Questions about the benign or malignant nature of liver tumours are
common and pressing since they determine how the patient is managed.
Benign masses are frequently encountered; they usually do not require
intervention but are easily mistaken for malignancies with conventional
imaging methods. Work at Imperial College demonstrated that microbubble
contrast agents have the special property of lingering in both normal
liver tissue and in benign solid masses, whereas malignancies do not
retain microbubble. The discovery of this property at Imperial has led to
their use worldwide as a diagnostic tool. In 2012 NICE recommended their
use as being cost-effective for this use.
ARTICULATED HEAD (2010-) and EAR ON ARM (2006-) reflect
interconnected but different projects within Stelarc's research into
alternate anatomical architectures. The ARTICULATED HEAD is the
robotic embodiment of Stelarc's Prosthetic Head, a conversational agent
that speaks to the person who interrogates it. It was a finalist for the
Australian Engineering Excellence Awards 2010 and was exhibited at
Powerhouse Museum, Sydney, for two years from January 2011, attracting an
estimated 1.8 million visitors.
EAR ON ARM is the first instance of an artist having an ear
surgically constructed and cell-grown on his arm and has been disseminated
globally through museum, festival, and media representations. In 2010 EAR
ON ARM was awarded the Prix Ars Electronica Golden Nica.
Within the art and medical communities, both projects have been
acknowledged as pioneering innovations in the conceptualisation and
realisation of biotechnological and engineering-based art and media
attention for the projects has brought the research to a worldwide public.
The key driver for this research is to provide clinicians with robust
tools that they can use to evaluate, treat and therefore improve the
clinical outcome in their patients. Our research has assisted the
development of the evidence base of many clinical treatments and
assessment tools. This has led to the design and development of new
rehabilitation products and medical devices in partnership with both large
companies and small to medium sized enterprises. The core impact of this
work has been improvements in patient care and quality of life by
improving the efficacy and effectiveness in these areas with a particular
focus on the advancement of conservative management and lower limb
In response to inadequately designed assessment systems for patients
orthopaedic surgery, researchers from the University of Oxford developed a
series highly reliable
and sensitive patient recorded questionnaires, known as the Oxford Scores.
Providing a set of
standardised outcomes for appraisal and on-going monitoring of patients,
the Oxford Scores
enable the informed assessment of clinical outcomes. Used to predict and
detect early failure of
poorly performing surgical interventions, the Oxford Scores have been
adopted by health providers
and regulators worldwide, leading to policy and treatment guideline
changes and significant
improvements in the quality of life of patients.
Research at University of Oxford led to the development of the Phase 3
Oxford Knee in 1998, a significantly improved and less invasive knee
replacement, allowing implantation through a small incision. Due to its
many advantages over other knee replacements, including faster recovery,
fewer complications and better function, the Phase 3 Oxford Knee is now
the most widely used partial knee replacement in the world. Approximately
1 million people have benefitted from this development.
Postoperative local recurrence affects 20-30% of patients with rectal
cancer. Between 1993 and 2013, University of Leeds researchers identified
the importance of pathology studies to show a disease-free margin around
the excised tumour and how to predict this margin routinely and accurately
using simple histopathology and preoperative MRI.
We also used photography in the pathological assessment of the quality of
surgery and were instrumental in the adoption of modern techniques by
professional organisations around the world.
Following adoption of our techniques in England and Scotland, local
recurrence has halved with 10% better survival and cost savings of £60
million. Our methods have also become the gold standard in the treatment
of rectal cancer patients around the world.
Each year an estimated 1,324,000 artificial knee joints (total knee
replacements — TKR) are implanted worldwide; an estimated third of these
utilise an implant manufactured by DePuy International. Underlying
computer-based research performed by the Bioengineering Sciences Research
Group has played a central role during the development of a new design of
TKR for DePuy. The design programme, the biggest in DePuy's history, had a
budget in excess of US$10 million and aimed to replace the existing TKR
system, which had annual sales of approximately US$100 million.
Between 2007-2010, DePuy adopted the computational techniques developed
by the group as screening tools to (i) assess polyethylene wear and (ii)
account for the effects of surgical variability during the early design
phases. DePuy states "This research allowed us to choose the most
robust solution when proceeding to mechanical testing and saved years in
the design cycle. Patients also benefit from increased confidence in an
implant that is able to withstand the rigors of use".
The World Health Organisation's (WHO) Surgical Safety Checklist is the
culmination of over 5 years of concerted research effort to better
understand, model and intervene in human factors that affect clinical
performance and patient safety in operating theatres and surgical care.
Imperial researchers were instrumental in the set up and implementation of
the WHO `Safe Surgery Saves Lives' working group, launched in 2006, from
which the Checklist was a primary outcome. Subsequently, we were
co-investigators, and UK-lead, in a global study the implementation of the
Checklist in 8 pilot hospitals across 7 continents. The Checklist was
demonstrated to significantly improve patient outcomes and was modified
and mandated for use in all NHS surgical procedures in England by the
National Patient Safety Agency. We have since lead a national study that
evaluated the implementation of the Checklist within the NHS and
successfully delivered a team training programme aimed at optimising use
of the Checklist in our hospitals.
Research at Strathclyde has brought about a change in eye surgery
practice throughout Europe and worldwide. A four-year cross-Europe study
in collaboration with the European Society of Cataract and Refractive
Surgery (ESCRS) investigated antibiotic treatment to prevent
endophthalmitis, a complication arising during cataract operations which
typically results in loss of sight. The findings showed that when the
treatment is given at the start of surgery it leads to a 5-fold reduction
in the risk of endophthalmitis. The European Society of Cataract and
Refractive Surgery has endorsed the discovery and widely promoted the
uptake of the treatment through publications and guidelines, which over
the last 6 years has led to the prevention of loss of sight in thousands
of patients. In Europe alone it is estimated that each year there have
been 7500 fewer cases of blindness following cataract surgery as a result
of the ESCRS guidelines.
A team of biomedical engineers at UCL has developed a non-invasive
growing implant that improves the health and quality of life of young
patients who have suffered from certain bone cancers. The prosthesis
avoids the costly and invasive surgical interventions of previous
treatment. Instead, the prosthesis can be lengthened in a quick and
pain-free procedure conducted at an outpatient clinic. As a result, it
reduces the costs of bone reconstruction and growing by around £19,000 per
patient, as well as reducing the risk of infection and subsequent
treatment. Since 2008, more than 400 devices have been sold; in addition
to the cost savings indicated above these devices have generated more than
£6 million income for UCL spin-out company Stanmore Implants Ltd, which
was sold for £10 million in 2008.