overcomes concerns that scanning corpses is expensive, says
Chandran. He estimates his UK operation will be profitable within three
years. But that, he says, is just the start. By then, he says, he hopes
to have built at least 10 more facilities in his native Malaysia, with
interest also from the Middle East, Latin America and elsewhere in Asia.
"The potential for this is global," said Mark
Rozario, CEO of Agensi Inovasi Malaysia, a government body which this
year bought a 20 percent stake in iGene for $21.5 million.
SUPPORTERS
Chandran and his supporters see this as the
beginning of his innovation, not the end of it. The digital autopsy
facilities are nodes in a broader ecosystem Chandran likens to Apple Inc's iTunes.
Michael Thali, a Swiss academic who has been
promoting a "virtual autopsy" for more than a decade, said he tried and
failed to get the scanner makers interested in developing such services.
Now an adviser to iGene, Thali says this leaves open the field to other
companies to deliver improvements in the chain of examination.
"The future will be for smaller companies who
are bringing a service for this niche," he says. "The most important
thing is that you have a real chain based on IT."
This is some way off - and may never happen.
Milos Todorovic, lead analyst at Lux Research
and a specialist in medical innovation, says that while iGene's approach
is intriguing, it faces hurdles - not least the fact that the company
is starting from scratch in an expensive business. "A lot of things
would have to fall into place for them to be able to succeed with
something like this," he said.
That isn't stopping Chandran from dreaming big -
including the idea of scanning the living as part of any regular
medical checkup. "Just like a birth certificate starts with the
birth of a baby, the end of a person's life will end with a report in
which the 3D body of a person is captured," he said. "In that way we can
archive every person born on this planet."
(Editing by Ian Geoghegan)
Edited by Ahmad Fakri
