Imaging Challenges and Innovations in Women's Health: Insights from Guru Singh and Negin Ashouri

Scispot, a leading provider of AI-powered solutions for life science laboratories, continues to drive innovation at the forefront of biotechnology. In a recent episode of "talk is biotech!" podcast, Scispot's Founder and CEO Guru Singh engaged in an insightful conversation with Negin Ashouri, CEO of FemTherapeutics, exploring how cutting-edge technology and artificial intelligence are revolutionizing women's healthcare.

Guru Singh, an entrepreneur and biotech innovator focused on AI applications in life sciences, leads Scispot's mission to provide comprehensive AI stack solutions for research laboratories. His guest, Negin Ashouri, heads FemTherapeutics, a Canadian medtech company specializing in personalized gynecological devices and advanced measurement technologies for women's health.

This compelling interview examined the complex challenges surrounding vaginal canal imaging and highlighted emerging innovations that are addressing long-standing gaps in gynecological care. The discussion covered everything from the dynamic nature of female anatomy and limitations of traditional imaging methods to breakthrough solutions and the expanding market for women's health technology.

Why Is Imaging the Vaginal Canal So Difficult?

Imaging the vaginal canal using traditional methods like ultrasound or MRI presents significant challenges, as Ashouri explained during the podcast. The vaginal canal functions as a dynamic structure that can expand, contract, and dramatically change shape depending on posture, movement, and physical activity. In everyday life, gravity and body position continuously alter the position and configuration of pelvic organs.

However, most medical imaging captures only static snapshots in controlled clinical positions, typically with patients lying flat. This fundamental mismatch creates difficulties in obtaining accurate readings of true anatomical structures. "Movement, posture, and activity make it hard to get accurate readings," Ashouri noted, emphasizing that an organ which "constantly changes shape" cannot be easily captured through one-time scans.

Traditional ultrasound examinations and MRI scans both have significant blind spots when imaging the vaginal canal. Standard pelvic MRI procedures are typically performed with patients in supine position (lying on their back), which fails to replicate real-life conditions. Important anatomical aspects, particularly pelvic organ prolapse, can be missed or severely underestimated when patients aren't upright.

Research demonstrates that pelvic organ prolapse becomes far more apparent on scans when women are imaged standing versus lying down. Standing MRI can detect significantly greater prolapse severity compared to supine MRI, illustrating how posture and gravity profoundly impact female anatomy, yet traditional imaging methods fail to account for these critical factors.

Ultrasound technology offers real-time imaging capabilities and remains widely used in gynecology. Transvaginal ultrasound is considered a first-line imaging modality for the female pelvis due to its high resolution, patient acceptability, and lack of radiation exposure. Clinicians can request patients to cough or bear down during ultrasound procedures to observe dynamic anatomical changes.

However, ultrasounds still present limitations including a restricted field of view that often focuses on one region at a time, and visualization quality that depends heavily on technician skill and individual patient anatomy. As Ashouri and Singh discussed, even advanced ultrasound techniques struggle to capture the complete 3D shape of the vaginal canal, which essentially functions as a collapsible, flexible tube. The canal walls may be touching at rest and only expand with inserted probes or devices, making it challenging to measure true dimensions using external imaging alone.

Broader Challenges in Imaging Female Anatomy

The difficulties in vaginal imaging represent a larger systemic pattern where women's health anatomy has been historically under-studied and under-served by medical imaging technology. Women were excluded from most clinical trials until 1993, creating a shocking historical gap that Negin Ashouri highlighted during the podcast. This exclusion led to persistent gender disparities in biomedical research and technology development.

Consequently, many diagnostic tools and protocols have been biased toward male or general anatomy, leaving female-specific conditions poorly understood. Even today, scientists struggle with modeling and imaging aspects of female reproductive health that change over time. For example, the uterus and endometrium undergo changes throughout the menstrual cycle, and pelvic floor strength varies with life stages including childbirth and menopause.

Several female pelvic conditions pose particular imaging challenges:

• Endometriosis often involves tiny lesions in the pelvic cavity that may not appear clearly on standard ultrasounds. While MRI can help, small or diffuse lesions remain difficult to detect.

  
  

• Fibroids and ovarian cysts can be visualized on ultrasound or MRI, but their impact on surrounding structures might be missed without dynamic imaging capabilities.

  
  

• Pelvic floor disorders including organ prolapse or incontinence are notoriously difficult to evaluate using static imaging because prolapse severity can change with position or straining. Doctors often rely on physical examinations or specialized tests, since supine MRI might appear relatively normal while the same patient shows significant organ descent when upright.

  
  

Traditional imaging modalities simply weren't designed with the dynamic, shape-shifting nature of female anatomy in mind. Standard imaging tends to capture anatomy in isolated moments, while many women's health issues are functional, manifesting during specific activities or positions.

For instance, a woman might have normal imaging results at rest yet experience bladder leakage or organ movement during physical activity. Ultrasound and MRI historically have not been able to continuously monitor or easily capture these functional states, though some innovations like cine MRI or real-time ultrasound exist in specialized applications.

This creates a diagnostic gap where conditions can go underdiagnosed or mischaracterized because imaging fails to replicate the conditions under which symptoms occur. The conversation between Guru Singh and Negin Ashouri underscored how these imaging gaps represent part of a broader historical neglect of women's health technology.

For decades, devices like vaginal pessaries (silicone support devices for prolapse) remained virtually unchanged since the 1950s. Female anatomy was often treated with one-size-fits-all solutions, partly due to the lack of detailed imaging data needed to enable personalization. Thanks to rising awareness and advocacy, the field is beginning to address these gaps, but first, innovators had to tackle the imaging challenge directly.

Limitations of Traditional Imaging Modalities in Gynecology

To better understand why innovation was necessary, it helps to examine how common imaging tools perform in women's health applications. Ultrasound and MRI serve as workhorses for gynecological imaging, but each has inherent shortcomings in capturing dynamic female anatomy.

Imaging Modality	Strengths for Women's Health	Limitations for Dynamic Anatomy
Transvaginal Ultrasound	High-resolution view of pelvic organs; Real-time imaging with immediate movement and blood flow observation; No radiation with relatively accessible, low-cost procedures	Limited field of view focusing on small areas; Operator-dependent results varying with technique; Captures mostly static images unless performing specific dynamic maneuvers
Magnetic Resonance Imaging	Excellent soft-tissue contrast with detailed organ and support structure visualization; 3D and multiplanar images ideal for anatomy at rest; No ionizing radiation	Typically performed supine, not reflecting gravity effects; Not real-time for motion assessment; High cost with limited availability
CT/X-ray	Fast acquisition with ability to image bony structures and detect certain masses	Poor soft tissue contrast for vaginal or uterine structures; Significant radiation exposure undesirable for reproductive organs; Static images only, unsuited for dynamic functional assessment

While ultrasounds and MRIs remain invaluable, neither provides a complete solution for capturing the changing, three-dimensional nature of the vaginal canal and pelvic organs. Ultrasound's real-time capabilities help to some extent, but typically yield a series of 2D slices. MRI provides 3D detail but usually in a single pose, clearly indicating the need for better methods to image female anatomy in motion.

Emerging Innovations in Women's Health Imaging

Fortunately, a wave of new technologies is emerging to meet these challenges. Ashouri's company, FemTherapeutics, exemplifies innovation born from necessity. The team recognized that without accurate imaging of individual vaginal anatomy, designing truly comfortable and effective pessary devices was impossible.

FemTherapeutics developed advanced measurement tools to precisely map the vaginal canal, creating custom devices to scan the vaginal canal internally. These measurements feed into AI-driven software that generates 3D models of patient anatomy. With these models, they can design personalized pessaries that fit specific patients rather than forcing generic sizes.

Initially, FemTherapeutics explored fully bespoke 3D-printed pessaries for every patient. While these provided excellent comfort, the approach presented high costs and scaling challenges. In response, Negin Ashouri explained that the company pivoted to creating "standardized" customizable models, essentially a semi-tailored approach that vastly improves fit and efficacy over legacy one-size-fits-all devices.

FemTherapeutics is not alone in this innovation space. Cosm Medical is also pioneering custom gynecological prosthetics using what they call a "digital gynecology" platform. They capture patient internal dimensions through ultrasound imaging and apply AI algorithms to design tailor-made pessaries dubbed "Gynethetics."

Notably, Cosm recently received funding to integrate AI for automating ultrasound image analysis, increasing pessary fitting accuracy. This means software can interpret ultrasound scans of the pelvic floor and vaginal canal, automatically recommending optimally shaped devices for tasks that would be extremely difficult for humans to accomplish by analyzing grainy images.

Both FemTherapeutics and Cosm are bringing the kind of customization seen in orthodontics or hearing aids into women's health, using imaging and AI to move from "one-size-fits-most" to "made-to-measure" solutions.

Beyond custom devices, innovations in imaging hardware are improving how we visualize female anatomy. Researchers have developed open MRI systems allowing imaging in upright positions (standing or sitting). Early studies with upright MRI show significantly better detection of pelvic organ prolapse, confirming that imaging women in natural postures reveals issues that supine MRIs miss.

Advanced ultrasound techniques are capturing more comprehensive views through "integrated total pelvic floor ultrasound," combining transvaginal, transperineal, and endoanal ultrasound to assess all pelvic floor compartments dynamically. This provides a more complete picture of how organs move relative to each other.

Researchers are developing small insertable imaging devices, essentially scanning wands or probes that can capture 360-degree internal views of the vaginal canal. While still experimental, these could provide true three-dimensional maps of the vaginal vault in various states.

On the software side, artificial intelligence is making significant advances in women's health imaging. In breast imaging, AI has already demonstrated the ability to detect cancers on mammograms more accurately and efficiently. In gynecology, AI-assisted image analysis could help radiologists identify subtle signs of diseases like endometriosis on MRIs or recognize patterns in ultrasound videos that correlate with pelvic pain.

Digital twin technology represents another exciting area, involving computerized 3D replicas of patient pelvic anatomy that can simulate surgeries or test device fit before actual manufacturing. Guru Singh has discussed how digital "Lab Operating Systems" and AI can function as a "unified digital brain" for biotech research and development, and this philosophy is now extending into personalized medicine for women's health.

By unifying data from imaging scans to patient symptoms and analyzing it with AI, these platforms yield insights that were previously unattainable. These innovations focus on patient outcomes, aiming not only to capture better images but to translate those images into improved results including less invasive treatments, comfortable device fits, and earlier, more accurate diagnoses.

As the "talk is biotech!" discussion highlighted, solving the imaging puzzle serves as a gateway to solving clinical problems. When healthcare providers can see what's actually happening inside a patient's body in all its complexity and motion, they can design interventions that truly address underlying causes rather than approximate solutions.

Market Opportunity for Gynecological Devices and AI Diagnostics

The convergence of these innovations points to a massive market opportunity in gynecology and women's health. For decades, women's health was underfunded and considered niche, but this is rapidly changing. Venture investors are finally recognizing that with 50% of the population as potential users, women's health represents a massive untapped market.

Areas like pelvic health, long ignored, are now attracting significant funding, which accelerates innovation. FemTherapeutics recently raised $2.5 million CAD to advance its custom pessary technology, and Cosm Medical raised $4.7 million CAD in a seed round for its gynecological prosthetics. These investments demonstrate confidence that modern solutions for issues like pelvic floor disorders have both clinical value and commercial viability.

Pelvic floor disorders alone affect an estimated 1 in 4 women during their lifetime, with up to 50% of women over 80 experiencing these conditions, indicating a vast patient population requiring better care.

Beyond specific devices, the broader FemTech sector (technology for women's health) is experiencing tremendous growth. Analysts project the global femtech market will reach tens of billions of dollars in coming years, driven by innovations in fertility, maternal health, menopause, and pelvic care. Gynecological imaging and diagnostics represent a key component of this growth.

Clear demand exists for better diagnostic pathways in conditions like endometriosis (which currently takes years to diagnose on average), polycystic ovary syndrome (PCOS), and gynecologic cancers, all of which could benefit from improved imaging and AI pattern recognition.

Improving women's health imaging addresses quality-of-life issues for millions. Take pelvic organ prolapse: while not life-threatening, it can severely impact daily life, yet many women suffer in silence or with suboptimal treatments. If a company's device can non-surgically relieve symptoms through tailored fit, the willingness to pay by patients or insurers is substantial.

Similarly, if AI can help detect ovarian cancer earlier through subtle ultrasound clues, it could save lives and reduce costs of late-stage treatments. The push for innovation comes from both market demand and medical necessity.

Guru Singh and Negin Ashouri's conversation on "talk is biotech!" made clear that we're at a turning point. They represent a new generation of biotech entrepreneurs who view women's health as both a moral imperative and a promising frontier. By merging life sciences with data science and harnessing tools like Scispot's AI-driven lab software and FemTherapeutics' biomedical engineering, they are closing historical gaps.

The market is responding accordingly with record-breaking investments and an "explosion in innovation" underway in femtech. This momentum suggests that challenges like imaging the vaginal canal, once deemed too difficult, will increasingly be met with high-tech solutions that transform women's healthcare for the better.