Adaptix Limited Public Funding

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Adaptix have proven their medical devices can inspect authentic aerospace parts to the required industry standard via a previous ATI grant. Inspecting these smaller parts via systems built for healthcare doesn't serve the typical large aerospace parts. Adaptix wants to scale-up their capability to image large aerospace parts (such as wings/doors/skins) while maintaining the required resolution of seeing typical failure modes in the composite. This scale-up while maintaining fidelity is a significant innovation challenge. The ability to determine failures in composite materials in the early, dry-preform phase of manufacture for the aero industry continues to be a challenge, but is highly desirable. Fast-acquisition inspection at dry-preform (where other methods currently can't inspect) via Adaptix' novel _Digital Tomosynthesis_ unlocks new manufacturing methods with significant financial and environmental impact. This will then hasten the desired greater incorporation of such composite material in the manufacture of aircraft and engines. Using technology developed for a different discipline, this innovative research will deploy low-power, robot-mounted, 3D X-ray inspection on real world composites. In doing so, this research will also explore longitudinal analysis of end-of-life parts, to feed back in to the manufacturing process. With such digital information, this work will contribute to work in NDE 4.0 and Digital Twins. The value of this project innovation has the backing or aerospace manufacturing primes, Airbus, Spirit AeroSystems, GKN and Dowty Propellers (a GE company).

**PD1\. Background**: Adaptix, a UK SME, has developed a novel affordable 20kg point-of-care 3D X-ray orthopaedic imaging system using 'Digital Tomosynthesis' ('DT'). One 3D extremity scan is approximately 0.001 mSv of radiation The FDA 510(k) was granted in Jan 2023\. CE Mark is in progress. The system gives a far better image than 2D but is currently 'static'. The core technology of the novel hardware pertains to the use of silicon field emitters, **PD2\. Project proposal**: This proposal relates to Proof-of-Concept validation as to the use of a novel coating for our silicon field emitters that will given enhanced life and enable new functionality. We will work with a leading UK university to deliver this (the University of Warwick). The focus of the project is to extend the capability of the (static) 3D device to allow (dynamic) 3D fluoroscopy through enhanced electron current (which will result in enhanced X-ray flux) to allow faster acquisition time by 'hardening' existing field emitters. If this is successful, as part of the subsequent major project we will: * Extend the coating approach with various coatings, various processes and various post-production treatments * Trial Field Emitters made entirely of non-standard materials and integrate them using standard production techniques (e.g., 'pick-and-place') to reduce production cost. **PD3\. Relevance to grant call**: _"understanding the existing facilities and capabilities"_: Adaptix currently works with the following foundries: Harwell (Oxfordshire) as the Research Foundry, SMC (Edinburgh) as the Development Foundry, and SEMEFAB (Glenrothes, Scotland) as the Manufacturing Foundry. This project would extend the foundries that Adaptix works with. _"identifying best practice"_: The University of Warwick has experience with novel materials with which Adaptix does not have experience. This project will help Adaptix understand best practice with respect to these new materials. _"establishing innovations and new manufacturing techniques"_: The application pertains to using novel materials within the production of semiconductor field emitters and applying them using new methods _"encouraging new collaborations across industry and academia"_: This would be the first formal collaboration between the partners.

**Background**: Adaptix has developed an affordable point-of-care 3D X-ray orthopaedic imaging system that uses 'Digital Tomosynthesis' ('DT'). The system is ultra-low dose: one extremity scan (0.01 mSv) is approximately equivalent to consuming 10 bananas in terms of radiation exposure and takes ~5 seconds. The FDA 510(k) was granted in January 2023\. During preparation for the 510(k) submission, independent reviewing clinicians stated that they could observe osteoarthritis within the joint and visualise trabecular structure far beyond what is seen within the 2D exams that the device replaces. **Project proposa**l: To extend the capability of the device to allow: * Enhanced assessment of degenerative joint diseases: The existing device will be enhanced such that (as part of a standard protocol) identification of rheumatoid arthritis/osteoarthritis/inflammatory arthritis will be enhanced. * Enhanced characterization/quantification of osteoporosis and osteopenia: Existing capability will be extended to dual-energy imaging to allow for 3 dimensional ('3D') Dual-energy X-ray absorptiometry ('DXA' also abbreviated to 'DEXA') plus an assessment of the trabecular structure. Current DXA is 2D only and represents the current 'gold standard'. We will improve on the standard-of-care by providing a 3D map of bone mineral distribution combined with assessment of the porosity of trabecular structure. This will allow osteoporosis assessment to be included in every acquisition allowing disease to be identified earlier and characterised better. **NHS Relevance**: Royal Devon University Hospitals NHS Foundation Trust and the University of Exeter are partners on this grant. They will assist in the independent validation of the approach and ensure that the device delivers clinical value, specifically relevant to the needs of the UK NHS. This small/low-flux/portable/deployable/low-cost product will enable the Community Diagnostics Centre concept (now 92 centres). CDC's resulted from Professor Sir Mike Richards independent report (2020), "Diagnostics: Recovery and Renewal" that recommended a new diagnostics model, where facilities are created in free standing locations away from main hospital sites, providing quicker and easier access to a range of tests on the same day, supporting earlier diagnosis, greater convenience to patients and the reduction of health inequalities. **Impact-on-economy/global ambition/potential-for-growth/value-for-money**: This project will transform assessment and early diagnosis of osteoporosis, its pre-cursor osteopenia, and osteoarthritis. Such disease states are highly prevalent and increasingly significant in an ageing society. Per ResearchAndMarkets: "The Global Point-of-Care Imaging Devices Market was valued to be $8.66 billion in 2019 and is anticipated to witness an impressive double-digit growth rate, to reach $19.84 billion by 2030."

The project objective is to deliver a Beta-Software Prototype to automatically identify high-frequency composite failure types during manufacture and maintenance; more importantly, in dry-preforms where other inspection methods are currently unable to detect at an early stage. This will reduce financial and environmental costs; allows (otherwise unviable) rework and frees up equipment and personnel to increase production capacity. This automated inspection will enable NDE 4.0 and can be performed using Adaptix' unique Digital Tomosynthesis 3D X-ray hardware technology. This method will also develop a consistent and comparable digital dataset that could input into the Industry 4.0 Digital Twin journey earlier in each part's manufacturing cycle.

Adaptix is a SME based at the Oxford University Science Park that develops low-cost, low-dose, portable 3D x-ray sources. The core technology is a 'Distributed Array' that digitises the source, replacing a single high-power tube with a multitude of addressable low-power emitters in conjunction with modern Flat Panel Detectors). Thus 2D diagnostics is replaced with 3D (digital tomosynthesis) in the acute care setting (A&E, ICU), and into Primary Care, improving initial diagnosis overall. Adaptix is currently selling its units for veterinarians, and is expanding its technology for the Non-Destructive Evaluation applications and for its biggest market, ortho x-ray imaging, chest and dental. For some applications it needs to increase the brightness of its panel x-ray source, e.g in chest imaging, because of the thickness of the human chest, with overlaying different types of tissue, bone, muscle etc. The development of the emitters' array by novel etching and coating technologies is Adaptix' current priority. For the theoretical background we are collaborating with leading experts in the modelling and characterization of field emitters from the Universities of Tartu and Lyon in France. Preliminary experiments on an inert coating on the silicon emitters held very promising results in terms of the improved current emission (3x) and its stability. In collaboration with the University of West Scotland and STFC in Daresbury we are investigating various methods for the fabrication of this inert coating. Initial results exhibit a huge variation in the performance of the emitters. We ascribe this to the film composition and structure, known to vary a lot among different coating techniques, but we have not the means to characterise that. The increased current emission (2-3X) and the improved lifespan that we observe in some of the coated samples would be a real game changer for our technology and open new markets for us. Analytical tools to characterise the exact structure and composition of the coatings are not easily available and Adaptix does not have the acute scientific know-how, analysis or facilities for the required measurements. In collaboration with NPL we hope to be able to understand the composition of our coatings. With this we aim for reproducible, stable results. An additional goal is also to develop a method for quality control in our production facility.

Adaptix develops novel 3D X-ray imaging technology for medical applications. A prototype has also been tested in Non-Destructive Testing (NDT) applications to inspect electronics devices and components and far exceeded the imaging capability of current 2D X-ray NDT systems. It also has a smaller footprint, is lower cost and produces less flux (requires less shielding to be safe, so portable for desktop use). The aim is to deliver a novel, commercially attractive quality assurance procedure, which doesn't involve manual handling of each sample and is applicable quickly to an entire batch of samples. This project lays the groundwork to add a new/complementary multi-modal capability to the existing product, within the shielded X-ray cabinet to detect electronic chip pins ('defect pins') as well as physical abnormalities in 'one scan'. Tin oxide has differential absorption of different optical wavelengths, a characteristic we aim to exploit. With an optical scan we want to detect tin oxide on electronic connectors. Oxides form when components aren't maintained in an appropriate environment. Tin oxide may also indicate if counterfeit/refurbished parts have been mixed into supposedly new products, which is often the case in global and unregulated supply chains where parts are bought and sold many times. Of the annual $800bn in semiconductors sales,~ $32bn go through 'channel'. The US Navy estimates 15% of its electronic parts are counterfeit, and this is probably a better controlled environment than the majority of supply chains. The industry requires a low-cost method of increasing test throughput without the use of expensive and scarce trained electronics inspectors. This adds significant value to our 3D X-ray system for NDT applications. It would offer a highly novel and market-leading feature (in a new market) for the second version of the system to drive further revenues and industry-benefit. As a continuation with NPL, we accomplished our main first goal of which method is the best for detecting oxidation. NPL also proved and identified where the tin oxide is located on an electronic component connector. Unfortunately because of the short time span we couldn't complete the second main task to research what the threshold/parameters are for this method to work in a commercial environment where 'good' parts that function acceptably well could fail, or we bad ones could pass. It is essential to complete the project in order to turn this into a viable commercial product for increased Adaptix revenue and industry gains.

Adaptix develops novel 3D X-ray imaging technology for medical applications. A prototype has also been tested in Non-Destructive Testing (NDT) applications to inspect electronics devices and components and far exceeded the imaging capability of current 2D x-ray NDT systems. It also has a smaller footprint, is lower cost and produces less flux (requires less shielding to be safe, so portable for desktop use). The aim is to deliver a novel and commercially attractive alternative to the industry's existing quality assurance procedures, which involve manual handling of each sample with a microscope: the industry needs automated, cheap quality assurance methods, applicable quickly, to an entire batch of samples. This project will lay the groundwork to add a new and complementary capability of multi-modal imaging to our existing 3D x-ray product. Specifically, Adaptix aims to incorporate multi-wavelength optical imaging within the shielded x-ray cabinet. Concurrent to the X-ray scan, we will conduct an optical scan that will be used to detect oxidation. Tin oxide has differential absorption of different optical wavelengths, a characteristic we aim to exploit. With an optical scan we want to detect tin oxide on electronic connectors. Such oxides form when the components have not been maintained in an appropriate environment. Detecting tin oxide may also indicate if counterfeit/refurbished parts have been mixed into supposedly new products, which is often the case in global and unregulated supply chains where parts are bought and sold many times. Of the annual $800bn in semiconductors sales,~ $32bn go through 'channel'. The US Navy estimates 15% of its electronic parts are counterfeit, and this is probably a better controlled environment than the majority of supply chains. The industry requires a low-cost method of increasing test throughput (potentially to 100%). It is important to reduce total test cost and the need for expensive and scarce trained electronics inspectors. This adds significant value to our 3D X-ray system for NDT applications. It would offer a highly novel and market-leading feature (in a new market) for the second version of the system to drive further revenues and industry-benefit. NPL will help us develop a test to identify the presence of tin oxide on the components. They will also help to establish the sensitivity and specificity of this approach, and establish the wavelength needed to maximise signal-detection and resolution, and identify commercially available source that are capable of delivering this.

**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.

**Project Description:** To demonstrate the "_fingerprinting_" of multiple representative aerospace parts made using composites and the ability to discriminate between them as a result of the fingerprinting, ideally for those parts to be actual production parts provided by an aerospace prime. **Need:** Counterfeit parts are: "_A product produced or altered to resemble a product without authority or right to do so, with the intent to mislead or defraud by passing the imitation as original or genuine_". The estimated counterfeit market size for all products exceeds $460Bn. The aerospace and automotive parts are in 10th place among the most counterfeited products, accounting for 2% of this illegal business (almost $10Bn). A 2008 report by the Boeing Company states that anything can be counterfeited including fasteners (bolts, nuts, rivets) and materials. Fake parts in the aerospace industry are among the most dangerous as they put unsuspecting people at risk of injury or death. The need is to create a mechanism for operators to have certainty as to device provenance to protect against the risk of catastrophic failure and resulting economic damage to manufacturers and operators resulting from counterfeit parts use. **Innovation**: Our combination of patent-pending innovations will allow composite components to be given a unique 'fingerprint' such that composite products can be traced through the supply chain and validated prior to use.

**Vision:** We will apply novel techniques developed for medical imaging to Non-Destructive Testing (NDT) of critical composite components in aircraft to transform the sensitivity and speed of testing, and hence transform maintenance economics. The long-term intent is to develop a new approach that can be applied in manufacture and routine maintenance. The vision is to develop NDT technologies that will be adopted by prime aircraft component manufacturers, and this will then drive adoption in the through-life maintenance programme to deliver value in terms of reduced manufacturing costs and reduced through-life cost-of-test. **Objectives:** 1\. To deliver a demonstrator for a new type of imaging modality for NDT of composites for aviation applications. 2\. The National Composite Centre ('NCC' a UK Research Technology Organisation) will work with Adaptix to integrate micro-fiducials (tiny specks whose position can be imaged) into composites and validate them for aviation use. 3\. The National Physical Laboratory ('NPL' a UK RTO as Contractor) will work with Adaptix to validate that: 3.1 The micro-fiducials do not affect critical physical properties; and, 3.2 That imaging is capable of better identifying the target failure modes than existing inspection modalities. **Focus:** We will focus on identifying delamination and wrinkles as these are the failure-modes with the greatest safety and economic relevance. In order to drive adoption, we will work with a specific early adopter and on high-value composite part to illustrate the value to an aerospace Prime. **Innovation:** We will deliver an imaging system to image composite structures tagged with micro-fiducials which will go beyond laminography in the ability to detect key failure modes. We aim to prove that the inclusion of micro-fiducials can enhance the ability to detect failure modes without adversely affecting the physical properties of a device, and in doing so overcome objections to the use of the technique.

This project is to deliver a 3D imaging system for small animal use by veterinary surgeons (the 'Small Animal 3D' \['SA3D'\] system) which will be launched at the British Small Animal Veterinary Association Congress 25-28 Mar 2021\. The system will be a low-cost low-dose (~same as existing 2D imaging systems) portable system that can deliver 3D images, whilst avoiding the need to purchase a CT. The innovation is to use 'Digital Tomosynthesis' ('DT') to create 3D images in veterinary applications. DT is routinely used in medical imaging (for instance in breast screening) but is currently only deployed in fixed high-cost installations. The innovations are: **Innovation 1:** Deliver 3D imaging in a form-factor that can be deployed on a standard operating table in an existing veterinarian's treatment room or operating room without modification (including the use of single-phase power). SA3D would operate within the same radiation protection regulations and have similar running costs as 2D. Operation of SA3D can be by the vet or nurse without the need for specialist training or dedicated specialist technicians. **Innovation 2:** Deliver 3D imaging that can be moved within the veterinary practice to enable 3D radiography to travel to the patient, rather than to take the patient to the 3D radiography. SA3D would be portable outside the clinic, enabling quick access to imaging diagnostics to patients who can't travel, cannot be moved, or need urgent access to imaging. **Innovation 3:** Create a new business model (for veterinary imaging) that creates an 'archive' of data to which Machine Learning can be applied to allow new computer-aided diagnostic tools to be developed and deployed to users. It is envisaged that incidental findings could be automatically identified for the clinician to review, such as identifying tumour metastasis when investigating a primary tumour. **Innovation 4:** Use modified acquisition protocols in conjunction with advanced image processing and mathematical techniques (compressed sensing) to allow enhanced imaging such that the system can acquire images of sufficient quality for extraoral dental imaging with a large detector with large pixel sizes. This will avoid the need for multiple intraoral images to be acquired and avoid the need for the vet to acquire a veterinary intraoral system. There will be value in environmental terms of reducing the need for vet practices to acquire a CT or (if no CT is on-site) for vets to refer patients to other centres for imaging.

Loan to mobilise high-value manufacture in BioCity in Scotland for 100% export market

This application is about improving an existing medical imaging technique which is used during cancer surgery to distinguish between healthy and non-healthy tissue. The improvements will rely on the application of 'quantum technology'. Pathology is the study and diagnosis of disease through examination of surgically removed organs, tissues (biopsy samples) and fluids. When a cancerous tumour is excised (taken out) the surgeon needs to be certain that all the diseased tissue has been removed, and therefore they also remove some surrounding tissue around the edge of the tumour (the 'margins'). The surgeon needs to be sure these margins are free of cancer and can be described as 'clear or negative'. Clear margins suggest all the cancer has been removed and is not able to spread, giving the best outcome for the patient. So, a highly sensitive method of differentiating between healthy and unhealthy soft tissue is vital, and also between soft and hard tissues (bones). The establishment of these 'clear tissue margins' is best done whilst surgery is ongoing -- so the technique also needs to give accurate 3D images quickly and not take up much room in a busy operating theatre. Currently this is done via 'pathology cabinets' which give 2D or 3D images - but are often are slow (several minutes) and bulky (similar to a filing cabinet). The need is for more accurate differentiation of the boundaries between the tumour and healthy tissue, enabling surgeons to make confident real-time decisions during operations. The equipment also needs to be cost-effective, have a small footprint in the operating theatre and give accurate, easily understandable images. This grant would be used to build a prototype of a new type of pathology cabinet -- using quantum technology applied to both key parts of the system (the X-ray source & detector), plus new software to produce high-resolution material discriminating images (which are also better suited for the training of machine learning and application of Artificial Intelligence). The resulting images would give better differentiation between cancerous and healthy tissue, enabling surgeons to confidently remove the minimum amount of healthy tissue whilst being sure of clear margins. This will benefit healthcare providers in terms of better patient care, reduced workflow and costs, and most importantly, improve outcomes for patients in terms of reduced risk of more than one operation and a reduced chance of cancer spreading from positive margins left after initial surgery.

Medical imaging is a vital and informative method for doctors to obtain information about the inside of a patient's body - enabling them to make appropriate diagnosis and plan treatment. The most commonly used type of medical imaging is based on X-rays and the core technology has not changed in over 100 years - fundamentally because of the need for large and immobile X-ray sources. X-rays generally only provide 2D images - which are of limited use as they are gross simplifications of the 3D human body, and the detailed information doctors often need is obscured by over and underlying body tissues. 3D imaging using X-rays relies on CT scanners - which are large expensive pieces of equipment, fixed in position and often with long wait times and travel for patients. Most importantly, CT scanning gives the patient a relatively large X-ray dose, which is a factor in deciding if it is best to subject a patient to a CT scan, as this is detrimental to health in itself. By inventing a new type of miniaturised X-ray source and way of collecting information from a scan (together with new software) - Adaptix can produce low-cost 3D images rapidly from a portable device - which crucially gives the patient a much lower X-ray dose. These 3D images give doctors much more information than a 2D scan and are comparable to CT images - which helps doctors make better diagnoses, and also plan and monitor treatment. Time to diagnosis should also be much faster for patients and this has an impact on cost saving for healthcare providers. Plus, the imaging can be brought to patients - vital for those unable to be moved easily (e.g. in intensive care units or old people's care homes) or into the wider community via poly-clinics and GP surgeries. This grant would be used to solve the few remaining problems with the technology used in Adaptix's prototype, to ensure reliability and a sufficient product life-time before moving into full manufacture. Adaptix is based in the UK - and employs over 30 staff at its R&D site. This number should grow significantly as it moves into manufacture and sales, creating high-value jobs and adding benefit to the wider UK economy and UK supply chain for the components Adaptix uses.

"This project aims to show how breast cancer can be detected earlier by Adaptix's novel X-ray source. In the UK, 1 in 8 women will be diagnosed with breast cancer at some point in their life, the most common cancer in women in the UK (31% of cancers diagnosed in women are breast cancer). Earlier, more accurate detection enables better chances of survival and reduces the likelihood of needing radical surgery (mastectomy) and aggressive follow-up treatment. The Adaptix source will enable higher sensitivity compared to current 2D mammography systems where some cancers can be obscured by overlying tissue, especially in women with dense breasts. Our source uses a stationary array of small X-ray emitters, instead of a single source, thereby covering a range of angles and a unique way to derive 3D information about a breast. This will make the examination faster and more accurate than current 3D breast tomosynthesis systems that physically move the source, since the movement can blur fine detail such as calcifications seen in the early stages of cancer. Adaptix have already demonstrated the use of a flat panel X-ray source for analysing teeth and joints. Breast imaging requires the highest image quality of all X-ray procedures, and requires the Adaptix source to be larger and with a lower X-ray energy. This project will support Adaptix to work with Surrey University and RSCH, who have developed a complete set of end-to-end mammography simulation tools and will apply this to the Adaptix source. The software models every emitter's X-ray output, a chosen detector's exact response to X-rays, and uses these to virtually image a large range of detailed and realistic virtual breast models with and without cancer. The results are indistinguishable from real images. It means that a huge range of parameters can be experimented with and optimized without having to develop multiple physical prototypes or subject women to radiation in a clinical study. This project will demonstrate the theoretical advantages of the Adaptix source, which will help Adaptix secure a contract with a global medical systems company, to integrate this source into a new line of precision mammography devices for worldwide distribution. The UK invented the CT and MRI scanner, both of which are now manufactured off-shore. Supporting Adaptix will help bring another transformational UK technology to market and reduce the cost of world-class healthcare, as well as keeping production on-shore to secure UK manufacturing jobs."

Loan to mobilise high-value manufacture in BioCity in Scotland for 100% export market

"Almost everyone will have had a dental X-ray. These help dentists make informed decisions about diagnoses and treatments. However, each X-ray is just a 2D shadow of a 3D shape so assessing the size and shape of feature such as cavities in teeth can be difficult. Large 3D imaging systems do exist today but they are expensive, only available at specialist centres and they give a relatively high radiation dose. Adaptix has a new method of obtaining 3D X-ray data. Adaptix have miniaturised the X-ray emitter meaning that many emitters can be arranged in flat panel array. Electronically firing X-rays from 45 different positions means that 3D information can be derived, in the same way that having 2 eyes in different positions gives us depth perception. Adaptix's device is small enough to be used at the dentist's chair, gives a low radiation dose and the 3D images give more information to the dentist than is obtained from current devices. This project will go further and develop software to analyse the 3D slices and _quantify_ the size of cavities. This will help dentists decide if a cavity needs to be filled or whether it can be safely left until next time and monitored to see if it will improve over time or get worse and need treating. This will make dentists more confident in their decisions and improve the quality of care that is provided. This is important as dental caries is one of the most prevalent diseases (42% of an adult population in the UK, Source: Murray et al. 2015, https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12677). Enabling Adaptix to bring this healthcare technology to the UK, will support the NHS by reducing the cost of high-quality dental care, as well as enabling our dentists to make earlier and more accurate diagnoses. Adaptix is a UK company, setting up a UK manufacturing site, creating jobs in the UK. Supporting Adaptix will enable its UK technology to be brought to market, which will benefit the UK, as well as dental care worldwide."

"Almost everyone you know will have had an X-ray or scan (whether CT, MRI or ultrasound) at some point. The data collected by these different examinations is very useful in enabling creation of an image of the internal body to help medical professionals make informed decisions about diagnoses and treatments. However, some functional data is hard to obtain using imaging examinations, for example, analysing how stretchy or stiff areas of tissue are, which can help in the identification and assessment of tumours and diseased tissue. Instead, this can require an invasive procedure to obtain a tissue sample that can be analysed (biopsy). Adaptix intends to create a new method of using 3D X-ray data, which can be collected by using its innovative Flat Panel X-ray Source, to compare how stretchy different areas of tissue are in relation to surrounding tissue. Where an area of tissue is 'stiffer' it may indicate disease or tumours, and along with the other information from the X-ray exam, will assist a medical practitioner in making an earlier diagnosis and starting patients on the relevant treatment sooner. Adaptix's vision is to provide medical professionals with a portable X-ray device, which involves low-doses of radiation, and can be used in multiple ways to image areas of concern, to provide them with not only detailed 3D X-ray images of the area but also vital information about the elasticity of the tissue being viewed. Enabling Adaptix to bring this healthcare technology to the UK, will support the NHS by removing burdens on the system and reducing the cost of healthcare, as well as equipping our world-class healthcare professionals to make earlier more accurate diagnoses. As a result of an ageing population, the number of urgent GP referrals to hospital for suspected cancer has increase by 90% since 2009-10, but 9 out of 10 patients who are referred are not diagnosed with cancer. Screening with Adaptix's X-ray source, enhanced by detailed information on tissue hardness, could prevent unnecessary referrals and the inherent stress for those patients. Adaptix is a UK company, looking to establish UK manufacturing, creating jobs in the UK. Supporting Adaptix will enable its UK technology to be brought to market, which will benefit the UK, as well as healthcare worldwide."

"This project will deliver a proof of concept for a ground-breaking medical imaging system for hands and feet. Fractures of these are common but the current imaging methods are unsatisfactory. Standard X-rays only give a 2D view (i.e. a shadow) of these complex 3D joints and subtle fractures or problems can be missed. CT and MRI scanners produce 3D images but are expensive, time-consuming and often immovable, and CT scans involve a relatively high radiation dose. Our proposed product will provide 3D images from a low cost, low dose, portable device. No current device on the market offers this. Adaptix will achieve this by fundamentally changing how X-rays are made. Conventional X-ray tubes haven't changed significantly in a century whilst televisions have changed from CRT tubes to flat screens and bulbs from filaments to arrays of LEDs. Adaptix's innovative technology makes a similar technological leap for X-ray sources. Instead of a single, high-power source of X-rays, we use solid state technology to create an array of many emitters arranged in a lightweight flat panel with low power consumption. The panel illuminates the patient from a variety of angles so can use parallax information to derive 3D information (a technique called tomosynthesis), in the same way that having more than one eye gives us depth perception. This is done at a radiation dose much less than CT. This project will take Adaptix's core technology and refine its use for imaging hands and feet. This will involve modifying the X-ray source to optimize its performance for these and elaborating requirements and designs with orthopaedic doctors. These outputs will confirm that the technology is viable and that the product will meet the market needs."

Many people will have had a Computed Tomography (‘CT’) scan to see a 3D image of the human body as part of their diagnostic and treatment pathway. These machines are miracles of engineering and have transformed clinical practice, with their use doubling over a decade. However, many of the people you know may have had to wait sometime to have their scan, due in part to the expense of such machines restricting availability in the UK. In addition, doctors have to balance their use with associated radiation exposure. Adaptix is developing an innovative Flat Panel X-ray Source (FPS), which can be integrated in imaging devices to allow truly portable low-dose, low-cost 3D imaging, using Digital Tomosynthesis (DT). Since we don't need to physically move the X-ray source to acquire a 3D image, the exam will be very fast. We do not intend to eliminate CT scans – they will always be with us for many clinical applications. What has been already shown however, is that high-cost fixed DT systems present excellent 3D images at a fraction of the dose and far better imaging information than a traditional planar X-ray and provide a low-dose and more accessible alternative to CT in many occasions. The low-cost and portability of our solution will allow even more patients to benefit from this technology. We are the nation that invented the CT and the Magnetic Resonance Imaging scanner, both of which are now made off-shore. Supporting Adaptix will help bring another transformational UK technology to market that will reduce the cost of world-class healthcare and keep production on-shore to secure UK manufacturing jobs.

"Need: Computed Tomography (CT) capability in many hospitals worldwide is under-constraint, resulting in delays to planned procedures. CT scans are expensive per scan, and the increasing use (\>10% per year) is driving costs beyond inflation. Challenge: There is a need for a lower-cost, lower-dose 3D imaging capability in healthcare. The Adaptix Flat Panel Source facilitates a highly portable and low-cost, low-dose 3D 'Digital Tomosynthesis' solution with enhanced resolution. Variability in X-ray emission from different areas in the flat panel needs to be identified and mitigated. Significance: 3D imaging is a fundamental clinical tool as it provides exquisite detail in images thereby enhancing the sensitivity and specificity of diagnosis. Variability in source emission restricts the quality of 3D images. Limited lifetime of the emitters is a hurdle to their commercialisation. Innovation: Surface analytical methods with sub-micrometre spatial resolution will enable understanding of the reasons for emitter variability and failure, and thereby the identification of mitigation strategies. Outcome: This project is part of developing a reliable 3D imaging solution, small (circa 20kg) and cheap enough (<$100,000) to be deployed on a mobile basis within hospitals and polyclinics. The work done under this project will be performed in conjunction with the National Physical Laboratory (NPL) and will build upon an earlier 'Analysis for Innovator' project but ocussed on even higher power output that is suited for General Radiology. It will extend the understand the reason for variation in emitter tip performance and aid developments that enhance lifetime, reduce variation and reduce manufacturing costs. Further variation in emitter coatings and structure will be made and tested in a series of iterations."

Healthcare need: Computed Tomography (CT) capability in many hospitals worldwide is under-constraint, resulting in delays to planned procedures. CT scans are expensive per scan, and the increasing use (typically>10% per year) is a factor in driving healthcare costs beyond inflation. There is a need for a lower-cost, lower-dose 3D imaging capability in healthcare. Significance: 3D imaging is a fundamental clinical tool as it enhances the sensitivity and specificity of diagnosis, and allows enhanced characterisation over time. Innovation: Low-dose 3D 'Digital Tomosynthesis' ('DT') imaging is currently achieved using a source on a computer controlled mover, or using a series of separate stationary tubes. Current DT solutions (used in Breast Imaging and General Radiology) are expensive (circa $450,000 fully installed) and so large the solution can only be fixed in place. The Adaptix Flat Panel Source facilitates a highly portable and low-cost tomosynthesis solution with enhanced resolution. Outcome: We see a way to allow to produce a 3D imaging solution, small (circa 20kg) and cheap enough (<$100,000) to be deployed on a mobile basis within hospitals and polyclinics. The innovative analysis by NPL will enable understanding of the variation in emitter tip performance and aid developments that enhance lifetme, reduce variation and reduce manufactutring costs.

Many people you know will have had a Computed Tomography (‘CT’) scan as part of their medical treatment. These machines are miracles of engineering and have transformed clinical practice, with their use doubling over a decade. However, many of the people you know may have had to wait sometime to have their scan, due in part to the expense of such machines restricting availability in the UK. In addition, doctors have to balance their use with the risks resulting from the radiation associated with CT. Adaptix is developing a Flat Panel X-ray Source (FPS), an array of small low-power emitters, something that allows 3D imaging without movement, and which allows a low-cost, low-dose 3D imaging solution that could be taken to the bedside or deployed in Primary Care. Innovate UK will support Adaptix, a UK SME, in developing novel manufacturing processes to alow the low-temperature bonding of ceramics to alumium to be used in the manufacture of their FPS. This will transform the cost of producing the source while allowing it to hold vacuum (and therefore operate) over a period of many years deployed within a hospital.

Everyone you know will have had a dental X-ray at some point. If you have ever had the chance or inclination to look at the acquired image, you will have seen they are difficult to read due to the fact they are a 'shadow-gram' of the full depth of the tooth, so the feature you are seeking to identify is obstructed by the over-lying tissue. As importantly the detector (typically 4 x 6cm) is illuminated by one single X-ray emitter with a diverging cone beam, so if there are two features the same size, the one further from the detector appears bigger. The outcome of this is that from a conventional 2D image it is not possible to quantify any features in terms of size. Finally, the lack of images from multiple points means that the feature cannot be characterised in terms of density, which is important if you are attempting to understand if tissue varies from that surrounding it. In Breast Imaging, and now in General Radiology, these problems are now being solved using 'Tomosynthesis' or 'Partial Sweep Tomography' which gives image resolution and characterisation approaching that of Computer Tomography (known as a 'CT' or 'CAT Scan'), but at a fraction of the X-ray dose and equipment cost. Adaptix, a company that was incubated in the European Space Agency incubator at the Rutherford Appleton Laboratory is seeking to apply Tomosynthesis to Dental Imaging to give your dentist the ability to: discriminate the position of a molar root relative to the nerve canal prior to an extraction; identify vertical root fractures that cannot be seen using 2D imaging; and (it is hoped), characterise dental caries ('tooth decay').

Adaptix has invented a novel flat panel X-ray source (FPS) technology that comprises an array of multiple X-ray emitters. Technology applications have primarily focused on new methods of medical imaging to date. This Proof-of-Market (PoM) application will explore the commercial promise of the FPS in materials science characterisation for new materials optimisation and discovery. The application follows successful SMART (for core technology development). Materials optimisation and discovery is at the heart of major technological and social advances, e.g.; energy, electronics, clean technology and sustainability etc. X-ray based analyses (e.g.; x-ray diffraction, XRD; reflectivity, XRR; fluorescence, XRF etc) are amongst the most widely used first-step, non-destructive techniques to gain a fundamental understanding of structure-composition influences on functional properties. This knowledge is the cornerstone of improved material optimisation and discovery and critical for filing effective IP protection. Adaptix will utilise the established economic IP advantage of its FPS technology and explore application feasibility in the materials characterisation arena. This is for faster x-ray based analysis through simultaneous and parallel characterisation via multiple x-ray emitters, for use in industries including polymers, mining, pharmaceuticals, semiconductors and many others. This PoM technology grant application will allow a detailed appraisal of the overall market, competitors, specification requirements, gain commitment from OEMs and academic partners to allow accurate estimates of funding requirements and project feasibility.

Radius Diagnostics Ltd, a spin-in to the European Space Agency BIC on the Harwell Campus is using space heritage technology to revolutionised clinical planar X-ray radiology – the modality used for 60% of all medical imaging worldwide and representing a >$5bn capital market. The transformation will be comparable to the effect that the introduction of LCD had on Visual Display Units in terms of reducing weight and bulk by >90% and cost, but more importantly it will transform form factors and portability. Most importantly it will allow 3D imaging from a modality that has traditionally only been 2D. This grant for 50% of a £200k project relates to initial concept development and market validation for the use of the planar sources to produce a low-cost CT (target < $200k) with no moving parts that would be used for stroke assessment in A&E Departments to reduce time to diagnose “clot versus bleed”.

Radius Diagnostics Ltd, a spin-in to the European Space Agency BIC on the Harwell Campus is using space heritage technology to revolutionised clinical planar X-ray radiology – the modality used for 60% of all medical imaging worldwide and representing a >$5bn capital market. The transformation will be comparable to the effect that the introduction of LCD had on Visual Display Units in terms of reducing weight and bulk by >90% and cost, but more importantly it will transform form factors and portability. Most importantly it will allow 3D imaging from a modality that has traditionally only been 2D. This grant for 45% of a £204k project relates to generating the Product Requirement Specification and creating a mock-up of a low-cost 3D dental imaging solution that is fully ‘solid-state’. A UK SME, has stated they would wish to market the full solution (integrating their own digital detectors).

The business opportunity presented by MAX is to introduce a radical technology to create a shift from vacuum tubes to crystal based sources that can be manufactured using existing semiconductor foundry processes. The MAX source enables a flat panel X-ray source that does not require an external high voltage supply, high voltage electronics or a vacuum tube. As a result the most costly, bulky, expensive and fragile components of an X-ray source are eliminated. The result will be as transformational in clinical, security and industrial applications as the introduction of flat panel LCD and Plasma screens have been in Visual Display Units. This project will deliver a full scale (40cm x 40cm) solid state source manufactured in a semiconductor development environment and tested on a phantom. This device will then be ready to transfer to a manufacturing environment, CE tested and released for commercial production.

Flat Panel X-ray Source to be used with existing Digital Radiography detectors. This transformation is important as, while the DETECTOR side of current systems has been significantly innovated (e.g. by advances in Digital Radiography, such as CMOS detectors), the SOURCE is still fundamentally the same 100 year old technology as that in the Science Museum. Current sources typically make up >95% of the weight and >60% of the cost of a planar X-ray solution. By replicating the transformation seen in Visual Display Units when LCD replaced vacuum tubes, we will: reduce the weight of a clinical X-ray source from c. >200kg to 30%; and,change the maintenance economics to those of a 'solid-state' device. As importantly we will improve functionality of planar X-ray (to give 3D imaging), reduce radiation burden (by enabling selective imaging), and make it easier to deploy X-ray radiology outside of a hospital. This is important as Planar X-ray is the work-horse of medical imaging, representing 60% of imaging procedures - improving its functionality and reducing its cost is important to healthcare. There is a demand for such a product. The company has a non-exclusive Collaboration Agreement with a major Medical Imaging company, and this relationship has been leveraged to define the Market Requirement Specification. The Total Addressable Market for such a source is conservatively estimated as exceeding US$1.5bn per anum. This project will deliver a full scale (400mm x 400mm) solid state source manufactured in a semiconductor development environment and tested on a clinical phantom (a model of a body used to test such devices). This device will then be ready to transfer to a manufacturing environment, be CE tested and released for commercial production. The company has a Letter of Support from a semiconductor manufacturer interested in manufacturing the source in the UK.

Resident in the European Space Agency Business Incubator at the Rutherford Appleton Laboratory on the Harwell Oxford campus, Radius Diagnostics Ltd is commercialising space heritage technology in a revolutionary 'solid state' X-ray source. This grant submission relates to protecting the Intellectual Property relating to recent technical advances.

The project utilizes the unique combination of X-ray optics skills and nanoengineering facilities at the Rutherford Appleton Laboratory (‘RAL’) to create an X-ray Collimator for clinical, security and industrial imaging applications on behalf of Radius Diagnostics Ltd (‘Radius’). The proposed project will: incorporate the lessons of a prior Viability Study and develop a basic prototype at centimeter scale; conduct specialist testing that will confirm technical feasibility; investigate production and assembly options; and, create a Collimator that can be integrated with the X-ray source.