Alzheimer's and other neurodegenerative diseases represent significant challenges for society, particularly given our aging population. This project aims to develop advanced new MRI brain imaging equipment to provide much more data on the composition of the brain. The hardware and software tools developed in this project have a clear purpose: to advance research in this field, enhance our understanding of the disease, and enable early detection. By allowing the safe use of new drugs that slow disease progression, the project directly contributes to improving patients' well-being. Moreover, a longer and healthier life benefits not only the affected individual but also positively impacts their social environment and, by extension, the entire civilization.
The project we are embarking on addresses a critical health issue: the challenge of accurately diagnosing prostate cancer. This is particularly important because prostate cancer is very common, especially as men get older. Right now, healthcare systems in Europe and the UK are starting to use MRI scans more often to try to catch prostate cancer early in men over 50\. Catching it early is key because it means less invasive treatment and lower healthcare costs. However, there's a big problem: current MRI methods can't tell the difference between aggressive and less serious types of prostate cancer. This leads to many men being overdiagnosed and treated more aggressively than they need to be, which can be costly and harmful to their quality of life.
This is where our project comes in. We've got a new type of MRI scan in the works, using something called hyperpolarised 13C-labelled pyruvate. This advanced technique has shown promise in being able to tell apart the aggressive and less serious types of prostate cancer. But there are some hurdles. The current way of doing this scan is very expensive and not always reliable. But most importantly, the results from these scans aren't consistent across different hospitals, which makes it hard for this technique to be used widely.
To tackle these issues, we have brought together three experts: N-Vision Imaging Technologies (NVIS), Gold Standard Phantoms (GSP), and University College London Hospitals (UCL). NVIS has developed a new, more efficient machine for these MRI scans, based on an advanced quantum technology. GSP has come up with a way to calibrate MRI scans so that they're consistent no matter where or how they are performed. And UCL brings valuable experience from their research in using this particular kind of MRI to spot aggressive prostate cancer.
Our goal is to create a system where this advanced MRI technique can be used in hospitals everywhere, reliably identifying the aggressive types of prostate cancer. This would help doctors make better treatment decisions, thereby saving a lot of money and improving the lives of patients. We're planning to put all of these pieces together -- the new machine from NVIS, the calibration technology from GSP, and the expertise from UCL -- to make this happen. In the end, we hope to demonstrate a complete, working system that can be used as a model for hospitals around the world.
Prostate cancer is the second most common cancer death in the UK. It is a general healthcare issue, and up to 1.5M men per year in Europe require testing of their prostate by Magnetic Resonance Imaging (MRI). The problem is that, because current MRI is really only taking images rather than making measurements, the images can vary from one scanner to another. It is difficult for doctors to provide a clear diagnosis for patients from MRI alone. The problem is so important that at present up to 40% of men will receive an unnecessary, painful and risky biopsy due to the lack of clarity from the MRI results. In addition, the fact that we cannot measure something by MRI consistently across different scanners makes it difficult to follow up patients over years suffering from this disease.
To address this problem, we have developed a product that can be scanned together with each patient, and that provides a reference measure, so that we can better compare the results between two scans or between two scanners, for example. But to do so, we need to solve some difficult mathematical problems. The National Physical Laboratory (NPL) can help us achieve this aim.
By solving this, we will be able to offer this unique medical device and service to make MRI much more reproducible and quantitative for each patient, reducing the costs and unnecessary interventions per patient, which we estimate is a market worth £12M per annum. Without it, what we have developed so far cannot be used to its full potential, and thus will not achieve this revolution in the diagnosis of prostate cancer.
ASPIRE will create a novel imaging biomarker for dementia for diagnosis support. Signs of Alzheimer’s (AD) will be detectable at early stages before clinical manifestation. The solution is based on the non-invasive magnetic resonance imaging (MRI) technique “Arterial Spin Labelling” (ASL) combined with scanner calibration,
physiological atlas comparison, and artificial intelligence (AI)-based diagnostic support. The technique will simplify the diagnostic process, reduce cost and patient risk.
"Prostate cancer is the **most common cancer** in men affecting 1/6 of all men. In 2013, over **47,000 men** were diagnosed with prostate cancer in the UK, with 90% of early detected disease not requiring any intervention. Currently, prostate cancer diagnostics can be localised, for the first time, using **advanced magnetic resonance imaging (MRI) methods**. This has enabled radiologists to start using MRI first before sending the patients to get a biopsy, therefore reducing healthcare costs. Yet the use of these specialised MRI methods is not accurate at 100% and **many patients need unnecessary biopsies**. In addition, there is a remaining risk for patients to be diagnosed too late at this current state.
Therefore, there is an unmet need to **improve the consistency of diagnosis of patients using advanced MRI methods**, so that the medical guidelines used by the NHS, which currently promote active surveillance of such cases, could start advocating for such methods to be used to reassess disease over time, as even partial removal of the prostate is associated with devastating decrease in quality of life for most patients.
Herein, we outline development of an automatic calibration software for standardisation of so-called diffusion imaging, the **most important tool** used for detection of early changes in prostate cancer. A feasibility study for the use of such a software will be undertaken concurrently with the in-house development of a new type of device specifically designed to be scanned together with the patient to guarantee **reproducibility of measured parameters** using MRI on the same scanner over time or interchangeably compared between scanners. We hope that such devices, dubbed ""Within Image Calibration Devices"" (WICADs), will completely transform the way radiology is currently practiced and help establish **widespread deployment of advanced MRI techniques** towards automated or assisted diagnosis leading to improved treatment implementation on an individual patient basis. The choice of prostate cancer as a first implementation of our product is very important as a so-called precision medicine approach is already in use, which aims at operating on patients only when truly necessary, in order to improve **their quality of life**."
Perfusion represents the amount of arterial blood delivered to an organ, and is of clinical importance for dementia, stroke, cerebrovascular disease, and cancer. It can be measured by Magnetic Resonance Imaging (MRI) using a technique known as Arterial Spin Labelling (ASL). ASL provides images in which every pixel has a given value; however, due to the lack of an existing device allowing to simulate what happens in the body, ASL has not yet seen a major clinical uptake, despite its advantages over other techniques. We have developed a product which can be used to calibrate ASL images, in which every pixel is guaranteed to have the proper value. Such a product would allow radiologists to use ASL as a clinical tool for diagnosis; however, in order for this to happen, we need to understand the uncertainties that apply to our own organ model, and how precisely MRI can measure perfusion. This project will be in partnership with NPL and NEL, using NPL’s expertise in mathematical modelling, in particular in evaluating the uncertainty in both our model and the MRI measurements, and NEL’s expertise in simulation of fluid velocities. Through this collaboration, we hope to further develop our device and allow our product to have positive impact on radiology worldwide.