Written by Whitney L.J. Howell

With many cancers – especially certain types of aggressive breast cancer – quick diagnosis can be critical to effective treatment. Imagine if knowing the severity were as easy as flipping on a light.

Actually, in some ways, it is. In her lab, Nimmi Ramanujam, Ph.D., professor of biomedical engineering, diagnoses malignant or benign cancers by shining light onto breast tissue that’s been removed from the body.

“We’re using light to say something about what the tissue is and what it does,” she said. “We’re using the light-tissue interactions that naturally occur to see the signs of cancer manifestation before the disease becomes overt.”

To make this capability more widely available – especially in low-resource areas – Ramanujam founded the company Zenalux in 2006. The company’s flagship product, the Zenascope is a pen-like, hand-held probe that shines white light between the visible and ultraviolet wavelengths onto tissue. The light is either scattered or absorbed, and the scope collects data about the different reflection angles.

As the photons from the light either scatter through a tumor or are absorbed, said Ramanujam, who is also the Center for Global Women’s health Technologies director, they come into contact with optically-detectable cancer biomarkers, such as blood oxygen levels, beta-carotene levels, and collagen content.

The team uses an algorithm Ramanujam developed to identify malignancies based on these scattering or absorption levels. Determining the results takes milliseconds, so feedback is real-time. This ability can be particularly helpful to surgeons performing breast-conserving surgery – they can check whether they removed all cancerous tissue.

But white light can’t penetrate tissue deeply. So, the probe isn’t effective for any invasive diagnostics, she said, though it is particularly useful for areas that can be accessed non-invasively, such as the breast, mouth, nasal cavity, and cervix. The ultimate goal, she said, is to bring quality healthcare to locations that traditionally lacked good services.

“I would really like for Zenalux to reach a global market where it’s able to impact people who traditionally aren’t able to access the kind of healthcare we have here,” Ramanujam said. “We have to figure out how to engage the company, population groups, and my center to work on solutions that will work for low-resource communities – we must find effective, low-cost solutions for communities that simply can’t afford traditional healthcare.”

In the future, she anticipates this technology will allow physicians to give patients a bedside, real-time diagnosis, while increasing accuracy and reducing unneeded surgeries. To this end, her team is currently testing whether the probe can accurately diagnose cervical cancer among women in Haiti.

Funding from one of the first Duke-Coulter Translational Partners Grants made founding Zenalux possible, but it was Duke’s human resources that truly made the research and the entrepreneurial venture a success, she said.

“The ultimate resource is people – having an intellectual pool of like-minded individuals who see the value in what we’re doing,” Ramanujam said. “These relationships in an institution that prides itself on having high-caliber research are the biggest asset Duke has.”