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Atrial fibrillation (AF), a form of cardiac rhythm disturbance, significantly increases risk of stroke, heart failure and sudden death. The Division of Imaging Sciences and Biomedical Engineering at King's College London and Philips Healthcare collaborated to develop a platform for guiding cardiovascular catheterisation procedures in patients with AF. The EP Navigator is a commercial, clinical product that integrates pre-acquired magnetic resonance and computer tomography images with real-time X-ray fluoroscopy. This enhances visualisation, thereby reducing procedure time and the patient's exposure to radiation. The EP Navigator is used in around 350 out of 2,000 centres worldwide that carry out ablation therapies for cardiac arrhythmias, despite strong competition.
We have developed a new technique of performing cardiac catheterisation in children and adults with congenital heart disease. This has led to the commercialisation of hybrid MRI and X-ray cardiac catheterisation laboratories, a new scientific technique for studying cardiac physiology and pathology and most importantly is being routinely used in clinical practice as it dramatically reduces X-ray radiation exposure (by a factor of 8) and improves the accuracy of physiological measurements leading to better clinical decision making and impact.
A collaborative research project between the Division of Imaging Sciences and Biomedical Engineering, King's College London (KCL) and Philips Healthcare has devised methods to register (i.e. align or match) pre-operative 3D computed tomography (CT) images to intraoperative 2D X-ray images, resulting in more accurate and robust registration/alignment measures. The measures can be applied directly to images from standard X-ray machines, allowing for rapid translation to guide surgical procedures and radiotherapy. These measures (or close variants) are used routinely in commercial products by Accuray, Philips Healthcare and Cydar Ltd (KCL spinout), benefitting the care of hundreds of patients worldwide, every day.
Positron emission tomography (PET) and magnetic resonance imaging (MRI) are two of the most powerful clinical imaging tools. They provide complementary information that is used in the diagnosis of many diseases and in assessing the effect of current and new therapies. Researchers at King's College London, in an international collaboration, demonstrated for the first time the simultaneous acquisition of PET and MR data and the application of the technique in preclinical models. Simultaneous PET-MR systems significantly improve the quality of patient care by allowing both PET and MR examinations to be performed in a single scanning session and by reducing radiation exposure by a factor of two. This pioneering work has led to clinical whole body simultaneous PET-MR systems recently becoming commercially available and there are currently around 40 PET-MR scanners installed in clinical/research institutions worldwide.
Impact: Commerce and professional services; the development of Optical Projection Tomography (OPT) — a technique for three-dimensional (3D) optical microscopy.
Significance: A step-change in scientific imaging; novel equipment and training services for imaging laboratories, offering a new standard in 3D microscopy. Over £2M in sales for the MRC.
Beneficiaries: Scientific institutions and imaging facilities, commerce.
Attribution: OPT was developed, by Sharpe, Baldock and Davidson, and commercialised at the MRC Human Genetics Unit, UoE.
Reach: World-wide: OPT instruments are used in Europe, America, Asia and Australia; chapters on OPT can be found in major microscopy textbooks.
Computed tomography (CT) and Magnetic Resonance Imaging (MRI) have revolutionised the practice of medicine by providing improved diagnostic accuracy resulting in improved clinical management and outcome. The evidence-based medicine approach developed by Professor Dixon and his team contributed to the timely evaluation of these technologies. Several of his studies proved improved outcome measures, including reduced mortality, shorter in-patient stay and enhanced diagnostic confidence. Examples include: CT of patients with acute abdominal problems and possible large bowel disease; CT for suspected pulmonary embolism; MRI for lumbar spine disease; MRI for knee and shoulder problems. These informed radiological guidelines adopted across Europe.
Research at the University of Cambridge Department of Engineering (DoEng) has enabled accurate positioning to be added to 2D freehand ultrasound probes to enable the acquisition of large coherent blocks of high-resolution 3D ultrasound image data. The software code base developed in the DoEng was licensed to two separate companies, Schallware and MedaPhor, to enable them each to develop an ultrasound training product. Both companies have sold to more than 30 customers worldwide during the REF impact period; the Cambridge software had a key role in contributing to the innovation and quality of the products developed by both companies, and significantly increased the speed at which they were able to bring these products to market.
New methods to study the biophysical action of the human digestive system were developed in Nottingham using high speed magnetic resonance imaging (MRI) and have been used by: (i) the food and drug industry (Unilever, Proctor & Gamble, Mitsubishi Chemicals, Reckitt Benckiser, Glaxo and McNeil Pharmaceuticals) to develop new products; (ii) Plant Bioscience Limited (PBL) to develop an artificial Dynamic Gut Model (DGM) which is now being applied commercially to characterise drug and food ingestion; (iii) the BBC and other media agencies in programmes related to the promotion of better understanding of nutrition in an effort to combat obesity.
The FLAIR (Fluid Attenuated Inversion Recovery) MRI sequence developed at Imperial College has transformed the sensitivity of clinical neuroimaging for white matter brain lesions. FLAIR has had significant commercial impact with incorporation as a standard imaging sequence offered by all manufacturers on their MRI scanners. The inclusion of FLAIR in routine diagnostic MRI protocols in radiology centres worldwide provides evidence of the continued extensive reach of impact for better healthcare outcomes through improved diagnosis and management. The use of FLAIR has led to more powerful Phase II trial designs for development of medicine for stroke, neuroinflammatory disorders, epilepsy and neuro-oncology based on imaging outcomes.
Pioneering research at Essex developed an innovative mathematical method for determining the chlorophyll fluorescence parameter Fo', as well as novel LED lighting technology and a multi-plant imaging system. This instrument is marketed by Technologica. Originally an Essex spinout, the company has sold 42 units across Europe, Asia and South America since 2006, recording its highest ever profits over the past three years (totalling ~£115k). Essex's mathematical method for determining Fo' is also used by other manufacturers, who have since developed their own imaging systems. This research has helped to establish chlorophyll fluorescence imaging as a mainstream screening tool, now used globally to inform a range of crop production and handling strategies.