Inveox founders Maria and Dominik Sievert (photo: Astrid Eckert / TU Muenchen)

Inveox: Digital Pathology

Inveox develops digital solutions for pathology labs. The technology created by the Munich-based company aims to avoid unnecessary diagnostic mistakes. The founding couple Maria and Dominik Sievert have a special secret to their success.

Diagnosis: cancer. After the initial shock, the doctor and his patient discuss the steps that will need to be taken: treatment, prognosis, chances of recovery. The family is informed, and then those close to the patient. What are we going to do now? A further biopsy is performed weeks later — and suddenly there’s no trace of cancer. Instead, the lab finds only benign tumor tissue – harmless. How is that possible? The lab where both samples were tested conducts an investigation.

At the very same time, suspicious tissue had been taken from a different patient. After it was examined at the lab, the patient received a clear bill of health. Weeks later, the attending physician calls: “We need to talk. Your sample was mixed up at the lab. You have cancer.”

As a result, the first patient and his entire family were put through a traumatic experience that was completely unnecessary due to a mistake in the pathology lab. The other patient received his diagnosis weeks later than should have been the case — a potentially fatal delay in the fight against the disease.

These types of situations happen time and again, said Maria Sievert. Together with Dominik Sievert, who is also now her husband, she founded the startup Inveox in February 2017.

“A case like that is just the tip of the iceberg. A lot of mix-ups are caught on time in the lab. The pathologist and attending physician then have to put in many hours to clear it up. That’s simply bad for the lab in financial terms. There are also cases in which the patient has to wait longer, or they receive the wrong diagnosis or even need to have another operation. A prostate core needle biopsy, for example, is not something a person would like to go through repeatedly.”

Of all the mistakes that occur in pathology, roughly 70-80% happen during sample receipt, said Maria Sievert. Medical samples are mixed up, packaged incorrectly or damaged when opened at the lab. Inveox is working on the digitization of pathology so cutting-edge technology can be used to avoid those kinds of mistakes.

Pathology 4.0

What began as a team of three has since grown into a company with 36 full-time employees that is located at Gate Garching. That’s where the startup developed three products that work together: A sample container for doctors to use to send tissue to the lab, a machine that takes the sample out of the container and a software platform.

The container is about the same size as a film canister in the olden days. The sample container has an integrated filter and the lower portion is filled with formalin for the sample to float in during transportation. The containers are opened and processed at the lab using a device developed by Inveox. First, the sample data is recorded and then the formalin is removed. The device then automatically repackages the tissue in what is known as a biopsy cassette and a photo is taken. The sample remains in the container the entire time. The process should eliminate mix-ups and contamination. Other companies have already worked on similar machines, but always ran into the same problem, said Maria Sievert:

“Their approach always involved touching the sample, for example with a robotic arm. First off, that introduces the risk of contamination. Secondly, formalin makes samples delicate, which means contact can break them into several pieces. To continue with the core needle biopsy example, it’s important to know if the cancer is in the top or bottom end. It’s not usually possible to determine that if the sample has fallen apart.”

That problem is avoided in the Inveox container thanks to a dispensing mechanism. An additional advantage: It’s no longer necessary for lab staff to manually pour off the carcinogenic formalin.

The sample container is labelled with an ID, which allows for transfer data, tracking and process control. Photos, descriptions, tracking data and other information are collected in an IT database, which is then made accessible to pathologists in their laboratory systems. By using the integrated image recognition module in the automated system, the sample is recognized with special algorithms. Altogether, Inveox provides a digital solution which comprises the packaging and description of a tissue sample at the doctor’s office, its transportation to the lab and its preparation for examination: Technology for Pathology 4.0.

“No startup can be successful all in its own”

Although the Munich company hasn’t been on the market for long with its digital pathology solutions, the startup has already been showered with awards: In 2017, Inveox won the highest number of startup competitions among all newly founded German companies. 2018 brought a whole new series of other awards, including the Munich Startup Award. There’s a method behind Inveox’s participation in the competitions, explained Dominik Sievert:

“Competitions help you quickly refine your ideas. The jury is made up of individuals who are well informed, who challenge or encourage you with their feedback and can help you make progress with their wealth of experience. Especially in the beginning, that was extremely helpful.”

The public impact made by winning an award is another positive effect:

“After we win a competition, we’re always contacted by a large number of applicants.”

Maria Sievert also emphasized the “networking effect” of competitions:

“You get to know a lot of mentors and supporters at competitions. Especially in the beginning, you really need support. No startup can be successful all on its own.”

In general, founder Maria finds networking extremely important:

“I’m networking when I’m standing in line for lunch and talking with our building’s landlord about other startups that will be moving in here in the future. Every time you talk with someone, you’re networking. What’s important is to simply be open to meeting new people.”

One example she shared happened while she was leaving for a vacation and started talking with the person standing behind her in the line for airport security: As it soon turned out, he was a professor of pathology. She said:

“I’m always asked what I would recommend for young founders. My answer is always: Do your homework when it comes to networking!”

Her husband and co-founder also advocates thinking outside of the box:

“I like to give students the advice to deliberately do something beyond the necessary events. You never know how that might help you at some point.”

For example, Dominik Sievert completed an internship at a patent attorney’s office during his studies.

“I never would have thought that I would be reviewing patent applications and would have to think about how we could protect our intellectual property. Now it’s super relevant for me to understand it.”

The same applies to personal contacts:

“In some cases, the person you met on the subway, at a bar one evening or during a Baystartup event might just be the person who invests in you, works with you or makes a customer contract with you just because of that encounter.”

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Inveox: Digital Pathology - Munich Startup