Escope Tech Secures Tens of Millions in Series A Funding to Advance Innovative CT-FFR Technology for Precise and Non-Invasive Coronary Artery Disease Diagnosis

Recently, VCBeat learned that ESCOPE has completed a Series A financing round worth tens of millions of yuan. The investors were not disclosed, and the funds will be used for clinical trials of its products and new product development. ESCOPE is dedicated to the research and development of imaging diagnosis and treatment technologies for cardiovascular and cerebrovascular diseases. Its independently developed innovative CT-FFR technology has transformed the diagnostic approach for coronary heart disease from invasive digital subtraction angiography (DSA) to non-invasive CT-FFR examination, thereby making the diagnosis of coronary heart disease more convenient and precise.

After earning his master’s degree in Engineering Mechanics from Tsinghua University, Zhang Chao chose to pursue further studies abroad, enrolling in the Ph.D. program in Mechanical Engineering at Johns Hopkins University. “At that time, our laboratory’s primary project focused on the heart, with our specific area of responsibility being hemodynamic and functional simulation and assessment of the heart and coronary arteries based on CT imaging.” Beyond his research duties, Zhang Chao and his laboratory team gradually gained insight into the state of industrialization in this field. In the United States at that time, HeartFlow, a company with relatively mature product technology, had already launched its first-generation CT-FFR product for the diagnosis of coronary artery disease.

Scientific research and industrialization are not isolated endeavors. During his doctoral studies and professional tenure in the United States, Zhang Chao and his team identified limitations in HeartFlow’s first-generation CT-FFR product. They attempted improvements and achieved significant results. “At that time, we had no intention of starting a business; we merely regarded it as a scientific research outcome,” Zhang recalled. After two years of working in the U.S., Zhang gradually solidified his idea of returning to China to launch a startup. “CT-FFR technology holds excellent application prospects in areas such as the diagnosis of coronary heart disease. Since HeartFlow had not yet expanded its market presence into China, I believed this presented a valuable opportunity.” In October 2017, Zhang Chao co-founded Escope with two other founders.

According to the "China Cardiovascular Disease Report 2018" compiled by the National Center for Cardiovascular Diseases, there are as many as 11 million patients with coronary heart disease (CHD), and the mortality rate from CHD has continued its upward trend since 2012. Currently, the diagnosis of CHD is based on the criterion of ≥50% luminal stenosis as shown by coronary angiography. However, increasing clinical evidence indicates that relying solely on the degree of luminal stenosis to determine the presence of myocardial ischemia is unreliable.

Current diagnostic methods for coronary heart disease (CHD) include digital subtraction angiography (DSA), computed tomography angiography (CTA), and fractional flow reserve (FFR) measurement. Among these, only CTA is a non-invasive examination method that is simple and safe to perform; however, occasional image artifacts may lead to deviations. Although DSA provides precise assessment of vascular morphology, it is an invasive procedure with high costs and does not yield functional indices. FFR is defined as the ratio of maximal blood flow in a stenotic coronary artery to the theoretical maximal flow if no stenosis were present. It is measured invasively by advancing a pressure wire distal to the stenosis and administering adenosine. An FFR value less than 0.75 indicates that the stenosis causes impaired blood flow to the distal vessel.

Currently, the American College of Cardiology (ACC) and the European Society of Cardiology (ESC) have respectively upgraded fractional flow reserve (FFR) assessment to a Class A (highest level) and Class IA (highest level) diagnostic criterion for stable coronary artery disease. They recommend performing FFR testing prior to percutaneous coronary intervention or surgical revascularization in patients with coronary artery disease. FFR has become the internationally recognized gold standard for evaluating whether coronary artery stenosis causes hemodynamic impairment (functional ischemia). However, due to its operational complexity and high technical barriers, this technique has not yet been widely adopted in China.

With advancements in image processing technology and computational fluid dynamics, it has become possible to calculate fractional flow reserve (FFR) values non-invasively through CT angiography model reconstruction and hemodynamic simulation, eliminating the need for invasive procedures. CT-FFR combines the non-invasive, simple, and safe advantages of coronary CT angiography (CTA) with the high precision of FFR measurements in diagnosing coronary heart disease (CHD). “The high mortality rate of CHD stems from the lack of a non-invasive, convenient, and rapid gold-standard diagnostic method. Patients cannot monitor their coronary vascular health in real time, making it difficult to detect abnormalities and seek timely medical attention,” stated Zhang Chao. Escope’s first independently developed product, Maiying, is a software solution based on coronary CT angiography to assist in the diagnosis and treatment of CHD. Leveraging the latest CT-FFR technology, it enables highly accurate diagnosis of coronary heart disease.

CT-FFR technology primarily involves processes such as CT angiography, geometric modeling, and hemodynamic simulation. Maiying is the latest CT-FFR technology independently developed by ESCOPE. It represents a significant improvement over HeartFlow’s original CT-FFR technology, mainly in three aspects: 1. High precision in image processing. In terms of algorithmic accuracy, Maiying achieves an accuracy rate of over 90%, whereas HeartFlow’s data falls below 90%. Furthermore, HeartFlow’s CT-FFR technology has a "gray zone," where the accuracy of CT-FFR measurements significantly decreases when FFR values are between 0.75 and 0.80, leading to errors. Maiying resolves the issue of errors in this gray zone. 2. Fully automated processing without the need for human-computer interaction. 3. A second-level hemodynamic simulation solver that is fast and efficient. Maiying’s hemodynamic simulation solver can perform calculations for coronary arteries within seconds, with the entire process taking only about 5 minutes per patient, compared to approximately three hours per case for HeartFlow.

Furthermore, in terms of cost, the total price for patients undergoing coronary artery examination using CTA and ESCOPE’s technology will not exceed RMB 2,000, whereas the cost of DSA angiography exceeds RMB 4,000. If specialized medical devices such as specific balloons, catheters, or stents are used during the procedure, the cost may be even higher.

Regarding the formation of its core team, Zhang Chao summarized it in one sentence: “Leveraging external expertise with precise domain-specific division of labor.” The team at ESCOPE has a clear division of responsibilities, primarily organized into four technical modules: medical image processing, artificial intelligence, hemodynamic simulation (biological simulation), and data mining. The company’s Chief Scientist, hailing from the KTH Royal Institute of Technology in Sweden, has conducted in-depth research in medical image processing and AI-based image analysis, particularly in vascular, liver, and tumor segmentation. On the more advanced front of computational simulation, the company has developed a proprietary ultra-high-efficiency computational simulation solver platform, enabling rapid fluid dynamics simulations with tens of millions of computational mesh elements using a single workstation (GPU-accelerated). Additionally, the company employs senior engineers from COMAC, who were key R&D members of China’s new-generation large aircraft CR929. The core technologies of the CR929, such as FEA (Finite Element Analysis), can be applied to simulate vascular walls, the heart, cardiac chambers, heart valves, and plaques. Furthermore, the team includes several seasoned professionals from Johns Hopkins University, the KTH Royal Institute of Technology, the University of Missouri, and Ghent University, specializing in fields such as artificial intelligence and mechanical engineering.

Leveraging a robust core team and mastery of foundational technologies—including graphic modeling, artificial intelligence, and fully automated hemodynamic simulation—ESCOPE has achieved rapid growth and launched its latest CT-FFR product, Maiying. “Our team’s image processing technology effectively addresses the issue of inaccurate CT angiographic vessel modeling, reducing errors in imaging data and enhancing the diagnostic value of CT angiography,” stated Zhang Chao. The company’s fully automated hemodynamic simulation technology is not limited to the Maiying platform but can be extended to many other products. For instance, ESCOPE has independently developed DSA-FFR, a technology based on digital subtraction angiography (DSA), which has entered the pre-clinical trial phase. The company is also developing other derivative products related to CT-FFR technology.

It is reported that Escope has successfully held its initial research and development meeting. Maiying has passed the national inspection report, entered the pre-clinical stage, and been put into use at Grade 3A hospitals such as Fuwai Hospital and Anzhen Hospital. Regarding product promotion, Zhang Chao stated that the Maiying software features various modules, including morphological post-processing, functional assessment, and data mining. By unbundling these modules for promotion and offering them in the form of offline workstations and software modules, the company provides relatively flexible customized services to cardiologists.

Currently, ESCOPE is undergoing its Series B financing round. Meanwhile, the company is seeking collaborations with hospitals and medical device manufacturers to integrate Maiying and other related products into clinical diagnostic workflows, jointly advancing the clinical implementation of functional medical imaging diagnostic technologies.