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Scientists in the MRC Cyclotron Unit within Imperial College pioneered quantitative Molecular Imaging methods for neuroscience drug development that have since been expanded through collaboration between Imperial and GlaxoSmithKline (GSK) scientists. Human Molecular Imaging has had significant commercial impact with adoption by the major pharmaceutical companies to reduce the risks and costs associated with early drug development. This led directly to the selection of the Imperial Hammersmith Hospital site for the world's first clinical imaging centre embedded in a pharmaceutical company. New GSK investment created new and highly skilled UK employment opportunities first at this GSK Clinical Imaging Centre (CIC) and then Imanova, Ltd., a specialised imaging CRO that was "spun out" from the CIC. Outcomes from studies commissioned by GSK in the CIC and later in Imanova have directly influenced GSK clinical development planning, strategy and drug candidate progression. More recently, outcomes from Imanova are influencing clinical development decisions of other pharmaceutical organisations in similar ways.
Theoretical and computational methods for optimising the design of gradient and shim coils with arbitrary shapes and topologies were developed in collaboration with Magnex Scientific as part of a CASE award (2004-07). The resulting software was licenced to Agilent (who now own Magnex Scientific), for whom it has opened up new market opportunities in the supply of novel magnetic resonance imaging systems, leading to £3.4M sales since 2009. The software has also been used by Paramed Medical Systems to improve their `open' magnetic resonance imaging systems, which are optimised for orthopaedic imaging, allow vertical subject posture, and facilitate image-guided treatment, as well as offering a better patient experience. Our work has thus resulted in impact in the economy and healthcare.
Research by Professor Karl Friston at UCL has led to the development of Statistical Parametric Mapping (SPM), a statistical framework and software package. By providing a way to analyse signals measured from the human brain in MRI scanners, SPM triggered the creation of an entirely new field of imaging neuroscience. Beneficiaries include: commercial manufacturers who provide imaging equipment; healthcare practitioners and patients, where SPM is used to deliver new treatments; pharmaceutical industries using SPM to deliver clinical trials; the IT industry developing new software based on SPM; and entirely new industries such as neuromarketing that could only have been created once SPM had been invented.
Nottingham researchers constructed the world's first 3T MRI scanner, thus demonstrating the viability and benefits of high-field MRI. This provided a stimulus for magnet and MRI system manufacturers to develop 3T scanners, which have now become established as the standard platform for high-end clinical MRI studies. We estimate that since 2008: 2500 3T scanners have been installed, representing a global investment of $5 billion;and 30-40 million patient examinations have been performed with 3T MRI scanners. Technical advances which underpinned the Nottingham 3T scanner also impacted on the development of functional MRI, thus opening up a new field of medical research and clinical application. In a subsequent phase of research, the Nottingham group developed ultra-high (7T) magnetic MRI in partnership with PhiIips; forty 7T MRI scanners (current unit cost >$10M) have now been installed across the world.
Professor Alexander's work on diffusion magnetic resonance imaging (MRI) modelling and processing has had significant and lasting impact on medical practice. In particular, neurosurgical support systems rely on his work to map the major connection pathways in the brain, helping the surgeons avoid damaging them during intervention. Specific examples are in epilepsy, where, since 2010, surgeons perform about one operation per week using these systems, and brain tumour resection, where surgeons in Milan have since early 2013 been using a similar system based on UCL's latest microstructure imaging techniques. The key impact is on patients, whose likelihood of permanent post-operative deficits in, for example, visual, verbal or motor skills, is significantly reduced.
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.
Novel methods of measurement developed by Marek Czosnyka, Peter Hutchinson, David Menon and John Pickard have provided new insights into the pathophysiology of brain injury, led to commercial applications, and influenced patient care in terms of improved outcome for clinical trials. Multimodality brain monitoring of intracranial pressure (ICP), brain oxygen and microdialysis; PET/MRI imaging of critically ill patients; and computerised CSF infusion tests for shunt function in hydrocephalus have each impacted on the clinical practice and the ability to evaluate novel treatments and interventions in brain injury. This work has led directly to the establishment of a National Institute for Health Research (NIHR) Health Technology Cooperative for Brain Injury.
Recent advances in MRI brain scanning developed at the UCL Institute of Neurology have underpinned major improvements in the surgical treatment of epilepsy. Information about the location of critical brain structures, such as the optic radiation that carries visual signals, and language areas of the brain, are used to identify the risks of neurosurgery in specific individuals. This helps to inform patient choice and to reduce the risk of loss of any part of the visual field or language when performing the surgery. UCL's pioneering use of these imaging techniques during surgery, with correction of the movement of the brain that occurs during surgery, showed that this approach reduced the occurrence of serious loss of vision to zero. This information is now used in epilepsy surgery every week at the National Hospital for Neurology and Neurosurgery and is being rolled out to other centres.
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.
Our research has had a major impact on the way pharmaceutical trials in Alzheimer's disease are conducted. The Boundary Shift Integral technique, which we developed and validated, has changed commercial practice and has become the industry standard for measuring atrophy progression. Our methods have largely replaced previous manual measures and in 2008-13 were used in over 20 large international trials. This had significant economic benefits for several companies providing image analysis services. For UCL alone they generated over £5m of industrial contracts. Additionally, through licensing and collaboration, UCL's research contributed to IXICO establishing a significant market share in this important commercial area.