Translational Alliance: SMART-Endomicroscopy

Lead Research Organisation: Imperial College London
Department Name: Dept of Computing

Abstract

Optical 'biopsy' is a concept whereby traditional histology is replaced with non-invasive, real-time imaging techniques such as endomicroscopy. This new probe-based technology provides live microscopy images to the operator, allowing for immediate cellular tissue characterisation in situ and in vivo. With recent advances in endomicroscopy, including the latest technological progress from the EPSRC SMART-Endomicroscopy project, it is timely to address the potential of endomicroscopy for assessing gut dysfunction, particularly given the large burden of enteric disease in all countries and across different age groups. The aim of this project is to form a new translation alliance in collaboration with a leading industrial design SME (Smallfry Ltd) and the Gates Foundation, exploring applications of the new endomicroscopy/robotics technology in global health. In particular, and in line with the Gates Foundation Enteric and Diarrheal Diseases Strategy, it focuses on how low-cost (yet high impact/tech) robotic technologies can provide a practical optical biopsy system for gut disease. This rather unexpected application of our research would complement the planned pathways to impact of the original grant supported by EPSRC, making the technology relevant to both specialised and global health settings, addressing additional challenges imposed by frugal innovation.

Planned Impact

The proposed project is in response to the current paradigm shift and clinical demand in healthcare for bringing cellular and molecular imaging modalities to an in vivo, in situ setting to allow for real-time tissue characterisation, functional assessment, and intraoperative guidance. It also aims to deliver the mission of the partners in developing safe, effective, and accessible technologies that are of global relevance. The focus of the endomicroscopy technology on gut dysfunction has significant value on global health, particularly given the large burden of enteric disease in all countries and across different age groups. The ability to provide non-invasive, real-time, large area surveillance, with suitability for long-term follow-up examinations, is attractive, particularly for low and middle income countries where enteric disease in infants is prevalent. These childhood gut infections are known to lead first to malnutrition, and subsequently to long-term developmental problems, including stunted growth and poor response to vaccines. By focussing on how low-cost (yet high tech) robotic technologies can provide a practical optical biopsy system for gut disease, we aim to make SMART-Endomicroscopy relevant to both specialised and global health settings, addressing specific challenges imposed by frugal innovation.

The stakeholders who will benefit from this research include: Academia (both UK and international) in medical imaging, biophotonics, sensing, vision, robotics, general biomedical engineering and global health research; Non-governmental organisations focussed on global health and charities championing improved healthcare provision and disease focussed organisations; Public and private sectors in healthcare provision; Medical devices industry; and more importantly patients and the general public.

The benefit from this research includes potentially significant technological, social, commercial and economic impact. It not only enhances research capacity but also brings tangible knowledge transfer opportunities. The project addresses important research and development challenges related to robotics and frugal innovation, and the end results are likely to transform the innovation pathways of new device designs that are of global value. Robotic technologies are often regarded as expensive and only relevant to the privileged few. The proposed translational alliance aims to challenge this by further advancing SMART-Endomicroscopy under the constraints and principles of frugal innovation, leading to a long-term partnership in addressing some of the unmet global health challenges in future.
 
Description The aim of this alliance is to develop clinical applications of the basic technology developed under the SMART Endomicroscopy Project (EP/I027769/1 ), with a particular focus on low-cost, accessible solutions for global healthcare. The first full prototype handheld endomicroscope scanner has been fabricated and integrated with a fibred ablation laser and is currently being tested on ex vivo tissue samples at a partner hospital. We have already held several workshops with the industrial partner, including visits to see frontline medical procedures and are now jointly working on the design of the next generation device with improved ergonomics and clinical applicability. New designs for the endomicrosopy system were explored with a focus on improving the spatial resolution. A fibre shifting endomicroscopy design was developed that improved the spatial resolution by a factor of 2. A highspeed dual wavelength line scan confocal laser endomicroscopy system was developed that is suitable for multiplexed molecular imaging applications. This could simplify the clinical introduction of endomicroscopy.
Exploitation Route The findings, once complete, will support clinical trials and commercialisation of endomicroscopy-related technology.
Sectors Healthcare

 
Description SMART TAP: Bill and Melinda Gates Foundation 
Organisation Bill and Melinda Gates Foundation
Country United States 
Sector Charity/Non Profit 
PI Contribution Imperial College is working to translate our endomicroscopy technology to global health applications.
Collaborator Contribution The Bill and Melinda Gates Foundation will support the project through advice on the application of endomicroscopy technology to global health problems in developing countries, as well as providing access to a wide range of experts.
Impact This is an on-going collaboration which will impact all output of this grant.
Start Year 2016
 
Description SMART TAP: Collaboration with Smallfry 
Organisation Smallfry
Country United Kingdom 
Sector Private 
PI Contribution Imperial College is working to translate its endomicroscopy technology to cost-critical applications, particularly in global healthcare.
Collaborator Contribution Smallfry have strong experience working across the healthcare industry, from medical device manufacturers to NHS Trusts, and are bringing this to bear on the project. They are contributing expertise in the '3P' chronology (people, product, place) of product design and frugal innovation.
Impact Initial workshops held between Imperial College, Smallfry and clinical collaborators have already influenced the design of our devices and future research directions.
Start Year 2016
 
Description Hamlyn Winter School on Surgical Imaging and Vision 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact The Winter School focuses on both technical and clinical aspects of Surgical Imaging and Vision, with invited lectures, hands-on demonstrations, workshops, and mini-projects.
Year(s) Of Engagement Activity 2017
URL http://hamlyn.doc.ic.ac.uk/winterschool/
 
Description Image guided therapies workshop at Hamlyn Symposium 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Surgical Imaging Workshop at the Hamlyn Symposium in 2012, 2013, 2014, 2015 and 2016 brought clinicians together with researchers in academia and industry to exchange ideas on the current state-of-the-art and future trends in optical imaging, image guidance and augmented reality with a focus on robot assisted intervention. For 2017, the theme was image guided therapies and the workshop was organized in association with UK EPSRC Image Guided Therapies Network Plus with an aim to improve the localisation and targeting of pathological tissue with surgical instruments. The workshop fostered discussions on simulation, computing, imaging and sensing aspects of these technologies with the goal of successful translation into practical clinical practice.
Year(s) Of Engagement Activity 2012,2013,2014,2015,2016
URL http://www.hamlyn-robotics.org/
 
Description International Robotics Showcase 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A showcase of robotics for academia, industry and the public
The International Robotics Showcase will be part of the International Business Festival this year, and this will be held on Thursday 21st June 2018 at the Exhibition Centre Liverpool, Kings Dock, Liverpool Waterfront, L3 4FP.The full-day programme includes exclusive talks by world-renowned experts in science and technology, panel discussions, exhibitions, robot demonstrations and an award ceremony for competition winners demonstrating cutting-edge robotics innovation.

Exciting demonstrations of cutting-edge robotics technology;

Lively discussion and debate, covering ethical, legal and economic impacts of Robotics and AI;

The release of several new White Papers, covering the current research landscape in:
Urban Automation & Transport
AgriTech
The day also offers academics, industry, government organisations and the public, the opportunity to enjoy the fascinating and diverse exhibits by our sponsors, as well as provide a lively forum for discussion and discovery of some of the latest technological developments and research challenges in Robotics and Autonomous Systems.

The event will take place within the 2018 International Business Festival and a 9 day pass is included withi your registration.
Year(s) Of Engagement Activity 2018
URL http://hamlyn.doc.ic.ac.uk/uk-ras/robotics-week/showcase
 
Description School Robot Challenge 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The challenge will be run jointly by any interested UK-RAS partner universities, and is aimed at teams of schoolchildren of ages up to 16 (year 11). It will be published in the UK-RAS Robotics Week 2018 brochure and on the website, and will be distributed via each participating university's local schools' network.

The challenge will consist of 2 separate activities: the first involves schools working independently to develop and then submit a design(s) for a robot system to help older people. The deadline for submissions for this activity is 18/05/2018.

The best entries will then be chosen, with one winning team selected by each participating university (the proximity of school to university may or may not influence the decision), which will then invite that team to a special one-day event on 26/06/2018 (that is, the Tuesday of UK Robotics Week). After a tour of the robot labs, the teams will be set another similar care-themed challenge using whatever basic, programmable robotics equipment is to hand (e.g., Lego Mindstorms - there is no requirement for the same equipment to be used at each university). This activity will last from 10.30am until 3.30pm with a working lunch provided, and if possible live streaming of video from the other participating sites (also shown on the UK-RAS website). The goal of each team will be to produce a smartphone video of no longer than 1 minute's duration that describes the problem, the concept and design of their suggested solution, and - hopefully - shows their solution in action.

The videos will be uploaded to YouTube or similar. A panel of judges - one from each participating university - will view each of the videos, and then confer to select an overall winning team. (Some of) the winning team will then be invited to the UK Robotics Week Showcase event on Thursday 21st June, where they will receive a prize (budget permitting) on behalf of their school.

The suggested text publicising the challenge is below. (Note that it is not intended to be as explicit as the above text to allow for some flexibility in the format to take into account the number and quality of submissions, budget available, participating universities, etc., and all dates are subject to confirmation.)


The UK-RAS Health and Social Care Challenge 2018

We invite schools to submit their designs for a robotic system that addresses the challenge of how to help older people stay healthy and live independent lives. Submissions should be the work of teams of up to 8 children aged 16 or under. Entries can be in any format, should be no longer than 1000 words (or equivalent) in length, and each school may submit an unlimited number of entries.

The closing date for submissions is Friday 18th May. The judging panel will then select the best entries, with submissions being judged according to their usefulness, practicality and creativity. The winning teams will be invited to a special one-day event on Tuesday 26th June at their nearest UK-RAS University, during which they will visit our robotics facilities to learn more about our research, and then get to develop and test their own robots.
Year(s) Of Engagement Activity 2018
URL http://hamlyn.doc.ic.ac.uk/uk-ras/events/school-robot-challenge
 
Description Surgical Imaging Workshop at Hamlyn Symposium 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Surgical Imaging Workshop at the Hamlyn Symposium in 2012, 2013, 2014, 2015 and 2016 brought together clinicians, computer scientists and engineers from academia and industry to share the latest developments in the fields of surgical imaging, image guidance and
augmented reality in surgery. The scope was broad, covering imaging technologies (including clinical
systems and applications) as well as the technical aspects of registration, modelling and visualisation.
Through the development and fusion of imaging modalities, and the enhancement of the surgeon's
sensory experience, participants in this exciting area of research hope to transform surgical practice.
Year(s) Of Engagement Activity 2012,2013,2014,2015,2016
URL http://www.hamlyn-robotics.org/
 
Description Surgical Robot Challenge 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact The aim of this challenge is to exploit the unique expertise of the consortium in medical robotics to develop low-cost robot-assisted surgical and diagnostic devices that can benefit the NHS as well as be used as solutions for global health.
Year(s) Of Engagement Activity 2017
URL http://hamlyn.doc.ic.ac.uk/hsmr/events/surgical-robot-challenge-2017
 
Description UK Robotics Week 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Acting autonomously or in close collaboration with humans, Robotics and Autonomous Systems (RAS) have a broad range of new and established applications. As the underlying technologies are further developed and translated from laboratory settings to real-world applications, RAS is playing an increasingly important role in the UK's economy and it's future growth.

The UK-RAS Network was established with the mission to provide academic leadership, expand collaboration with industry and integrate and coordinate activities at the EPSRC funded RAS capital facilities, Centres for Doctoral Training (CDTs) and partner universities across the UK.

We are delighted with last year's inaugural UK Robotics Week and proud to build on its success with this year's event. The UK Robotics Week provides a spotlight on the UK's technology leadership in RAS, and engages the nation's schools, colleges and universities in developing the digital skills needed to drive the UK's future economy.

The UK Robotics Week also acts as a forum for discussion of technological, commercial, legal, ethical and social aspects of robotics. The wide range of events covered, from symposia, workshops, conferences, festivals, competitions and hackathons, contribute to a thriving programme across the country. We endeavour to provide promotion to other robotics related events in the calendar and aim to ensure robotics remains high on the government's agenda as one of the transformative technologies of the present and future.
Year(s) Of Engagement Activity 2017
URL http://hamlyn.doc.ic.ac.uk/roboticsweek2017/welcome
 
Description Workshop on Human-Robot Interactions Applied to Health 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0
 
Description Workshop on Micro-Robotics and Micro-Fabrication 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0
 
Description Workshop on Surgical Work?ow and Process Modelling 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact As part of the Hamlyn Symposium 10th anniversary on Medical Robotics, a workshop was run. This workshop was for academics, industry and show casing the latest technologies for medical robotics and latest research.
Year(s) Of Engagement Activity 2017
URL https://www.dropbox.com/s/5uobgz4tjq7c1ue/HSMR17_programme-FINAL.pdf?dl=0