Information. Ideas. Intelligence. Innovation. All of these concepts are essentially related to human ingenuity and wisdom. But without passion, purpose and empathy, such wisdom is often wasted. Perhaps no industry better represents the nexus of these concepts with the role of compassion better than medical technology. At the end of the day, most people in the industry are in it to help other people, and I could see this sincerity of purpose and hope to change the world for others in the eyes of John Kelley, CEO of CereScan. With a disarming smile and persuasive exuberance, I found myself as excited as he is about the advances in medical imaging technology and the potential revolution in brain injury/disorder treatment that could affect millions of people, perhaps hundreds of millions worldwide. Kelley has an extensive background in technology and found himself in the epicenter of the computer revolution in California in his formative years. He was the CEO of McData and held an executive position with Qwest. But CereScan is different. CereScan is not, specifically, a medical device but a multilayered, or “stacked,” technological approach to the imaging and diagnosis of an afflicted human brain. CereScan is a Denver-based company that has taken the MRI into the 21st century by enabling doctors to see, in real-time, the behavior and activity of the working mind, helping identify such disorders as ADD/ADHD, Alzheimer disease and dementia; anxiety disorder; bipolar disorder; depression; OCD; Parkinson disease; toxic brain injury; and traumatic brain injury. While John Kelley may be a techie at heart, he also deeply cares about what his product can do for those afflicted with brain injuries, giving power to his passion for innovation.
The real difference between CereScan and an MRI, for example, is a model of how an impaired brain functions, what it means for our understanding of that disorder, and ultimately how that understanding impacts treatment. Kelley outlined the different technologies and approaches: “You've got two pieces of the puzzle. There is the MRI CT, but there are two other modalities there as well—patent SPECT other cameras and New SPECT. Here's the best example. My wife and I were in a head-on collision on February 29. We were taken to emergency care where they immediately did CT. A CT MRI looks at the physical structure of the brain—so if we had a cracked skull or if we had this tumor, the MRI would detect it—it looks at structure. And, if we would have died, and they had done an MRI 15 minutes later, it would have still shown good structure. It would not be able to tell if we were alive. But, on the PAT SPECT, it is basically measuring the glucose being used by the cells, and we get 5 to 7 million data points when you come in, but if you die, it goes blank.” So, by gauging the amount of glucose being consumed in different areas of the brain, a more detailed picture of brain injury and/or damage can be generated.
Kelley is direct and says that their number-one concern is to use nothing but the best available technology, and for them, it is SPECT. For clarification, SPECT, according to the Mayo Clinic, is a “single-photon emission computerized tomography (SPECT, or less commonly, SPET) imaging technique using gamma rays. It is very similar to conventional nuclear medicine planar imaging, using a gamma camera to create 3-D pictures. While imaging tests such as X-rays can show what the structures inside your body look like, a SPECT scan produces images that show how your organs work.”
Therefore, an MRI CT is a vital tool for those in an accident, and the most pressing concern is to detect structural damage. A SPECT and CereScan are valuable tools to help with long-term recovery. John tells me he does see, in the foreseeable future, a convergence of the two technologies into one, so doctors have the best of both capabilities. He also tells me that soon, as the technology advances, he expects to be able to provide 10, 20 or 30 million data points.
CereScan and SPECT are invaluable when trying to identify the specific region of an afflicted brain, as well as the long-term effects of the damage. This long-term analytic tool, therefore, can provide a more accurate roadmap to be used during treatment. Kelley elaborates, “We provide differentiated diagnoses for doctors to be able to use to treat. A camera is really a computer. Then on top of that you have the software that compiles the images mathematically. Then you have another layer of software that takes the bits and makes them into mathematical measurements, and then you have software that takes those measurements and combines it with clinical. It’s a layered approach. In the computer world it’s called a stack. We’re taking each plank that provides the stack that allows for a higher-quality diagnosis.”
At the end of the day, the technology is about a more precise diagnosis that hopefully guides a more effective and targeted treatment, allowing for a faster recovery. Kelley continues, “So the diagnosis is, ‘Look you’re experiencing xyz because the damage is sitting in the part of the brain that is correlated with what we are seeing in you.’ Now you get peace of mind. Not only do we know what caused it, I can see it; I know what symptoms are occurring; then perhaps there are treatments that can be targeted to it. More importantly, if the treatments occur, then down the road you can take another image, and you will be able to measure the effectiveness of that treatment, or if the brain is beginning to heal itself.”
As exciting as the research is, I was also curious if the procedure and some of the treatments he described were covered by insurance. “We’re one of about 150-plus entities that do scanning for Parkinson’s. It’s called DATscan and that’s a General Electric proprietary product, and it’s used throughout the United States. So that’s insurance reimbursed. If you come in for one of the traumatic brain injuries, there are codes that exist in the insurance system and it is likely that it will be insurance reimbursed. On the psychiatric side, which includes bipolar disorder or ADD/ADHD, treatments are not universally accepted by insurance—it depends on the severity of the case,” says Kelley. Current out of pocket expenses average $3,500—including two sets of scans and the whole stack. But what’s more exciting is that as the technology advances, costs will come down. He tells me that there are new treatments that CereScan is currently working on that could lead to type-two medical devices that could be purchased at local pharmacies, such as Walgreens or CVS. The near-term potential for dramatic life-changing and affordable technology that correctly diagnoses and treats brain injuries and disorders in the near future is certainly palpable.
Kelley assures me that some truly ground-breaking and revolutionary discoveries are coming—soon. But he promised to keep quiet until I can write my follow-up on this story. Believe me when I say you will want to stay engaged with this story to see what is coming next.
But I digress. As with all stories in ICOSA, there should be a mention of collaboration. And here is where the passion for others meets the advances in technology. Perhaps no other occupation has the risk for brain injury more than that of soldier. While Kelley tells me they have treated NFL players, he is excited for the opportunity to give back to those that have selflessly given so much to us. It looks like there will be announcements on the collaborative effort soon. He says, “With respect to the military, we are hoping to be able to announce a relatively sizable collaborative effort, specifically focusing on traumatic brain injury, before the end of November. It's been a year since the first contact, but six months of multiple presentations by multiple doctors at all levels. But you just can’t report it. You’ll want to be back. If what I tell you is true, you’ll want to be back.”
What I can say is that the research is startling, and if true, has profound implications for the treatment of brain injuries for not only our service men and women, but anyone with a brain injury or disorder. The benefits to humanity and the impact of such innovative techniques and devices are clearly what drives John Kelley and the people behind CereScan. I can say that I am genuinely elated to be able to tell their story and share what the future holds. I am looking forward to a follow-up in the next issue of ICOSA to outline the success and results of their research. Stay tuned.