Multi-Modality Imaging for Minimally Invasive Surgery

Brief description of the context of the research including potential impact

Minimally invasive procedures are replacing traditional surgery, but significant improvements in sensor technology are required to realise their full potential. Here, only small incisions are necessary leading to reduced recovery times, costs, and patient discomfort, however, clinicians must rely on imaging to visualise the anatomy and surgical devices. Currently available guidance falls short, providing insufficient visualisation. External imaging, such as X-ray, is deficient in contrast and resolution, whilst internal imaging lacks resolution and molecular specificity, and is often too bulky. An alternative is urgently needed to improve guidance during procedures and enable new applications. All-optical ultrasound, a novel imaging technique which uses light to generate and receive ultrasound, is ideally suited for this. The technology has the potential to provide high resolution imaging from miniaturised devices perfectly suited to minimally invasive applications. Further, the use of optics enables the elegant integration of complementary imaging and therapeutic modalities, enabling multi-modality devices. Realising the potential of this technology would revolutionise healthcare, providing clinicians with a powerful tool across numerous medical fields.

All-optical ultrasound has been established at UCL, with key demonstrations using optical fibres to acquire two- and three-dimensional images, as well as, real-time imaging in vivo, and co-registered ultrasound and photoacoustic imaging. This work builds on this established technology and aims to make revolutionary advances in device design to tackle current problems in cardiology. Extreme device miniaturisation and the integration of complementary imaging and therapeutic modalities will allow novel uses during cardiac procedures and open new clinical avenues. As a part of this work, further clinical collaborations will be sought in areas such as neurovascular imaging and endobronchial imaging to leverage the engineering advances.


Aims and Objectives

Developing methods and components to generate and receive ultrasound from a single optical fibre which could enable imaging in previously unreachable locations

Developing novel image and data processing protocols and algorithms which could improve image resolution and specificity amongst other parameters

Developing complementary imaging and therapeutic modalities, such as photoacoustic imaging and laser ablation, and integrating them with all-optical ultrasound

Developing integrated medical devices for key proof-of-concept and translational imaging experiments

Novelty of Research Methodology

The project will combine elements of nano- and micro-fabrication for optical and acoustic components, imaging system design, ultrasound experimentation, developing experimental setups including lasers, ultrasound equipment and other components, designing and performing imaging experiments (both on the bench top and in preclinical environments), and performing computer programming for data handling, data visualisation, and systems control. By utilising cutting edge fabrication methods and novel computational methods, a new class of medical devices will be fabricated.

This project is aligned with the EPSRCs Healthcare Technologies Grand Challenge 'Frontiers of Physics Intervention' and 'Optimising Treatment'.

The project will be carried out in collaboration with clinicians from leading London hospitals. These include Dr. Roby Rakhit at the Royal Free Hospital, Dr Malcolm Finlay at Barts Heart Centre, and Dr Sami Sarmed at University College London Hospital.

The critical mass of scientists and engineers that i4health will produce will ensure the UK's continued standing as a world-leader in medical imaging and healthcare technology research. In addition to continued academic excellence, they will further support a future culture of industry and entrepreneurship in healthcare technologies driven by highly trained engineers with deep understanding of the key factors involved in delivering effective translatable and marketable technology. They will achieve this through high quality engineering and imaging science, a broad view of other relevant technological areas, the ability to pinpoint clinical gaps and needs, consideration of clinical user requirements, and patient considerations. Our graduates will provide the drive, determination and enthusiasm to build future UK industry in this vital area via start-ups and spin-outs adding to the burgeoning community of healthcare-related SMEs in London and the rest of the UK. The training in entrepreneurship, coupled with the vibrant environment we are developing for this topic via unique linkage of Engineering and Medicine at UCL, is specifically designed to foster such outcomes. These same innovative leaders will bolster the UK's presence in medical multinationals - pharmaceutical companies, scanner manufacturers, etc. - and ensure the UK's competitiveness as a location for future R&D and medical engineering. They will also provide an invaluable source of expertise for the future NHS and other healthcare-delivery services enabling rapid translation and uptake of the latest imaging and healthcare technologies at the clinical front line. The ultimate impact will be on people and patients, both in the UK and internationally, who will benefit from the increased knowledge of health and disease, as well as better treatment and healthcare management provided by the future technologies our trainees will produce.

In addition to impact in healthcare research, development, and capability, the CDT will have major impact on the students we will attract and train. We will provide our talented cohorts of students with the skills required to lead academic research in this area, to lead industrial development and to make a significant impact as advocates of the science and engineering of their discipline. The i4health CDT's combination of the highest academic standards of research with excellent in-depth training in core skills will mean that our cohorts of students will be in great demand placing them in a powerful position to sculpt their own careers, have major impact within our discipline, while influencing the international mindset and direction. Strong evidence demonstrates this in our existing cohorts of students through high levels of conference podium talks in the most prestigious venues in our field, conference prizes, high impact publications in both engineering, clinical, and general science journals, as well as post-PhD fellowships and career progression. The content and training innovations we propose in i4health will ensure this continues and expands over the next decade.