All-Optical Pulse-Echo Ultrasound Imaging for Real-Time Guidance of Minimally Invasive Procedures

Medical needles are central to a wide range of diagnostic and therapeutic interventions, including minimally invasive procedures in the heart to treat rhythm problems, and nerve blocks to treat back pain. Accurately and efficiently reaching tissue targets within the body can be very challenging. Many needle insertions are performed with ultrasound or X-ray imaging systems that are exterior to the body. These imaging systems are often insufficient for directly detecting the tissue targets, however, and consequently there is a risk of inaccurate needle placement.

As a Lecturer and Senior Research Fellow in the Department of Medical Physics and Biomedical Engineering at UCL, I will lead an ambitious research programme to develop new imaging probes to visualise tissue in the human body. These imaging probes will be integrated into medical needles and catheters to visualise tissue surrounding the medical devices. One of the novel aspects of the imaging probes is that they will transmit and receive ultrasound with optical fibres. This all-optical method for performing ultrasound imaging will lead to high-performance imaging with low-cost components and scalable manufacturing processes. As such, they could provide visualisation of tissue during clinical procedures that is not possible with current technology, or which is too expensive to be used routinely. Patients will benefit directly with improved clinical outcomes and decreased risks of complications.

As principal investigator, I am driven to ensure that developments in my laboratory are translated into prototypes and products that can improve outcomes for patients. Prior to UCL, I was a Project Leader at Philips Research, which provided me with hands-on experience with overcoming challenges encountered in the translational process and a wide range of connections in industry. As a PhD student, I received one year of medical school training as part of the Harvard-MIT Health Sciences and Technology Programme. In my role an academic at UCL, I am well positioned to lead the development of new imaging technologies and medical devices.

The proposed research will result in the creation of entirely new types of probes for performing ultrasound and photoacoustic imaging within the human body. These imaging probes will provide visualisation that was previously unavailable with current technologies, or which was prohibitively expensive to make it routinely available in the UK. As such, they could be integrated within a wide range of medical devices to address needs in several different clinical fields including interventional cardiology and interventional pain management. The resulting clinical impact could include reduced complications and increased procedural efficiency resulting from greater awareness of the tissue environment in which the medical devices are situated.

Starting with the engineering and scientific ideas outlined in this proposal, I will take the following steps to translate developments in my lab into prototypes and products:

a) optimisation with tissue ex-vivo, and in-vivo pre-clinical studies [EPSRC HTCA];

b) development within an ISO-compliant quality system (QS) and risk analysis;

c) CE-marking;

d) first-in-human studies;

e) larger-scale clinical studies.

The QS in step b), which will demonstrate adherence to all relevant ISO standards for compliance with the Medical Device Directive 93/42/EEC, will be established with the support of a Proof-of-Concept Grant from the European Research Council that was awarded to the applicant (MOPHIMPOC). An EPSRC HTCA is crucial to arrive at a design freeze for step b), to obtain follow-on funding for CE marking (step c), and for a first-in-human study (step d). The larger-scale studies (step e) could be undertaken together with an established medical device company.