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Working life: Stefan Neubauer

Cardiologist Professor Stefan Neubauer has invented a test for chronic liver disease which could cut diagnosis time from weeks to a single day. Here he tells us about his working life and what it’s been like to set up a company to develop his discovery.

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I’m a professor of cardiovascular medicine and, in a nutshell, my job is to develop new ways to characterise the inner workings of the heart, based on magnetic resonance (MR) imaging and spectroscopy. I’m Director of the Oxford Centre for Clinical Magnetic Resonance Research, and setting up this clinical research unit from scratch – which is now recognised worldwide – has been the highlight of my academic career. But in 2012, I also took a leap into the world of industry. Together with three colleagues I founded a spin-out company based on an important discovery we made.

I remember the moment we first realised that wed found something with commercial potential. A PhD student of mine at that time, Dr Rajarshi Banerjee, was doing a project looking at the cardiac changes in obese people. We saw these interesting bits of the liver at the edge of our images and realised that the MR imaging technique we were applying to the heart might also tell us important things about the liver.

So we studied patients who’d been referred to the hospital for liver biopsy – currently the ‘gold standard’ for diagnosing fatty liver disease – and compared the MR imaging with the biopsy results. We were astonished to discover that our test accurately predicted the main parameters that pathologists would look at in a liver biopsy sample: fat content, iron content and inflammation/fibrosis.

The test clearly had enormous clinical and commercial potential, but we weren’t sure how to take it forward. So we talked to our colleague, Professor Sir Mike Brady, a serial entrepreneur who has successfully set up several medical imaging companies. He immediately saw the test’s promise, and together with our chief MR physicist Professor Matthew Robson, we founded Perspectum Diagnostics in 2012. Working with the university’s intellectual property branch we also filed five patents to protect our invention.

Fatty liver disease is a looming epidemic worldwide, mainly due to rising obesity rates. It already affects 10 per cent of the UK population, and projections for future figures are frightening. It’s known as a ‘silent killer’ because generally it doesn’t cause symptoms until tissue damage is severe and irreversible. It’s usually diagnosed with a needle biopsy, which is costly, painful and carries a risk of bleeding. Biopsy can also be inaccurate because if you happen to take a sample from a less diseased area of the liver you won’t get a full picture of the organ’s overall health.

In contrast, our LiverMultiScan test gives detailed information on tissue characteristics of the whole liver from a 10-minute, painless scan. It’s also quantitative, repeatable and easy to read – we use traffic light colours on the image which change with increasing severity of fibrosis.

Presently it can take several months for patients to get a diagnosis. They’d usually have to have an ultrasound, liver clinic appointment, a biopsy and a further appointment to discuss the results. Soon we may be able to replace all of this with a single LiverMultiScan test and get a same-day diagnosis.

Starting up a spin-out company gives an academic scientist insight into a completely different world with opportunities that are difficult to achieve in the traditional academic environment. One can raise funding and realise ideas relatively quickly, and bring new concepts into clinical practice in a short space of time.

If, as academics, we feel we work in a high pressure environment, it’s no different in industry – the investment you’ve got sets the runway, and there’s a limited and strictly defined time to either succeed or fail. As in academia, there are no guarantees of success, and it’s extremely hard work.

The best advice I’d give to a scientist looking to set up a spin-out company would be to ask the experts for help early, and choose the right people for your core team. Their vision and enthusiasm is as least as important as the actual idea and the intellectual property. With the right team in place, a clinical academic can realistically set up a company without it eating too much into the time dedicated to academic work.

When you make a discovery with commercial potential, it can be hard to suppress the academic’s instinct to rush to submit an abstract or sneak it into slides for your next plenary talk. But you have to keep it under your hat and think about protecting it first, because if you show your data in a public forum that negates any intellectual property you might want to file.

These are exciting times because we expect the company to grow rapidly over the next year or two and to begin marketing this test worldwide. We now have 12 staff, and last year we got further funding from Innovate UK to develop the scan further and show that it works in the ‘real world’. We also achieved CE marking last September so that we can sell the test in Europe, and we’ve applied for FDA approval in the US.

I’m still first and foremost a clinical academic, and I am fortunate in that I really love what I am doing – my work is my hobby. As a clinician I’m always glad if I can help diagnose a difficult case or guide challenging treatment decisions so that a patient receives the best care. As a scientist I love to push the boundaries or our knowledge and develop new techniques. I hope that LiverMultiScan will be a great success but if, by the end of my career, I can say I’ve made a lasting contribution to improving patient care in cardiovascular and liver diseases and to training the next generation of scientists, I’ll be happy.

As told to Sarah Harrop

This article appears in the Spring 2015 issue of Network magazine, which will be published on 10 April.

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