Silicon process enhancement to enable 3D chest-imaging at the Point-of-Care

**Key Objective:** To develop a low-dose, low-cost system that can be used by the NHS to provide 3D chest imaging at the point-of-care throughout the hospital (with the capability to deploy into Primary Care).

**Vision:** 2D imaging is the workhorse of the NHS diagnostics. According to NHS statistics, "_42.7 million imaging tests were reported in England in the year to March 2018." ..._"_The most common of these tests was Chest X-ray, with 8.3 million tests being requested through all source settings in 2017/18 (up 1.0% from 2016/17)._ _This was also the most common test requested by GPs (2.2 million)."_ (NHS Diagnostic Imaging Dataset Annual Statistical Release 2017/18)

In the NHS 3D imaging is growing faster in clinical practice than 2D due to the greater diagnostic certainty that results from 3D imaging. However, currently the patient must travel to 3D imaging which creates cost and (in some cases) risk.

**Focus:** The focus of this innovation would be to replace 2D X-ray with 3D X-ray. The specific focus would look to replace 2D Chest X-ray ('CXR') which alone represents 36% of UK X-rays and 19% of UK diagnostic imaging. 2D imaging already travels to the patient in the ICU, pulmonary ward and Accident & Emergency ('A&E').

Chest X-rays ('CXR') are the primary imaging modality used in the intensive care unit (ICU), given its portability, rapid image acquisition, and immediate bedside return of information on the preview screen. We aim to provide an alternative 3D chest imaging modality, at the point-of-care, with enhanced sensitivity, with roughly equivalent dose as 2D X-ray, and at a similar price.

**Innovation:** The key clinical innovation is "_3D-at-the-bedside_". The technological innovation encompasses novel hardware, elements of the software and reconstruction approach and various technological approaches for specific use cases. This project is focused on increasing the capability of the core technology to deliver bedside 3D chest imaging.

**Collaboration:** The University of Edinburgh (the Scottish Microelectronics Centre \['SMC'\]) will focus on enhanced silicon manufacturing processes to increase the output, decrease variation in output, and increase yield.