Micro-X: The Future of Mobile Stroke CT Imaging

Micro-X's patented X-ray technology is smaller, lighter, faster and more precise than anything the world has seen before, creating new opportunities for industries. 

The company, based at the Tonsley Innovation District in Adelaide, has developed a mobile X-ray platform manufactured in Australia and sold around the world. 

Now it is using this lightweight tech to create the world's first portable stroke head CT scanner, small enough to fit in an ambulance or retrieval aircraft using precise imaging to diagnose stroke patients before reaching hospital, giving patients access to treatment sooner and increasing their chances of survival. 

Micro-X Chief Executive Officer Kingsley Hall and Chief Operating Officer Anthony Skeats join AUScelerate’s Caroline Duell and Dana Bell to discuss the company’s trajectory that led to the development of their life-saving diagnostic platform using unconventional carbon nanotubes. 

Transcript

Episode Kick-Off And Acknowledgement

Natalie Vella 0:00

It's time to AUScelerate. MTP Connect has a new name that better reflects our mission as we enter our second decade. We're supporting the commercialisation of Australian life sciences through impactful, world-class accelerator and innovation programs. The AUScelerate Podcast continues to showcase the people behind the life-saving innovations, driving Australia's growing life sciences sector from bench to bedside for better health and well-being. AUScelerate acknowledges the traditional owners of country that this podcast is recorded on and recognises the Aboriginal and Torres Strait Islander peoples are Australia's first storytellers and the holders of first science knowledge.

Micro-X Vision And Guests

Caroline Duell 0:46

Hello and welcome to the podcast. I'm Caroline Duell. Micro X's patented X-ray technology is smaller, lighter, faster, and more precise than anything the world has seen before, creating new opportunities for industries. The company based at the Tonsley Innovation District in Adelaide has developed a mobile X-ray platform manufactured in Australia and sold around the world. And now it's using this lightweight tech to create the world's first portable stroke head CT scanner, small enough to fit in an ambulance or a retrieval aircraft, and using precise imaging to diagnose stroke patients before reaching hospital, giving patients access to treatment sooner and increasing their chances of survival. To tell us more, we're joined by Micro X Chief Executive Officer Kingsley Hall and Chief Operating Officer Anthony Skeats. Welcome to the podcast, Kingsley and Anthony. It's great to have Micro- X joining the show.

Kingsley Hall 1:47

It's very nice to be here. Thanks for having

Founding Story And Independence Day

Speaker 2 1:49

us.

Caroline Duell 1:49

Kingsley, you're the CEO of Micro- X. Tell us how the company was founded and where did it all start?

Kingsley Hall 1:56

The company's been around since around 2010, 2011. The company's founder, Peter Rowland, identified this technology on a kind of study research trip into Japan. And he um he immediately had these thoughts around what a novel approach this X-ray image carbon node tube X-ray imaging was and what it could be applied to. And originally Micro X was going to be a manufacturer of X-ray products, but not necessarily a technology development firm that developed and manufactured tubes and high voltage generators and reconstruction software like we do today. It was about outsourcing that manufacturer of the core technology. And essentially Micro X being a compiler or a manufacturer of the product and then selling that product to other people. So that that's the that that was the original genesis of the company. And essentially what happened over a, I guess, a four, five, six year period of time, and you know, Ant was intimately involved in a lot of those years, was that whilst the idea was really solid and there was certainty around our ability to make great innovative applications from it, we couldn't find people externally that could reliably make the core technology. So Micro X took it upon ourselves to actually make that technology in-house. So there was a long, there was a long period of time where we worked with a a US-based uh X-ray tube company to get the tube. And they couldn't make it reliably, but but we were certain around the fact that it would work if it was made right. Um, and so we in-sourced it and started making x-ray tubes at Tonsley in two small little Atco huts in the car park. Um, right, if you can imagine that. And um uh the 16th of May, actually, internally at Micro X is called Independence Day. Right. And that was the day that we made our first carbon nanotubes, um, and we've continued making them ever since.

Carbon Nanotube X-Ray Explained

Kingsley Hall 3:59

So the the the core difference between our X-ray tubes and a and a traditional thermionic x-ray tube is the thermionic x-ray tubes require a lot of heat um and they heat up a filament, and that filament then liberates electrons, and those electrons fly through the vacuum chamber and and cause an x-ray to come out of the x-ray tube, um, in quite simple, simplistic terms. Um, we have the same output, but instead of instead of heating up a filament, we have a we have an emitter that's about probably about the third the size of your thumbnail, and it's covered in millions of carbon nanotubes. And what we do is we run a high voltage electric current across that field of nanotubes, and that causes them to stand up and liberates the electrons from the tips of the carbon nanotubes. So you get the same output. Uh, we just don't have any heating, we don't require any cooling. We we see our X-ray tubes as an LED as opposed to a the old style incandescent light bulb. Yes. Um and what it does is it removes a lot of the weight and the size from the tube. You know, our the the tube that's currently powering our head CT for stroke imaging weighs under 300 grams compared to a traditional mobile x-ray tube that could be 25 kilograms. So um the step change has been really significant. It's not a small change, it's it's a it's a massive step change in in technology. Um, so that that's the tubes. We then moved on to making our own high voltage generators. So our team of very talented engineers and manufacturers uh manufacture high voltage generators up to 160,000 volts. Um, you know, it's a kind of the size of a you know really large football. Um but it's it's really small by global standards. And if you think about there's not much point being able to make a small portable x-ray tube that weighs two or three kilograms if you've got a tower 40 or 50 kilogram generator behind to use it, right? So that's what kind of drove that need. Um one of the projects that Anthony's been leading over the last four years now, which is our head CT for stroke imaging, um, required us to find a really novel way of turning our X-ray tubes on and off in sequence. Um, Ant will probably talk to it shortly, but the the future of our business lies squarely in computed tomography or CT imaging, um, which traditionally has a big X-ray tube and a detector and a generator and a cooler spinning around a big ton and a half gantry at 300 times a minute. We just use a series of our X-ray tubes that don't need to move and we turn them on and off really, really quickly, instantaneously, and that gives us enough images that we can then reconstruct to give a three-dimensional image of what's being uh of what's being scanned. Um so it's a it's a massive step change. It enables uh CT imaging to become portable and for it to become really mobile. And we see that at Micro X as really the heart of our business, taking imaging to where the patient needs it rather than taking the patient to the imaging.

Caroline Duell 7:03

That is really revolutionary.

Kingsley Hall 7:05

Yeah, it is. And yeah, that's it's part of our it's part of our core purpose statement, um, revolutionary x-ray imaging to better lives. Like it's it's it's it's but the fabric of who we are.

Why Cold Cathode field emitters are different

Caroline Duell 7:16

You mentioned that um Anthony's been developing this mobile x-ray system for stroke CT scanning. Anthony, maybe we can talk to you uh about the advantages of using this technology um, you know, to develop mobile x-ray systems.

Anthony Skeats 7:32

Yeah, well, um and Kingsley touched on a few of the uh key value points really around uh what we call cold cathode field emitters and and why they are uh different to conventional X-ray tubes. They they're really I guess the number one um I guess difference is there's no heat generated. So, you know, as you're boiling electrons off of a filament-based tube, the actual tube gets very, very hot. They're normally made of glass. You have to surround it in oil to keep it cool. You can't really control where that heat's going. The whole thing heats up, and then as a result, the whole tube gets to about 20 or 30 kilograms in size. With the cold cathode field emission, which is purely based on electric fields, you've eliminated that that thermal problem. And it means you can miniaturize the whole X-ray tube to something the size of a can of beans for the same amount of energy. Yeah. Now, um, I mean that's just one of the key features of it. The other thing is that it's a it's a fully digital source. And Kingsley used the term the LED versus the light bulb, but it does, in fact, behave in the very same way as an LED. It's an instantaneous response. When you turn it on, it's on. When you turn it off, it's off. Filament tubes have a hysteresis problem where you turn it on and fluctuate around what you're trying to deliver and it doesn't quite deliver your your peak output. It kind of like, you know, it's like a sine wave going over. And then whereas our tube is absolutely precise, you turn it on at 120,000 volts and you know, 100 milliamps, and it's on at that level, and then it's on at that level until you turn it off. And that's really important because um not only can we make um very, very small electroy tubes as a result, but they're also much lighter because there's no cooling required. Yeah, and we can condense the shielding down, but we can we can basically pulse them very, very fast and switch between tubes, which means we can replicate CT imaging without having to spin a tube around and hold it on for a long period of time. The net benefit of that is it's quite significant reduction in dose. The precise delivery, the x-ray pulse that we have, uh, our customers are telling us is typically allowing them to reduce dose around 40%. I mean, it varies between 50 to 30 to 50 percent depending on the pathology. Not a small dose reduction, it's quite significant. Yeah, so size, weight, dose reduction, precise control also makes it more power efficient, and which means we don't need to carry as much weight around in our products because we can use essentially a lot much lower power systems. So we're really completely changing how x-rays are made. And the net benefits are miniaturization, you know, lower complexity, which drives lower cost, and the ability to um construct or conceive different machines allowing us to take X-ray where it's not normally been taken before. We can do pathology-specific X-ray because we can afford to make a machine small enough and cost effective that it people can use it in different places compared to conventional machines, CT machines, which can do everything, but require quite a large amount of infrastructure to install them and to operate them.

Rover Mobile X-Ray In Action

Caroline Duell 10:38

So you're talking about uses in remote locations, possibly in in ambulances?

Anthony Skeats 10:44

With our first product in the market, which we call the Rover, um, this is a mobile X-ray that's designed to be really easy to use and move around different parts of the hospital to take X-rays. Now these products have been in the market for quite a long time. We're not the first, but the existing products basically take an X-ray room and put it on wheels. Now, the X-ray components are very heavy. So you have like a, you know, maybe a 100-kilogram generator and a 30 kilogram tube that you have to suspend a couple of meters over a patient. The whole cut gets to about you know 150, 60, you know, 200 kilograms. Then you've got to motorize it and add batteries to power the motors. So you go very quickly to seven or eight hundred kilograms. The power efficiency of our system means we can just run off, you know, tool batteries that you could buy from Bunnings. We don't use those, but you could. Um, and um we're suspending a weight over a patient that's only six kilograms. So the whole thing scales proportionally. What that rover product has allowed us to do is demonstrate that the carbon nanitude technology is a direct replacement with the equivalent imaging performance of the conventional technology that everyone's been used to since Mr. Rontagen invented it in 1897. And in fact, it was Madame Curie, I think, who uh was the first person to actually invent a mobile. The machine was called the Curies, and they were running around in the war at the front line trying to X-ray uh injured soldiers. So it's been around as a concept for a while, but it's been greatly restricted to infrastructure, big hospitals where you've got you know wide corridors and you can drive these things along.

Caroline Duell 12:14

Yeah.

Anthony Skeats 12:15

All the problems you get with motors and stuff like that. So, but what we're finding is people uh are taking our X-ray machine and and and out of the hospital, moving it to where people are, such as care homes, um, sports teams, um, in ships. Um, for example, we've got them in in expedition ships, and uh, and we're getting um people are putting them in deployed hospital environments, such as in Ukraine, where they have these pop-up hospitals that have to move quite frequently because they become targets and you can easily travel in the back of a van and move it somewhere else. So this notion of taking the X-ray to where the patient is is really kind of changing, it's a it's a changing mindset in the market. And we're extending that into the into the CT space. Now, a CT is typically one to two tons. Uh it's massive. And it generally hospitals are built around them. You know, the the floor has to be reinforced, they have to put shielding up all around the walls. There are some smaller systems out there, but they're around seven or eight hundred kilograms. And uh people have attempted to put those into vehicles because really some conditions, such as stroke, you know, which is the second leading cause of death globally, and has a as a time component to it, where 85% of strokes, which are ischemic, uh, if treated with uh intravenously with uh uh an anti clotting drug called TPA within the first hour, can have dramatic recovery rates, almost 100%. And it diminishes over time by the nature of how the clot builds up in the brain. So a timely response to treating 85% of stroke patients requires you to know is there blood or not in their head. And the only way you can really do that now, the best clinical way to do it is with a CT. You can use MRI, there are other techniques, but CT really is the is the state-of-art benchmark for doing it. W what we're talking about doing with our miniaturized switching array technology, which is a program that's been funded by the Australian government with in partnership with the Australian Stroke Alliance through the MRF program, is a 70 kilogram CT that can fit into the sidewall of a standard Mercedes Sprinter ambulance. We're not we're not talking about just taking uh sophisticated imaging and putting it in specialized vehicles and moving it somewhere where it might be slightly better. We're talking about putting it everywhere and anywhere, basically where care happens. And that's really what we're focusing on.

Caroline Duell 14:38

Dana, over to you.

Global Growth And Beyond Boundaries

Dana Bell 14:40

Anthony talked about the use of the rovers in a number of different settings. I understand you have about 400 mobile x-ray units sold in over 38 countries now. Can you tell us more about that international market, please?

Kingsley Hall 14:54

Yeah, so it is it's over 400 in 38 countries. Um, look, the US has obviously been a really big market for us. Um and we've sold, well, we've sold into the US, we've sold into Europe, we have sold into Southeast Asia in November of last year. We announced our largest single deal ever, actually, which was um just under three and a half million dollars to the Malaysian Ministry of Health, uh, who Ant and I were fortunate enough to host at our Tonsley facility about a month ago. Um, but yeah, so we've we found that um if the the Rover Rover Plus, as we call it, um, has enormous workflow benefits because it's so light, it's easier for the radiographers to use. Um, it's easy for them to position. Um, you can push it around with one hand. There's no, you don't need an engine. Um as Ant mentioned, the the efficiency of our tube means you can achieve the same diagnostic quality image with a lower dose of X-ray going into the patient. Um, we've sold into, I think about half of the major league baseball teams in the US have have at least one of our rovers, some have two. Um, and you know, I think when when I think about that market, um, you know, when you when you're not only are the fact that you're paying your athletes so much money that you you don't want to risk their their health and you don't you don't want to risk a small injury by having them play, it's also a great initiative around player welfare. Um, in that, you know, you want to take care of your players and you want to make sure that they don't have these injuries. Um, I think the college market in the US is also has enormous potential. Um, you know, there's 220, I think, tier one colleges in the US. Um, we've found Southeast Asia, as I mentioned, a really strong market for us, and they are early adopters of technology. Um, and Microx stands to that. Um, Europe, we're still making our way into, but we've sold some some units into Europe and we've got a new distribution agreement there. So look, we've found um, and as Ant mentioned, we've got 29 units that are currently active in the Ukraine. Um, and you know, in addition to being able to be really easily moved, our units will run on a battery all day. Um, so you get a full day's use on a battery, you don't need to plug it in. And when you think about deployable military hospitals, they're often on wooden floors. And a four or five hundred kilogram machine just doesn't work. Um, so for our unit at you know 95 to 100 kilograms, it's it's tailor-made for those types of situations. Um, so yeah, look, it's the it's a strong market. Um, we need to continue to penetrate it as best we can. What we find is that when we can get in front of customers and demonstrate the unit, they they like it.

Dana Bell 17:35

I'm guessing as well that the sporting context, for example, once some teams or some sports see it being used, that that will run, I'm imagining, through through those different verticals.

Kingsley Hall 17:46

So our our first sale was to the Seattle Mariners, um, which is a um uh baseball team based in Seattle, um, which is where our US um subsidiary is based. Um they've been really strong advocates for us, and it's kind of then kind of blown out across the rest of the major league baseball teams. We've also sold into an NBA team and a National Hockey League team. Um so you're right, that that they do start to see a competitive advantage to be able to be able to care for their players um, you know, pretty proactively. So it's been quite helpful.

Dana Bell 18:18

Incredible. And and literally, uh Beyond Boundaries is one of your taglines. Can you tell us more about that, please?

Kingsley Hall 18:26

Beyond boundaries really is we we we want to we want our people to think beyond what has been traditionally expected and understood. Um, and we want people to feel free to challenge existing paradigms. And the reality is that our technology is revolutionary. Our company purpose statement is creating revolutionary x-ray imaging to better lives. And that statement of itself speaks to the creativity of our engineering and our design teams. Uh, it speaks to the revolutionary nature of the way we um create our x-rays and ultimately our CTs. Um, and in terms of bettering people's lives, that speaks to our need and our desire to get it out into as many customers' hands as possible. Um what sits alongside Beyond Boundaries is whilst we want our people to um you know always seek to deliver innovative solutions and not be bound to you know the traditional constraints of how X-ray might have been manufactured historically, our core values are curiosity, collaboration, and determination. Um so that's what we look for in all of our staff. Um but yeah, the the the whole the beyond boundaries um strategy really is just about looking beyond what is accepted and and currently the norm uh and just just seeking to get better.

Dana Bell 19:47

I think it's really powerful um that it's applied both internally within Micro X and if you're thinking about the step change that is required for clinical practice, it takes that curiosity, collaboration, and um both internally and externally.

Kingsley Hall 20:04

And that was that was part of you know, when the when the all of the staff had a hand in it, but when our leadership group and management team um elected to go, it was about that. It was a it was a common statement that can be used internally and externally. Um, you know, we have a not inconsistent with a lot of companies, we have a a staff award. And that that staff award is hotly contested and is based around who demonstrates those core values of curiosity, collaboration, and determination the best, and who goes beyond boundaries. Uh, it's really important to us.

Caroline Duell 20:39

How many staff are we talking about here in Australia and in the US?

Kingsley Hall 20:42

Uh the total number is 95, um, or around about 95, of which uh I think there's about 80 in Australia, 14 or thereabouts in the US and one in the UK.

Caroline Duell 20:53

And are you a strong engineering base? Is that your core sort of capability?

Kingsley Hall 20:57

I'll let Ant speak to that. But we're about two-thirds of our staff are engineers.

Anthony Skeats 21:01

Yeah, we have about uh 55, I think, and a mixture of uh engineers and scientists. We have some mathematicians, we have some physicists, we have some chemists, as well as just your tradition, you know, your normal traditional engineering disciplines. We take a spread of uh skill sets because you know we're a real end-to-end company. It's very there's very few companies that I've worked on in my career where you're really there at that front-end innovation when you're developing brand new physics, right? And you're trying to turn that into something, and then you'd have to turn that something into something else, which is the X-ray tube. Then you've got to develop some high voltage, which is another unique field around how you control and operate it, and that's all well and good, but then you've got to turn it into a product, right? And the product has a very different level of kind of skill set required to bring to market. And of course, we manufacture that. We are fully vertically integrated all the way through the emitter manufacturing into the tube, the generators, and then our products. So it is a broad range of skills, and we also um As the company evolves, I guess, uh, as it's built its platform, and as it evolved, it's evolved more from a kind of raw physics core invention into a product company. Naturally, we're moving more into that imaging software space. And that's where you know we're kind of starting to grow our team and grow our internal capability because our previous product, the Rover, uh, was designed that it could interface with existing people's imaging software. So we were kind of agnostic to whether the detector went with it and that kind of thing, which is great. But in the CT space, the approach is so novel, it doesn't exist. So we've had to develop that from grassroots. And we've really worked closely with leading institutions such as uh Johns Hopkins, you know, the SD i Star Labs teams there, who, you know, are world-renowned in CT imaging and have been since it's kind of was uh uh invented in the 70s. And their team has really engaged with our team. We have close research collaborations. We've sent some of our staff from Adelaide, they've gone and done a PhD at Hopkins, so they learn that stuff and bring it back into our organization and help us think more creatively about how we can develop even better solutions in the both software and the hardware space.

Caroline Duell 23:10

And is the radiology profession sort of open to these innovations?

Anthony Skeats 23:16

Yes, absolutely. And you know, uh it was quite interesting that uh a number of years ago when AI started coming out and it was being touted as the uh the tool that would eventually uh kill off all the all the radiographers and radiologists, quite the reverse has happened. Um what it's enabled is uh, I guess, a higher demand in those skill sets. Um, because there simply isn't enough people. There is there is not enough people out there to take X-rays, there's not enough people to read X-rays. So the tools that are being developed are to enhance that capability and make it simpler and it's welcomed. You know, if you're uh if you're a mobile radiographer and you turn up in a hospital and you've got to go and do your morning round, go and take 20 or 30 x-rays before before the clinicians come around at 8 a.m. The clinicians have a very high expectation that the x-ray you did on Monday is the same like type of x-ray that was taken on a Wednesday, and they can see the kind of change in the pathology they're looking at. They want it done quickly, they want it done accurately. You've got a non-compliant patient in there, right? These guys need their jobs to be really easy, and that's what technology is enabling. It's making their jobs easy. So it's all about workflow improvements and efficiencies. It's about easier positioning, less time, uh, I guess, manipulating the machine at the bedside, and more time in patient care, which is a crucial aspect of the skill set. And then the image quality when it's delivered to the radiology department, you know, they don't want to be sitting there spending a lot of time changing settings, you know, changing the windowing things trying to understand the pathology. They just want to go and say, yep, that's what I was expecting to see. Here's my diagnosis. So, oh, and here's the next one, here's the next one, and here's the next one. So that's where their technology is really helping in the field. Yeah, areas like the CT, where we're talking about in the future potentially having uh non-radiographers, non-CT technologists actually taking the image. It could be an upskilled paramedic. Um, again, the level of support from the radiology fraternity and radiographers is terrific because they're recognising the fact that the patient will benefit from having that scan done in an emergency situation, and they can't be there. They just can't be sitting in an ambulance on the odd occasion that they might need to turn up for a head scan. Yeah, so it's really well supported.

Portable Stroke head CT scanner

Caroline Duell 25:30

So tell us a little bit more about your portable stroke head CT scanner.

Anthony Skeats 25:35

So, I mean, I touched upon earlier about the uh the criticality of what is known as time is brain uh and the golden hour in terms of um how quickly you basically become uh paralyzed once you've had a stroke. And the binary nature of it being a clot or a bleed means a diagnostic image really is the critical timing factor in in determining treatment pathways. So moving it to where the patient has the stroke obviously saves hours, right? And and you could you could basically limit the time from what they call door to needle for thrombolysis to the time it takes for the ambulance to arrive, and two minutes later you've got a CT scan. The um the Australian Stroke Alliance uh are all world experts and renowned experts, key opinion leaders and and clinical professionals in the world of stroke. Um, and the guys in the Royal Melbourne Hospital have been the guys around pioneering having a first mobile stroke unit in Australia. They actually have two now, but only one really is operational, and nowhere else in Australia has one. So if you happen to have a stroke, ideally you're within half an hour of the mobile stroke unit in Melbourne. Otherwise, you're suffering like the rest of us, so you just want to take your chances. And and there's lots of different um challenges around stroke pathways. So, for example, where I'm located here at Tonsley, I'm very close to Flinders Hospital. If I was to have a stroke and it was a hemorrhagic stroke, they would rush me to the hospital there. They don't know. I'd get a CT scan and they go, Oh, it's a hemorrhage. We can't do anything about that. Please transport Anthony to the Royal Adelaide Hospital. So you can see the problem, really. That the it it's it's you need to really move that imaging to where it's needed. And we didn't really know whether we could do it or not. We didn't have a CT pathway or a technology when we engaged with the Stroke Alliance. We had the X-ray tube we've got in our rover, and we just quickly mashed together this kind of like very crude test bench and put a tube in several places with a phantom in it. Phantom obviously doesn't move, not breathing, so you can take your time. And we showed that we could crudely reconstruct a head that looked like a head scan. And we approached Strugglance and said, Look, would you be interested in us partnering in the program? And they were very keen. We took this test bench to the uh Flory Institute in Melbourne, but we did the imaging on a cadaver and it looked even better than the Phantom. So it became part of the program. It uh little side story. The uh intern that did that for us was the guy that joined our company three years later and went into his PhD at Hopkins. So he's been around Thomas with us from the beginning of the program. Yeah, and then it kind of led to quite a whole heap of like innovation. So working on, you know, what would the optimum kind of imaging geometry look like? Is it possible to take a curved array of tubes and can you even make a curved detector? All these were uncertain at the beginning, but over the time we've matured all of these kind of like, I guess, technology limitations and developed them, working with our partners and internally to produce um hospital test benches that are now actually imaging real life, but what yeah, life patients in in the Royal Melbourne Hospital. So these are these are currently patients that are presented with a stroke, have been treated, uh are in recovery essentially in the in the stroke clinic. And we image them with the micro X scanner because the dose is very low. It's only about 0.3 millisieverts, which is about well, you know, put a normal head CT scans around two and a half to three millisieverts. So it's a significantly lower dose, and it's way less than uh patient annual dose limit. So very the dose isn't an issue at all. And we're collecting imaging and we're working on that imaging to make those images meet the diagnostic standards across a broad spectrum of capability because we want we want lower skilled people to be able to read them as well as higher skilled people ultimately. And um, yeah, that that will run that that trial will run probably for the remainder of this year. We have a we have a peer-reviewed, independently constructed um clinical study that's being run. Actually, the sponsor is actually um the Royal Melbourne Hospitals, so it's being run by the Stroke Alliance, but they're all employees essentially for Melbourne Health. Um, patients come down, they scan them, and then they do a reader study to determine can they see any pathology there. Meanwhile, the patients already had a full CT, so they know what the pathology is, and then they can check whether the reader got it right or wrong. And if we're successful, then we have all the clinical data that proves our technology actually works clinically. Uh, second unit is um completed and ready to install in the Royal Adelaide Hospital. We're literally working out, planning the scheduling around that now, so we'll have a second unit doing Adelaide at the same time. And um what it's led to is um essentially, now we're getting towards the end of our MRFF program. It's led to some additional Commonwealth funding through the industry growth program to commercialise it. And what we're doing there is essentially building the product that will go into an ambulance and actually configuring the first ambulance in South Australia, working with the South Australian Ambulance Service and South Australia Health, um, to have an ambulance running around in Adelaide, simulating the workflow of going to a patient, loading them into the ambulance and doing a scan, transferring the data. And we won't actually do any scanning of patients in the first instance. But as the test bench systems in the hospital get towards proving they're diagnostically acceptable, then we can extend that uh trial to do real patient imaging. And it will be the first uh stroke-capable ambulance is the term I use in the world, as opposed to a mobile stroke unit, which is this customized vehicle, heavy, big, expensive, relatively clunky and limited, but it'll just be a standard ambulance with stroke imaging capability.

Caroline Duell 31:24

That's going to be massive. And what sort of timing are we looking at for this incredible innovation?

Anthony Skeats 31:30

Well, if it all goes well, um, we're hoping to be uh in market next year. So, you know, it's uh it's it's close. We uh we've been working on the program really for three and a half years in terms of the technology space. So that's maturing very well. We know we can reproduce the image of the head. We've proven that with the phantoms. We've now got to reproduce that with the range of human samples and different conditions, and then obviously phantoms and human heads are a little bit different, so there's some tweaking that has to be done. But once we have the clinical validation, really it's just about proving the engineering. And the engineering work is occurring. We are months away from building our first actual mock-up system, and then we'll iterate that and it'll become the first integrated ambulance probably around November or December this year. Yeah, with fingers crossed, we'd be looking at um, we'll be looking at building some more systems, certainly in the first half of 2027.

Dana Bell 32:22

The promise and the benefits for patients, for clinicians, and for the health system is really clear. Definitely beyond boundaries.

Working in the Defense & Security Sector

Dana Bell 32:31

And speaking of which, you're working not only in health, you're also working in defense. Kingsley, what's it been like working in the defense sector? And also what are the benefits of working across both health and defense?

Kingsley Hall 32:43

I mean, I think that the first thing I'd say is that but but they're both really significant size markets. Um, and I think if you're if you're looking to launch new products, um, the larger the market, the better the opportunity that exists for you to attack. But the the opportunities in medical and security came to us differently from different parties. So yeah, our security product, we have a quite significant um up to $31 million contract with the Department of Homeland Security in the US to build a self-service airport checkpoint. So if you think about instead of having to line up behind, you know, 150 people in a conveyor belt with your belt and your shoes in your hand and you know all of that stuff, um, our unit is different to that. So we propose we we've designed a system that has eight individual pods to take up the same floor plate as an existing conveyor belt system. And each one of those pods is about the size of a small lift or elevator. You you walk through the sliding glass door, you put your your carry-on bag in a little bin that's in the corner. Now, that bin is essentially a CT device. It's got six of our X-ray tubes and a high voltage generator inside of it uh and a detector. Um, you put your you put your belongings in that bin, door shuts, it rotates 360 degrees. We take a number of images and reconstruct those images to give a three-dimensional CT of what's in your bag. Whilst that's happening, you're standing between two millimeter wave panels and you're getting a a body scan like you get at the airport now, on the basis that there's nothing in your bag that shouldn't be in there, and that there's nothing on your person that shouldn't be there. Uh the the sliding door on the other side of the room opens and you walk out. That's all in under 60 seconds. You just go on board your flight. Um, and so that that's what we've been developing for the Department of Homeland Security. We've got uh a full prototype with them for testing now and a couple of the baggage scanners, um, which is what scans the luggage. We we manufacture it. Um we're in the process of building two more prototypes so that they can then trial a set of three from a workflow perspective. Um so that's what we're doing security-wise. Medical, as Ant touched on, it's the head CT. We're also undertaking an extension of that project, a full body CT for the US government, ARPA H, Advanced Research Projects Agency for Health. And that will enable, you know, a full a full body CT, a circular ring, but again, that doesn't move around like a big electric, uh like a big um traditional CT machine does. And that can go into the back of a van and be transported around regional and rural America, giving regional Americans healthcare equity that they don't currently have. You know, they won't have to drive eight or nine hours to get to a CT. Um, that's being funded, that's up to $25 million. I think over four or five years, we're about 18 months, 20 months into that project. And I think the thing that I would say across all of those verticals is the technology platform is consistent. So the way we manufacture our X-rays for security is exactly the same as we do for medical. So whilst we've probably over the course of the last four or five years invested $80, $90 million into the development of our technology and the development of our applications, each one of them uh assists the other. So the work that we've done for the Department of Homeland Security contract assists the work that we've done for Anthony's head CT. And that again supports the work that we've done for full body CT. Um, so it's really enabled us to accelerate the development of the technology. And I guess broadly speaking, the consistent kind of homogenous platform that our imaging is taken from has been able to grow at a quicker rate. That's probably the great benefit. Um, our focus moving forward as a company is medical imaging. Um, but um, and we're looking to realize value out of the applications that we've developed for security. But uh we we see ourselves as the manufacturers of the core technology that would go into that security product. So again, uh it it's one the left hand benefits the right hand.

Dana Bell 36:55

We're thrilled to hear that um medical is going to be a priority moving forward, and we're even more thrilled that the the world firsts are happening so close to

Tonsley Roots And Seattle Expansion

Dana Bell 37:04

home. Um, and speaking of which, you're based at Tonsley in the Tonsley Innovation District. Um, and on a personal level, it's been awesome watching physically the space grow where Micro X started in one corner, and then slowly there've been more and more containers, and it and you're taking up half of the half the precinct now. It's been amazing to watch. Um, how do you find the innovation ecosystem in at Tonsley and in South Australia?

Anthony Skeats 37:31

You know, and many for many, many reasons. The close proximity to Flinders University and the Medical Device Research Institute, and of course, the terrific Karen Reynolds that lives there. And then and then, of course, you there was great access to the state government. There was a big push uh to promote South Australia as a health state. It was a really terrific policy, and I think it's it's benefited us all and the local economy. And and I thought the whole kind of this like notional um facility, which is a bit like a giant events hall where you can mingle and move around and talk to different people and learn from them and leverage them, was something that I'd seen uh quite a bit in my consulting days when I was traveling around working for large organizations like Philips in Europe, where they had these big innovation campuses. So I thought it was a a really good idea. And he said, Well, I'll do it if you move to Adelaide. I said, okay, so give that a go. And uh luckily fell in love with Adelaide very quickly. And it was almost a little bit of fortune. Um, but the the fact that the uh car auto industry was closing down meant at the time when we needed really high quality manufacturing talent, we were able to approach Holden and say, look, we're a small, you know, startup company here, want to build a medical device manufacturing business. Uh, we'd like to talk to some of your people. And they were really looking for um to help and relocate their staff and have all these really good stories about how their highly skilled staff could be reskilled and redeployed in different industry sectors. And we were fortunate enough to get the site manager to recommend five super candidates, of which we uh took two immediately. And then subsequently um they brought in all of their mates and all of the right people that we needed to build this great manufacturing business that we have now, which is super lean, super efficient. And we layered the kind of like medical device regulations on top of that. So rather than starting in the all right, well, we've got we need a medical device quality system, what do we do next? We developed a manufacturing process and made it compliant, which means as Kingsley was saying earlier, we can make X-ray tubes very effectively and we can transfer them across different products, and it's all very efficient. So um it's it's so it's been terrific being in here in Tonsley. The I think the collaboration with the universities um with Flinders, but also with Adelaide University today is great. Um, everybody knows each other. So if there's somebody you speak to at Flinders, they know they're not the right person, and you should go and speak to that person in Adelaide, it'll happen. You know, the state government, I think, has been terrific at connecting us, and they've been really helpful in when we're looking to go to the federal government for some of our grant funding to say, hey, don't forget about us here in South Australia. So it's worked out really, really well from that perspective. There are some great, some really highly talented people. I have to say the quality of the students coming out of the local universities is exceptional. And um and this local supply chain, which has had to diversify a great deal from the days when they were just supplying components at a high volume into automotive, to become uh those that have decided to become more niche manufacturing and and um diversify a little bit themselves, continue to provide us with really exceptional quality components, which again really helps us with our manufacturing process, our quality of our products, and um and we don't have to travel too far when things go wrong, which they always do, of course, but people are always willing to try and help and fix those issues.

Dana Bell 42:12

And you're absolutely right, where things inevitably will go wrong, and it's having the will and the connection um to support each other to navigate those challenges. And and people often say that Adelaide is small enough that people know each other and big enough to have a global impact. So it's wonderful to see you've had such a good experience.

Caroline Duell 42:31

So you you've got an Australian manufacturing uh strength here, but you've also got um a US Center of Excellence in Seattle. So how does that all fit together?

Anthony Skeats 42:42

Yeah, so one of the key members of staff in our kind of innovation journey is uh Dr. Brian Gonzalez, who's now is uh now our chief scientist and and our uh head of uh or CEO of Americas, as we call it, I think. So at the time he was in North Carolina. Fortunately, he wanted to move to Seattle , so that made it a little bit closer to home, which is quite helpful. And then we started looking at, well, the US is one of our largest markets and uh will remain to be one of our largest markets for a very long time. You know, should we be setting up some operations over there to actually help stage our products into the US? So rather than us having to ship products everywhere from Adelaide, we can now basically move things into our US factory and then they can distribute it and manage service and replacements and all that sort of stuff from there. So it's really, really, really helpful. At the same time, uh Brian was very well connected with the security industry uh through his previous work. And um security being security, right? They're very sensitive, particularly in the US, about where they're funding research and who's doing that research and where their secrets might go. So it made sense for us to set up operations in Seattle with Brian to help us leverage uh the Quite substantial grant and funding opportunities that you get from the US government. And it just so happens that Seattle also is a terrific place to recruit very, very talented software engineers. Because, of course, home of Microsoft, you've got, you know, I think Google and Amazon, they're all there. And the software team we have are really, really high quality people who I think have worked previously for those large companies and got bored and want to do something more meaningful to take and work for us. And as a result, we've now got um really strong access into software talent that is perhaps not so easy to get into here in South Australia. We have a stable platform for us to enter that North American market and with the ability to have stronger relationships with US government entities as well.

Caroline Duell 44:46

So strengths on both sides of the world and and being able to sort of tap into you know the right workforce that you need is obviously critical to this this type of innovation development.

Kingsley Hall 44:59

We have a very strong positive culture. We don't we don't have difficulty in attracting people, and and we've been we've recruited for a few roles over the last probably six or eight months, and the the response rate and the quality of the applicants have been absolutely outstanding. Uh, and we found that um in Australia for a long time, but also in the US. Um the quality of the team that Anthony mentions um absolutely first rate.

Next Milestones And Final Thoughts

Caroline Duell 45:23

So what's next for Micro X in the next six months?

Kingsley Hall 45:26

The short-term catalysts for us are really the human imaging trials that Ant mentioned around the head CT in Royal Melbourne Hospital, but also in Royal Adelaide. The images that we've taken with phantoms to date demonstrate that the technology works. Human heads are different, obviously. Um, but that's really going to be a massive inflection point for us because I think at that point um it it becomes a product that that is doing what it needs to be doing rather than a well-engineered idea. Um so it's a it's it's quite a significant inflection point. So that's probably the biggest the biggest thing we've got. And and um as you move beyond that, it really sets the foundation for Micro X to become a reimagining medical CT imaging company. I mean, that's what that's what we're about. Um we see ourselves firmly at the intersection of you know high value CT imaging and global um healthcare decentralization. You know, our our want to take the imaging to the patient rather than the patient to the imaging. The CT market globally is an enormous market. I

Closing And How To Follow the AUScelerate Podcast

Kingsley Hall 46:31

mean, depending on what, depending on which publication you read, it's anywhere between seven and nine billion dollars a year, um growing at a quite significant rate because of um largely because of the the can the increase in the prevalence of chronic disease. Um so yeah, that the future's really bright um and we're we're right on the cusp of it. Um, you know, I think the rover will continue to demonstrate that the technology is reliable, um, useful, and innovative. Um, and as we progress through head CT and then through the full body CT projects, um, you know, we'd like to see Micro X CT in a lot of places you don't currently see it.

Caroline Duell 47:12

Well, we cannot wait to see this type of imaging become available to really help uh stroke patients to get the treatment that they need as quickly as possible. That will make a huge difference for that group of patients um all around the world. And obviously, world domination is on your list, so we will be watching with interest. Thanks for joining us on the podcast.

Speaker 2 47:37

Thank you, Caroline. Thank you, Dana.

Caroline Duell 47:39

You've been listening to the AUScelerate Podcast, brought to you by AUScelerate, a not-for-profit life sciences innovation accelerator. This podcast is produced on the lands of the Wurundjeri people here in Naarm, Melbourne. Thanks for listening to the show. And if you love what you heard, share our podcast and follow us for more. Until next time.