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MAGAZINE FOR UK HEALTH PROFESSIONALS // NO. 2 // JUNE 2020

NHS, we stand with you. 6 // COVID-19

Our service team are here for you

MRI 1.5T install at High Wycombe

The Power of the New Aquiliion ONE PRISM

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28 // MRI

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Canon Medical Systems stands behind the NHS to help minimise the negative impact of Covid-19. As those on the frontline put themselves at risk, our team is committed to providing the best research, products and support during this challenging time.

// EDITORIAL At Canon Medical we want to thank those of you in the NHS frontline that are doing incredible work and taking considerable personal risk in the interests of all of us. It cannot be an easy time, particularly as we are approaching an expected peak in all patients which will only increase the burden on the NHS for the foreseeable future A primary focus for Canon Medical Systems here in the UK has been to keep providing our legendary services and products to the NHS, and other healthcare providers, thoughout the restricted period. Despite the difficulties and stresses on global supply chains we are proud of our colleagues who have gone the extra mile. We have certainly been able to keep providing products, and services, and training on our machines. Moreover, we have also meanwhile developed and designed some new solutions in reponse to demands and needs in this extraordinary time, and these have been so well received we have been overwhelmed.

The VISIONS magazine is a publication of Canon Medical Systems UK and is offered free of charge to medical and health professionals. The magazine is published two to three times a year. Registration to access full, previously published, digital editions can be done via the web site: https://uk.medical.canon/news/latestnews. For Canon Medical Systems UK's privacy policy go to https://uk.medical.canon/technical-information/ privacy-policy. The VISIONS magazine covers Canon Medical across the UK's regions and, as such, reflects products, technologies and services for this particular area. The mentioned products may not be available in other geographic regions. Please consult your Canon Medical representative sales office in case of any questions. No part of this publication may be reproduced in whole or in part, stored in an automated storage and retrieval system or transmitted in any manner whatsoever without written permission of the publisher. The opinions expressed in this publication are solely those of the authors and not necessarily those of Canon Medical. Canon Medical does not guarantee the accuracy or reliability of the information provided herein. Infinix-i, Alphenix, Alphenix Sky, Aplio, Aquilion ONE PRISM Edition, Aquilion Precision, Aquilion ONE GENESIS Edition, Vantage Orian 1.5T, Vantage Galan 3T , Ultimax-i and Made for Life are trademarks of Canon Medical Corporation.

Publisher Canon Medical Systems UK Boundary Court, Gatwick Road, Crawley, West Sussex, RH10 9AX +44 1293 653700 https://uk.medical.canon/ marketing@uk.medical.canon

Editor-in-chief Amy Rosoman amy.rosoman@eu.medical.canon

Design & Layout Ice Blue Sky icebluesky.com

Editor Nicola Fox nicola.fox@eu.medical.canon

Print Management Ice Blue Sky icebluesky.com

Text contributions and editing Charlotte Graham-Cumming - Ice Blue Sky

As we undergo a unprecedented upheaval in our lives, making changes to who we see, where we shop and how we spend our leisure time, it’s important too that we spare a thought for those that live their lives with constant restrictions and inconveniences. Despite those distractions, here at Canon Medical, we are very committed to our work in the wider community, working with charities to help reduce NHS appointments, limit prescriptions and ensure that fewer social care appointments are needed. We do this by continually investing in charitable programmes developed to support communities that have significant challenges to overcome.

In this edition of the UK Visions Magazine, you can see this work first-hand, including our support of the wonderful charity Support Dogs, that specialises in the training of dogs to help those with epilepsy, autism or disabilities. We also have an update on the Sheffield Sharks RESPECT programme for disadvantaged children, who have a colourful new minibus on the way. The current impact of COVID-19 in the UK is devastating, and for countries where electricity and running water is not guaranteed, nor is access to quality healthcare, the effect is many times worse. We are continuing to help our partners, CO2 Balance, to provide facilities for people in rural Africa to help reduce the impact in the region by investing in much needed equipment to provide electricity and running water. For the rest of us, let’s ensure we continue to support those charities that are doing much needed work to improve the quality of people’s lives. Perhaps the difficulties we are all facing may make us have a greater understanding of what others face in terms of healthcare challenges all the time, not just pandemic times.. I wish you good health, and hopefully we are all free to meet again soon. Kind regards,

MARK HITCHMAN Managing Director Canon Medical Systems UK

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// CONTENTS

CMSUK Assures 'Business Continuity' to Support Hospitals in Fight Against Coronavirus

Canon Medical Systems UK Carbon Zero Ambassadors take ‘life-changing’ trip to Uganda to see Impacts of its Carbon Offset Scheme

COVID-19

CSR

A Warm Welcome

Canon Medical Systems Global Effort in the Fight Against COVID-19

COVID-19

08 CMSUK Assures 'Business Continuity’

to Support Hospitals in Fight Against Coronavirus

COVID-19

Advanced Wellbeing Research Centre Opens to Develop World-Class Innovations

The Power of the New Aquiliion ONE PRISM Edition

RESEARCH CENTRE

We’re here for you, Even when we’re not

News

The Power of the New Aquilion ONE PRISM Edition

COMPUTED TOMOGRAPHY

LOCATIONS

Why Trust is the Keyword in AI AI

COMPUTED TOMOGRAPHY

Our Premises Across the UK

Equipment Procurement and Capacity Planning COMMERCIAL SOLUTIONS

Advanced Wellbeing Research Centre Opens to Develop World-Class Innovations RESEARCH CENTRE

MSUK and Wessex Diagnostic kick C off 2020 programme of vascular ultrasound training days

MAGNETIC RESONANCE

TRAINING

Canon Medical Systems UK Carbon Zero Ambassadors take ‘life-changing’ trip to Uganda to see Impacts of its Carbon Offset Scheme

CSR

It's All in a Days Work - Neil Dyer INTERVIEW

Canon Medical’s Vantage Galan 3T makes it to Premier League MAGNETIC RESONANCE

AI enhances cardiac CT image reconstruction & reporting at Frimley Health in UK first

Equipment Procurement and Capacity Planning

Introducing the Children’s Health and Exercise Research Centre RESEARCH CENTRE

Vantage Orian 1.5T

AI enhances cardiac CT image reconstruction & reporting at Frimley Health in UK first AI

COMMERCIAL SOLUTIONS

Deep Learning Reconstruction in Magnetic Resonance Imaging

Sky’s the Limit for Royal Bournemouth with Alphenix Ceiling-Mounted imaging system X-RAY

PRODUCT // SERVICE // COVID-19

Canon Medical Systems global effort in the fight against COVID-19

Canon Medical UK release multiple relocatable CT Scan Units The design and development of relocatable CT scanners that work outside the normal healthcare environment, for example, in hospital car parks or in newly created arena field health centres, have been stepped up by Canon Medical in the UK as part of its fast response to the 2020 Coronavirus COVID-19 pandemic. Equipped with Aquilion Prime SP, Aquilion Lighting SP or Aquilion One Genesis CT scanners, they feature correct clinical flooring, hospital grade HVAC requirements and datalink connectivity and can be operational within hours of deployment.

Leveraging its outreach as a global company, Canon Medical Systems has come together to support its communities worldwide. Disinfection Guide Canon Medical is closely monitoring the COVID-19 outbreak situation and focusing our efforts to provide a safe and secure diagnostic environment for both patients and healthcare professionals. As such, we provide direct access to the cleaning, disinfection and sterilization guides for our products in order to help health facilities to prevent the spread of COVID-19.

InnverVision Diagnostics With our InnerVision remote diagnostics, we ensure that most calls are resolved remotely by our highly trained engineers or application specialists, who can monitor your systems remotely and assist our local engineers in preventing problems. All without the need for an engineer to attend on site. All without interrupting your essential flow of patient care.

We are here for you We understand that your patients are relying on you and, equally, we want you to rely on us. At Canon Medical we are making every endeavour to minimize the impact of the COVID-19 outbreak and to maintain the highest level of customer service, by providing support on critical healthcare equipment.

Read the full article here

"I would like to thank our industry partners for doing everything they can to keep us safe and well." Toshio Takiguchi, President and CEO Canon Medical Systems Corporation

Canon Medical helps develop rapid COVID-19 testing kits Canon Medical Systems Corporation announces the start of development of a rapid genetic testing system for the novel coronavirus (COVID-19) reaffirming the company’s commitment to the basic research and development of rapid diagnostic test kits. Canon Medical was selected to participate in this research program in cooperation with Nagasaki University. This was in recognition of Canon Medical’s strength in leveraging the company’s technologies in delivering practical solutions to support medical emergencies. // Read the full article here

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NEWS // SERVICE // COVID-19

THANK YOU

Canon Medical Systems UK service team continuously working to deliver the best imaging equipment support to healthcare organisations.

Canon Medical Systems thanks the NHS and key workers for their support during this difficult time.

CMSUK assures ‘business continuity’ to support hospitals in fight against Coronavirus Supply chain continuity, remote diagnostics & 7-day support to maintain continued delivery of exceptional service

o reassure and actively support its NHS and independent healthcare customers and stakeholders, Canon Medical has announced that it has created a ‘fast response task force’ to quickly adapt to a rapidly changing environment and ensure business continuity in light of the coronavirus (COVID-19) pandemic. This is in full swing to ensure the continued delivery of first class, reliable imaging equipment service to healthcare organisations.

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Canon Medical is continuing to maintain a 7-day support network on critical healthcare equipment including CT, X-ray, MRI and ultrasound, with minimal changes. It is working to provide uninterrupted supply chain management for products and spare parts. Brexit contingency stock is already on location in the UK, ready to deploy and maintain equipment to ensure hospital imaging systems are fully operational at this time of additional pressure.

The Canon Medical remote diagnostics service solution ‘InnerVision™’, is being enhanced for faster response and predicting issues before they become apparent, as well as improving remote fix to relieve the need for engineers to visit hospital sites. These systems enable remote fault diagnosis on all products and even customer training. It also allows applications teams to support clinical questions, aids remote training on all systems and speeds up

the resolution of equipment issues to prevent patient care interruptions. Plans to increase access to and deployment of mobile and relocatable Canon Medical CT scanners, diagnostic Ultrasound and X-ray are also in preparation. This will help hospitals increase frontline imaging capacities as part of emerging diagnostic pathway planning. Stocks of new products are being built to quickly respond to emergency demand, and personnel are ready to embrace the new challenge.

“Working for the good of all is at the heart of our organisational philosophy. Now, more than ever, it is the time to show a spirit of cooperation and work together to battle the Coronavirus pandemic,” states Mark Hitchman, Managing Director at Canon Medical Systems UK, “We are following closely the guidance from the Department of Health, Public Health England and devolved health administrations in Scotland, Wales and Northern Ireland.

This will support the global supply chain and put the safety of our staff, our healthcare customers and patients at the forefront of our business operations in this unique time.” // Ongoing updates to Canon Medical’s COVID-19 statement can be viewed at https://uk.medical.canon/coronavirus-covid19-supply-chain-impact/

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PRODUCT // SERVICE // Support and Service

We’re here for you, even when we’re not Canon Medical's service team are always available to support customers even in the most challenging of times

hould the unthinkable happen and you need urgent support to fix a problem, we want to take away the stress and leave you feeling assured.

This means our engineers have access to the right tools at the right time, and can resolve any issues quickly, efficiently and with minimal disruption to your service.

We have a skilled technical team awaiting your call seven days a week, who can offer you logistics and escalation services, as well as access to a local UK support centre providing parts and a workshop.

And on top of all this, our clinical applications support is unlimited, so there’s nothing to hold you back should you feel the need to call us.

Find out more about our full service offering

We understand that your patients are relying on you, and equally, we want you to rely on us too. In fact, thanks to Canon’s InnerVision remote monitoring, we’re often beavering away in the background without you even being aware. The system runs 24 hours a day, seven days a week and can mean that we detect and resolve any issues before you even know about it. It goes without saying that when it comes to healthcare, time is of the essence. You don’t want to be kept waiting, nor do your patients. We therefore aim for spare parts to be with you on the same day and, in the unlikely event of downtime, replacement equipment is available for loan or hire while your machine is being repaired.

Our UK Service Support Centre will remain open during this uncertain time. Our opening hours continue to be: Monday – Friday: 8am – 8pm Saturday and Sunday: 9am – 5pm You can reach us on:

01293 653710

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“Friendly, knowledgeable and willing to advise - rather than seal a deal.”

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// NEWS That’s a wrap – the Sheffield Sharks RESPECT programme and Canon Medical Systems UK choose the mini bus design winners

CO2 offset a win-win for UK patients & the wider world

After the success of raising £15,000 to buy a mini bus for the Sheffield Sharks RESPECT programme in 2019, we asked the children who are part of the scheme to create colourful designs for the mini bus, to give it a new lease of life. Here are the following winning entries:

Find out more about the RESPECT programme here and our collaboration with the Sheffield Sharks:

Canon Medical and Support Dogs partner at Crufts for fundraising success Earlier this year, on 5th March 2020, we sent some of our brilliant dog-fanatic employees to Crufts to volunteer alongside Support dogs in raising vital funds for our partner charity. What a success this event was, raising £7500 for such an essential and incredible cause – what a fantastic team effort. //

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The new ultrasound systems will help the clinical team at Derriford Hospital make informed decisions about patient cases. Simultaneously, people in rural villages in East Africa will be helped by improved cooking-stove and water borehole projects. These schemes have huge healthcare and sustainability impacts on the individuals involved and the wider world. For example, new energy saving cooking stoves mean a 50% reduction in firewood, cutting carbon emissions by 3 tonnes while also reducing indoor smoke that has serious long-term health implications on families. Canon Medical is still the only UK medical equipment provider to be ‘carbon neutral’, meeting all PAS 2060 requirements by the British Standards Institute and has gained official partner status from the United Nations’ Division for Sustainable Development Goals. //

Learn more about Support Dogs here ad meet our very own Support Dog Candhu

How to scan the QR codes throughout our magazine:

Two new Aplio ultrasound systems have been installed into Derriford Hospital, part of University Hospitals Plymouth NHS Trust, to assist with obstetric and gynaecological patient examinations. At the same time, the ultrasound systems’ carbon footprint, taking into account manufacturing, packaging, shipping and average energy usage for the standard lifetime, has been offset by Canon Medical to a high impact project in Uganda and Kenya.

Read the full article here

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Working together to understand your needs and challenges drives valuable outcomes that positively impact you and your patients’ future. Canon Medical’s vision and commitment to improving life for all, lies at the heart of everything we do. By partnering to focus on what matters, together we can deliver intelligent, high quality solutions. With Canon Medical, true innovation is made possible.

CANON MEDICAL SYSTEMS LTD

https://uk.medical.canon/ VISIONS 2 // 13

INTERVIEW // COMPUTED TOMOGRAPHY // Aquilion ONE / PRISM Edition, AiCE, Deep Learning Spectral

The Power of the New Aquilion ONE / PRISM Edition Since its global launch in December 2019, the Aquilion ONE / PRISM Edition has been making waves all around the world particularly with its Advanced intelligent Clear-IQ Engine (AiCE), Deep Learning Spectral and CT fluoroscopy capabilities. To find out more about what our customers think, we sat down with leading clinicians from two-prestigious institutions, Radboud University Medical Center (the Netherlands) and Strasbourg University Hospital (France), for an in-depth review of the CT system that’s designed for deep intelligence.

ne of the most exciting features of the PRISM is our Advanced intelligent Clear-IQ Engine (AiCE), a cutting-edge Deep Learning Reconstruction technology that’s been trained to reduce noise and boost signal to deliver sharp, clear and distinct images at speed.

Can you tell us a bit about how your teams have adopted AiCE?

first patients. The difference with AIDR 3D was so immense that we decided, ok, let’s use it for every patient.

Prof. Ohana: We weren’t sure in the beginning whether to use AiCE for specific applications or as an additional reconstruction, so we tried it with the

Prof. Prokop: Our people accepted AiCE extremely quickly and have used it immediately for most applications.

Radiology Team Strasbourg University Hospital, France

Watch here the full video testimonial of Prof. Roy.

“The image quality is excellent with the new PRISM Edition.” Prof. Catherine Roy, Radiologist, Strasbourg University Hospital, France.

“AiCE lets us obtain thinner images at high quality, which helps us make a more confident diagnosis.” Prof. Mathias Prokop, Head of Radiology, Radboud University Medical Center, the Netherlands.

Watch here the promo video of Aquilion PRISM.

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Watch here the full video testimonial of Prof. Prokop.

- Part 1 -

- Part 2 -

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Watch here the full video testimonial of Prof. Ohana.

Watch here the full video testimonial of Dr. Smit. - Part 1 -

- Part 2 -

“With Spectral Imaging, we are more confident.”

“I really like AiCE because of its low contrast detectability and the much sharper contours.”

Prof. Mickaël Ohana, Radiologist, Strasbourg University Hospital, France.

Dr. Ewoud Smit, Radiologist, Radboud University Medical Center, the Netherlands.

“I really like working with the new console. It’s faster and I can stay more focused for a more efficient and safe procedure.” Dr. Sjoerd Jenniskens, Radiologist, Radboud University Medical Center, the Netherlands. Prof. Catherine Roy and Prof. Mickaël Ohana at Strasbourg University Hospital, France.

What’s the most significant difference that AiCE has made to your practice?

What about dose, have you seen any benefits there?

Spectral Imaging: Improved quality and workflow

Have you noticed an improvement in tissue classification?

The new Aquilion ONE / PRISM Edition features a hybrid CT Fluoroscopy interface that enables one-handed operation with ergonomically designed controls and a versatile touchscreen tablet.

Have you seen an overall reduction in iodine load?

Prof. Ohana: In oncology imaging, we sometimes have subtle lesions. With spectral imaging, we are more confident and can see if there is or isn’t contrast uptake in these lesions. Spectral imaging is also more specific, mostly for gout or kidney stones. We are able to characterize the tissue and give more specific answers to the clinician.

What about workflow, is that better?

Dr. Jenniskens: I really like working with the new console because it’s faster and I have everything under my control. I have an overview of the whole process and can stay more focused for a more efficient and safe procedure.

Prof. Prokop: AiCE lets us obtain thinner images at high quality, which helps us make a more confident diagnosis. When you’re looking at complex cases in which you have to focus on detail, your confidence goes up.

Dr. Smit: Because AiCE in integrated in the automatic exposure controle, there’s no guessing on how low the dose should be. It’s just about switching on the button for dose reduction. I generally check the dose report for every scan, and I’m often surprised at how low the dose is.

In addition to AiCE, the new Aquilion ONE / PRISM Edition features advanced spectral imaging to improve workflow and help reduce patient iodine load. Images can be analysed directly at the workstation with a range of new Vitrea applications.

Dr. Smit: I really like AiCE because of its low contrast detectability, especially with liver lesions or peritoneal metastases. Also, the contours are much sharper, which helps with the delineation of bowels, to assess fat stranding, or to see if a tumour is infiltrating another tissue.

Prof. Prokop: We wanted to move on from using morphological information, like in the past, to using more functional information, and we wanted to do that using the lowest possible dose and in a repeatable, reproducible fashion. AiCE lets us do that.

Prof. Roy: That’s the main application in our department and all around the world. Spectral imaging means that we’re now able to use a contrast agent of 270 mg I/ mL instead of staying in the 400 mg I/mL range. Plus, you can still see everything perfectly, with all the tiny details. This is a user-point that still amazes me.

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Prof. Ohana: Acquisition time is the same as a single energy examination; there’s no difference in terms of timing. But also, speed of reconstruction is almost the same.

CT Fluoroscopy: More control where you need it

Has the new CT Fluoroscopy panel made things easier for your team?

Watch here the full video testimonial of Dr. Jenniskens.

Prof. Prokop: It’s important to control the system from inside to do what you want quickly and without too much hassle. The Aquilion ONE PRISM Edition offers more flexibility for improved control and safety during the procedure.

Are there any benefits for the patient? Dr. Jenniskens: Absolutely. You can now stay close to the patient, which is more comfortable for everyone. Patients also benefit from the new console because the procedure can be expedited, and they can be out of the room earlier. // Find out more about Aquilion ONE / PRISM edition on our website: https://eu.medical.canon/ product-solutions/computed-tomography/ aquilion-one-prism-edition/

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INTERVIEW // COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING // Commercial Solutions, Mobile Units

Equipment Procurement and Capacity Planning Introducing the Commercial Solutions team from Canon Medical Systems UK

ealthcare demands can change rapidly or unexpectedly and the current situation facing the NHS is placing unprecedented demands on crucial services. Providing healthcare services in the right place, at the right time, for the right cost, is a monumental challenge at the best of times. Add to this any temporary fluctuations or sudden increases in demand and the availability and allocation of resources becomes an even more daunting task. But this is exactly what we, the Commercial Solutions team from Canon Medical Systems, are experts at. The company has been working

with the NHS for 50 years, providing successful solutions for equipment procurement and capacity planning. This includes the provision of mobile and relocatable units and community imaging centres and flexible financing with rental and leasing options. Over the years we have expanded our network of specialist partners. This means that through Canon Medical Systems UK, healthcare providers not only receive clinical expertise directly from our experts, but also gain access to shared funding, logistics capabilities, and project management via our partner programmes.

Mobile or Relocatable CT & MRI equipment

The fleet of mobile and relocatable CT and MRI units is built and delivered by leading healthcare service vehicle manufacture WH Bence, operated by Canon Medical Systems and used by healthcare professionals to provide services to the public. Patient and user experience are at the top of the agenda when designing these units. People are often surprised when they see how spacious the units are. Elements such as dimmable lighting, wall and ceiling art, and calming music combine to help the patient feel more comfortable and relaxed.

“Features such as dimmable lighting, wall and ceiling art, and calming music combine to help the patient feel more comfortable and relaxed.” Joe Vincent, Commercial Solutions Manager, Canon Medical Systems UK

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Thorough and regular cleaning and servicing of the units means you can be confident of meeting the stringent hygiene standards required for a healthcare environment. Our deployment model ensures that mobile units can quickly be transported to wherever they are needed. So we are able to provide excellent support for customers, whether to meet peaks in demand, cover a period of planned system downtime, or as a rapidly deployed backup. Our team

aims to deliver 100% uptime and 100% satisfaction, through our oustanding customer service and support. Relocatable units have been designed to feel like a distinct building, whilst still being part of the hospital. So the unts are situated at ground level, stairs are not required, and there is plenty of room for both operator and patient to move around. Through good communication with the customer, our team gains an under-

standing of equipment requirements. We calculate expected capacity and develop an appropriate solution for both patient and practitioner needs. This may include CT and MRI services as part of a turnkey solution. We arrange for highly skilled assessors from our logistics partner, WH Bence, to carry out a detailed site survey. Then, we work with you to ensure a seamless installation of each mobile or relocatable unit, prior to delivering training and aftersales support.

Ultrasound: Aligning your budget with your equipment needs

We can also help minimise demands on Capital Expenditure budgets by providing ultrasound units on a rental basis. We facilitate this for customers throughout the UK and can also offer static CT systems and MRI systems this way. Renting our equipment enables clinical teams to access the latest technological developments and enhancements. It also means the responsibility for servicing the equipment lies with us, as per the rental agreement. You use, we maintain. Whether a customer wishes to rent

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a single ultrasound unit on a flexible or short-term basis, or multiple pieces of equipment via Managed Equipment Services, for ultrasound or indeed entire imaging departments, the Commercial Solutions team endeavours to accommodate your requirements. For customers that do not have a constant throughput of patients, we may offer a "pay per scan" option.

Supporting health in the future Canon Medical is well prepared to help its customers address the future challenges presented in delivering high-quality healthcare to patients.

Canon Medical has provided equipment to Sheffield Hallam University’s Advanced Wellbeing Research Centre (AWRC), for a Department of Health

and Social Care funded study on population health and physical activity level improvement. Our involvement with the Bristol Clinical Research & Imaging Centre led directly to the development of our mobile ultrasound cardiac unit. We have donated Cardiovascular Aplio i900 Eco Cardiology systems to the Centre for research designed to prevent sudden death from previously undetected congenital heart anomalies. We have also supported research into strokes. The University of Cambridge has used an Aplio 500 Ultrasound for quantifying the vascularity of plaque leading to a “probability score” of stroke incidence and The Walton Centre in Liverpool uses a wide area detector CT in advanced neurology settings involving stroke and trauma.

“Our deployment model ensures that mobile units can quickly be transported to wherever they are needed.”

We also sponsor the RESPECT programme provided by the Sheffield Sharks professional basketball team. This is designed to build community links with children aged 9-11 who are vulnerable to pressure from cyber-bullying, exploitation and crime, by focusing on community values, physical activity, and healthy lifestyles. Canon Medical Systems is a mainstay and leading light in the UK healthcare landscape. Our Commercial Solutions team is there to help you deploy the equipment you need, where you need it, and when you need it. We have the capacity to help you plan yours. //

Read more about our rental and mobile solutions

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TRAINING // ULTRASOUND // Wessex

CMSUK and Wessex Diagnostic kick off 2020 programme of vascular ultrasound training days Four practical events planned in Birmingham, Manchester & London

he first of four Canon Medical and Wessex Diagnostic training days of 2020 on ultrasound imaging has successfully taken place in Birmingham. Delegates attended to gain knowledge about the latest application of B-mode, pulsed wave and colour Doppler techniques, in the investigation of the abdominal, extra and intra-cranial and peripheral vasculature. Four different platforms, from across the Canon Medical ultrasound range, were used to support the hands-on sessions. A further three courses have been scheduled for 2020*. A one day carotid ultrasound imaging training day is planned to cover the application of B-scan and duplex, pulsed wave, colour and power Doppler techniques in the investigation of the extracranial and intracranial vasculature; on 22-23

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September* in Manchester, vascular ultrasound imaging will again be covered; and a venous ultrasound imaging training course on 7 November* in London is scheduled to focus on ultrasound colour duplex imaging of the deep and superficial venous system. “The emphasis at all 2020 training workshops with Wessex Diagnostic will be about ‘hands on’ practical working using the latest Canon Medical ultrasound imaging systems. This will enable delegates to practise the investigation protocols under discussion and expand their knowledge in an interactive way,” states Sally Davey, Ultrasound Product Manager at Canon Medical Systems UK. Helen Humphries, Director at Wessex Diagnostic states, “NHS and independent healthcare specialists are

continually expanding and developing their use of diagnostic ultrasound as a front-line clinical tool. Our training courses are designed to keep pushing the boundaries of ultrasound knowledge to meet the challenges of modern healthcare. We’re delighted to have the support of Canon Medical in providing the system for delegates to get hands-on experience with and have received really positive feedback from people attending the first course.” A full programme of Canon Medical 2020 events* and the ability to book online can be found at https://uk.medical.canon/events/ // *These dates may be subject to change if Governmental social distancing regarding large groups prevails

The first of four Canon Medical and Wessex Diagnostic training days of 2020 on ultrasound imaging has successfully taken place in Birmingham. Four different ultrasound systems from Canon Medical’s range were used to provide practical, hands-on workshops.

“ The emphasis at all 2020 training workshops with Wessex Diagnostic will be about ‘hands on’ practical working using the latest Canon Medical ultrasound imaging systems. This will enable delegates to practise the investigation protocols under discussion and expand their knowledge in an interactive way.” Sally Davey, Ultrasound Product Manager, Canon Medical Systems UK

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INTERVIEW // CSR // PARTNERSHIP

Canon Medical Systems UK’s Carbon Zero Ambassadors (centre) meet villagers in North Uganda to see first-hand the water bore hole projects. L to R centre: Tim Palarm, Ultrasound Regional Manager, South; Nicola Fox, Marketing Team Lead; Cassie Rose, HR Assistant; Danielle Johnson, Service Sales Account Executive (South); and Mat Aylen, Business Support Manager at Canon Medical Systems UK.

Canon Medical Systems UK carbon zero ambassadors take ‘life-changing’ trip to Uganda to see impacts of its carbon offset scheme Unique initiative delivers health benefits to UK, the global environment & developing nations

n amazing welcome, with thanks and hope, was given to a Canon Medical Systems UK team visiting a rural village, school and hospital in Uganda to observe first-hand the positive impacts of clean, fresh water via the company’s Carbon Zero initiative. Since 2014, every Canon Medical Systems UK imaging system installed by a hospital or clinic in England, Scotland or Wales has had its carbon dioxide (CO2) emission footprint calculated and verified by a third party, CO2balance and a United Nations’

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auditor, and offset to a high impact project in Uganda or Kenya. The carbon emission offset from the manufacture, packaging, shipping and average energy usage for a products lifetime, goes towards greatly improving the lives of local people, by providing clean water boreholes and modern cooking stoves. Canon Medical Systems UK also offsets all operational CO2 emissions, by contributing to the same incredible initiative. This also means less CO2 damaging the natural environment and less contributing to climate change.

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All Canon Medical Systems UK systems are carbon neutral to help the environment.

“ When they heard the borehole project would run for 21 years the look of relief on their faces was indescribable. Although they had very little, no toilets, small huts to live in, limited clothes etc. they had an incredible community spirit and were very proud people.”

Read the full blog of our trip to Uganda

Nicola Fox, Marketing Team Lead, Canon Medical Systems UK

The recent trip involved visits to the villages of Apala Ilera, Omar, Awat and Aweiwoo in the Kole District of Northern Uganda where a history of political unrest has taken its toll on infrastructure such as water provision, schools and hospitals. Development projects run by international organisations in conjunction with the Ugandan Government and supported by companies such as Canon Medical are vital. They rebuild communities, boost gender equality and improve overall health and wellbeing.

“We received such a warm and enthusiastic welcome from the villagers in Uganda. The supply and maintenance of water bore holes goes far beyond just the provision of water for them. Although the obvious benefits are that waterborne disease such as cholera and dysentery are avoided, villagers no longer need to walk as far each day to fetch clean supplies, or look for firewood to boil and sterilise unclean water. This means children, relied on by their families to help, have time to go to school and receive an education. Furthermore, with fewer fires needed

to boil water, fewer trees are cut down to reduce deforestation, and families have fewer medical conditions related to smoke inhalation. The gratitude we received was warm and truly inspiring,” comments Danielle Johnson, Service Sales Account Executive (South) at Canon Medical Systems UK. “We received a rapturous welcome to the Amunamum Primary School for 1000 pupils with singing and a play to thank us for the visit and gifts of new books, skipping ropes, hoops and footballs,” states Tim Palarm, Ultrasound

Regional Manager, South at Canon Medical Systems UK. “Since the water borehole projects, more children are able to go to school as they don’t need to walk miles each day to fetch clean water or firewood for their families. This is helping give them greater opportunities in life and channel their energies in a positive way. This trip has been humbling and an amazing oncein-a-lifetime experience.” The Kachung Health Centre was also visited by Canon Medical with the

CO2balance project team to deliver a new steriliser. It is a basic hospital serving an area of 10km2 and treating 1600 patients a month from surrounding villages, with only 3 nurses. Mark Hitchman, Managing Director at Canon Medical Systems UK states, “In tandem with meeting NHS or independent healthcare medical equipment needs, Canon Medical also ensures, through our Carbon Zero scheme, that all of our systems are carbon neutral. The health of our planet is in crisis and

we should all be playing a part to help slow down climate change and aid the environment.” The team from Canon Medical Systems UK visiting Uganda were all winners of an internal Carbon Zero company competition championing sustainability and were selected to take part in the Ugandan trip based on their individual achievements in living an environmentally conscious life and encouraging others to do the same. //

“ Every village was completely different from the last and we were welcomed with open arms, dancing and traditional high-pitched cooing. Despite the conditions and poverty in these villages, the sense of community is thriving and the energy is contagious, you can’t help but smile and fall in love with the local people. I wonder if they will remember these visits just as well as we will.” Danielle Johnson, Service Sales Account Executive, Canon Medical Systems UK

Canon Medical Systems UK visiting the Amunamum Primary School in Uganda. Pictured left: Nicola Fox, Marketing Team Lead; and Tim Palarm, Ultrasound Regional Manager, South.

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INTERVIEW // MAGNETIC RESONANCE // Vantage Orian

It's all in a days work Interview with Service Engineer Neil Dyer

e sat down with Neil Dyer, Service Engineer, to find out exactly what's involved when installing an MRI system. Neil talked us through a recent install of a new Vantage Orian 1.5T MRI system at Wycombe Hospital in Buckinghamshire. He gave us a fascinating insight into the daily life of a service engineer, and explained why the installation of an MRI system takes longer than a day.

Delivery of the system

The logistic challenge started with the delivery of the MRI system to its desired location. Or more specifically, getting it into the building. Wycombe Hospital is situated on a steep hill leading into the town of High Wycombe so, to minimise disruption, we organised the delivery for a weekend, which enabled the access road to the main car park to be closed. The all-important magnet had to be winched slowly down the hill, onto a level platform from which we could enter the hospital. We removed a 4 m × 3.1 m panel from the hospital wall to fit the magnet through, then, once inside, we had to negotiate a dogleg in the corridor before we reached the magnet room. Challenging, but manageable.

Cooling and set up

When the magnet had reached its destination, a scanning room, our first priority was to cool it back down as quickly as possible; the magnet was in transport mode, but would still boil off helium. This cooling stage took around two days, as we had to connect the cooling cabinet fridge, which cools the helium and a further fridge which chills it to the required four kelvin, allowing the helium to re-condense back onto the magnets. We also set up a chiller unit on the roof of the building, to cool the water and transfer heat away from the system. Having got the coldhead connected and working, we were able to restore cooling to the magnet. This typically takes place three days into an install. Using a combination of the heat exchanger and the re-condensing coldhead, we were able to maintain the magnet and reduce boil off to zero. Because helium can be dangerous to work with, we instigate a lot of additional security protocols during this stage,

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In an emergency, a quench pipe allows the helium to be extracted and vented safely, and the ERDU turns off the magnetic field in a controlled way.

Service Engineer, Neil Dyer

“ Because helium can be dangerous to work with, we instigate a lot of additional security protocols during this stage, and only trained magnet engineers can carry out these connections.” and only trained magnet engineers can carry out these connections. At this point in our High Wycombe installation, the builders came in to reinstate the wall of the scanning room. Iron shielding had previously been added to the room, so that once it was sealed, the room itself would become a Faraday cage; this had been fully tested by the manufacturer to ensure that RF signals weren’t coming into the room.

It took us around five days in total to do all of the cabling and connect everything in the system, prior to powering it up. The system was then ramped to the field for the first time; this involved increasing the current within what is basically a simple electromagnet up to around 475 A. Since the windings are kept close to absolute zero (by the helium), the copper became a superconductor. This meant that once the current was present in the windings, we could close a switch within the magnet and remove the power supply. Providing the helium remains present, this current should remain stable for many years.

Ensuring the magnetic field is perfect

The magnetic field in an MRI system must be homogeneous within the FOV (field of view). To achieve this, we had to shim the magnetic field, a process which takes several days. It involved several iterations: a field check followed by setting the ramp down, adding iron, then getting the ramp back up. We distributed small iron plates (roughly half the size of a playing card and much thinner) across 700 pockets

to create the right field balance, adjusting these until the field was correct. Each plate was 0.1 mm thick, and they were all insulated from each other with special packing, ensuring absolutely nothing could move.

System calibrations

At this point, we started the system calibrations, which were followed by coil checks and networking, plus remote access. This remote access is now an important part of an installation as it enables us to monitor the health of the magnet and allow applications to provide help remotely or even take control if requested.

Using the system

Our final task was to do an equipment handover session with key hospital personnel to explain how the system should be operated. We ran through safe operating procedures, safety features, and routine maintenance procedures. The installation process was complete. Wycombe Hospital was ready to train its staff on their new Vantage Orian MRIsystem. //

The function of the Faraday Cage is to stop interference coming from the outside of the room to the inside magnetic ring, whilst the iron shielding prevents the magnetic field exiting the room and sensitive areas. It also prevents the magnet’s own field being distorted by external sources such as cars or lifts. Without this,the images produced would become distorted.

Powering up

A hugely important part of an install involves setting up security protocols to keep people away from the magnet room and the controlled area. As part of this process, we perform checks on the quench pipe and signage, and most importantly test the ERDU (Emergency Ramp Down Unit).

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SPORTS MEDICINE // MAGNETIC RESONANCE // Vantage Galan 3T

Canon Medical’s Vantage Galan 3T makes it to Premier League Manchester United FC welcomes first-class MRI for quick, quiet & quality sports imaging

outine monitoring of player health and specialist sports medicine research projects at Manchester United Football Club have received a boost with the introduction of the Vantage Galan 3T MRI from Canon Medical Systems UK. The system has taken its place in the club’s state-of-the-art imaging centre at Old Trafford training ground alongside CT and Ultrasound imaging systems supplied as part of Canon Medical’s role as ‘Official Medical Systems Partner’.

Manchester United FC’s doctors and physiotherapists will benefit from quicker MRI scans and more detailed image outputs via the Vantage Galan MRI, ensuring optimum health planning of the team’s premier and youth league players. Reactive and proactive health surveillance, performance management & injury grading will also be optimised from enhanced functionality of the system, delivering sharper, clearer images for decision making. The players undergoing MRI procedures will benefit from a quieter and

more comfortable scan due to Canon Medical’s Pianissimo and Pianissimo Zen technology that significantly reduce noise in and around the MRI environment. “Even the smallest injury in elite sports has implications. Having the right diagnostic tool at the peak of its development is vital to diagnosing subtle injuries that could impact player health,” states Dr Steve McNally, Head of Football Medicine & Science at Manchester United Football Club.

Routine monitoring of player health and specialist sports medicine research projects at Manchester United Football Club have received a boost with

“Using high resolution MRI therefore helps to identify very minute intra-articular joint injuries, muscle oedema changes or very small fibre tears.” He continues, “We are very pleased with the ease of image acquisition and quality from the new Vantage Galan MRI for diagnostic purposes. We are looking forward to the additional opportunities the new technology provides for specialist imaging and post-processing applications that will enhance our ‘performance imaging’ and athlete health surveillance projects.”

“ The Vantage Galan 3T MRI from Canon Medical Systems enhances image quality for more confident diagnoses and makes examinations faster for better workflow efficiencies.” Dr Steve McNally, Head of Football Medicine & Science at Manchester United Football Club

The Vantage Galan 3T MRI from Canon Medical Systems enhances image quality for more confident diagnoses and makes examinations faster for better workflow efficiencies. It offers a maximum gradient amplitude of 45 mT/m, a slew rate of 200 T/m/sec and employs proprietary Pure RF Rx and Pure RF Tx technology dramatically increasing the signal to noise (SNR).

the introduction of the Vantage Galan 3T MRI from Canon Medical Systems UK.

Scan planning can also be enhanced with ForeSee View, a new tool that previews slice planning in real time, particularly useful for anatomies that are traditionally difficult to scan. In sports medicine this is particularly useful when imaging orthopaedic joints and ligaments. This includes the anterior cruciate ligament (ACL), a key knee joint ligament most often torn during sports that involve rapid change in direction and sharp stops in movement. The ForeSee View functionality will reduce the need for re-scanning and can save time on planning for all body regions. EasyTech Cardiac incorporating CardioLine+, an application that accurately and automatically identifies all the right and left ventricular and cardiac valvular planes, is also included in the Manchester United FC Vantage Galan MRI installation. It reduces examination times to a minimum, enabling challenging cardiac exam-

Canon Medical Systems is the ‘Official Medical Systems Partner’ to Manchester United Football Club.

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inations to be performed easily as part of daily routines. This functionality will be particularly useful for proactive sporting health surveillance campaigns, for example, cardiology profiling that is required every two years on anyone undertaking vigorous training and competitive sports matches. “Adding the Vantage Galan MRI to our system line-up at Manchester United Football Club is a natural progression of providing our best-of-breed imaging solutions over the last 6 years to monitor the very highest echelon of professional athletes,” states Mark Hitchman, Managing Director at Canon Medical Systems UK. “At the same time, the Galan MRI will be used for research projects that have the potential to cascade understanding of anatomical conditions to benefit wider health populations.” Canon Medical Systems has been Manchester United Football Club’s ‘Official Medical Systems Partner’ since 2012, providing CT, MRI and Ultrasound systems to ensure that the world-class players and youth academy receive the best possible diagnostic care. Other football medicine partnerships include FC Barcelona, Real Madrid and English national league club Barnet FC in North London and Spanish La Liga team RCD Espanyol. Wider sports medicine collaborations across Europe include basketball, cycling, ice hockey, rugby and tennis. //

Launching the

1.5T

Our customers are of universal importance at Canon Medical Systems and we strive to be an extension of your team. With the support of our experts, from our Application Specialists to our Sales and Service Teams, we will ensure a combination of the best equipment and a partnership to give you complete confidence in your investment. Read the full blog about the partnership

The perfect answer to your MRI clinical requirements, the Vantage Orian is designed to increase productivity while ensuring patient comfort and reducing running costs.

Dr Steve McNally, Head of Football Medicine & Science at Manchester United Football Club

First UK installation at Buckinghamshire Healthcare Trust in January 2020 uk.medical.canon 32 // VISIONS 2

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Our premises across the UK Even during these uncertain times, we're still operating as usual to support you and your teams.

1. Headquarters Canon Medical Systems Ltd Boundary Court, Gatwick Road, Crawley, West Sussex, RH10 9AX 01293 653710 2. Stirling Branch Canon Medical Systems Ltd 2A Hillside House, Laurelhill Business Park, Stirling, Scotland, FK7 9JQ 3. Northern Ireland Branch Canon Medical Systems Ltd. C/o Antrim & Newtownabbey Borough Council, LG Floor, Carnmoney Road North, Newtownabbey, Co.Antrim, BT36 5QA 4. Dinnington Branch Training facility and storage 1, Redwood Court, Campbell Way, Dinnington, Sheffield, S25 3NQ

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INTERVIEW // ARTIFICIAL INTELLIGENCE // Trust in AI

Why 'trust' is the keyword in AI Mark Hitchman, Managing Director of Canon Medical Systems UK, a leading supplier of diagnostic medical imaging equipment for a range of clinical specialities, discusses why trust and business values will be the cornerstones to defining AI ethics.

here’s no doubt Artificial Intelligence (AI) has a place in modern healthcare. But as the pace of innovation and adoption into health organisations accelerates, there will be the prejudices and voices of caution. The concerns surrounding its capacity to replace people seem to be abating as understanding grows around its supporting role to workforces and how it will co-pilot clinical diagnoses. However, the key to garnering a warmer embrace by end-user stakeholders is to inspire confidence through trust and sound governance. Just as clinicians take a Hippocratic Oath, medical technology innovators also need to be guided by a moral and ethical compass. Everyone’s vision for AI in healthcare is the application of deep learning techniques with rich medical datasets to positively impact patient outcomes. It’s exciting, inspiring and most importantly, it promises solutions to some of the very big challenges facing UK healthcare today. But with the AI hype, there also comes caution. Can we trust AI? Where is the data coming from to build the algorithms? Is data diverse enough to represent our health populations? AI will support modern healthcare The 2020s will be a decade of health innovations led mainly by the deep learning-based technologies that are fuelling the AI evolution. The early pilots and entry-level machine-learning case examples are providing benefits for many process, clinical and operational efficiencies in our overstretched health services. Examples include its use as a second-layer checking tool of breast cancer screening scans, as automated assistants

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in routine surgery, or to improve the diagnostic quality of CT scans whilst keeping patient dose low. Continuous innovation in developing algorithms that drive healthcare technologies is the quest of all the major players. Working in collaboration with global academics, innovators and clinical luminaries is a common theme. So too is the issuing of ethics charters or guidelines, that set out how AI will benefit and support health establishments, patients and society. Business values are the cornerstone of AI ethics The way a company does business is the cornerstone to gaining trust in Artificial Intelligence. This portrays its overall ethical stance and values. This can help define answers to all the key ethical questions around where data is coming from to build algorithms and ensuring AI is representative of all the health demographics it is going to serve. The business of ethics goes far beyond the statutory requirements of a commercial organisation - it’s about discretionary decisions and behaviours guided by core corporate values. Business values influence how we interact with employees, suppliers and customers. They govern accountancy practices and indeed inject a commercial consciousness. Examples of the business of ethics can define the authenticity of a company over the long-term. Does it have a strong corporate social responsibility (CSR) pedigree with deep altruistic charity links? Does it have an opinion on the key macro-environmental

issues of our time? Is it doing something concrete to make a difference to climate change, world poverty or race/ gender inequality? Often the wider ‘personality’ of a medtech innovator illustrates the values behind its ethics and ethos. Its culture and philosophy for its own people and society beyond tell a story about the leadership and innovations it builds. You don’t need to be a tech leader like Bill Gates to roll out initiatives for the greater good. Philanthropy woven into business leadership can champion a higher level of trust in the brand, the business and ultimately

the AI advancements that are being developed. Relationships are always governed by trust Innovation and trust go hand in hand. Especially where the lives of patients depend on it. So in this early stage of AI evolution and collaborations it is crucial that we all act transparently to build a trustworthy foundation. Individuals and companies that undermine integrity, by fast-tracking developments or gathering data from unvalidated repositories, risk setting back the reputation of the whole of the industry.

“ The way a company does business is the cornerstone to gaining trust in Artificial Intelligence.”

Let’s hang on to the excitement of AI to boost med-tech innovation, drive the ethics of transparency and good governance, and look forward to the rewards. AI without shock and awe will ensure a steady and supported adoption of this inspiring innovation. Championing trust and working with businesses with ethics is vital to deliver the greatest rewards. //

Read the full article online

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RESEARCH // ULTRASOUND // AWRC Partnership

Advanced Wellbeing Research Centre opens to develop world-class innovations Diagnostic ultrasound from Canon Medical deployed for sports, stroke & ageing projects

he most advanced research centre in the world for developing innovations that will increase physical activity and improve population health has been officially opened by Sheffield Hallam University. The new multi-million pound Advanced Wellbeing Research Centre (AWRC) is supported by several strategic partners including Canon Medical Systems to provide cutting-edge equipment and

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technology, expertise in the health sector and research and development opportunities. The AWRC has been supported by £14m of funding from the Department of Health and Social Care and a £905k investment from the European Regional Development Fund. It is located in the Sheffield Olympic Legacy Park and has a mission to prevent and

mance management of elite athletes to the rehabilitation of stroke patients and the health of older people. For example, the Canon Medical ultrasound system is being used to explore the effectiveness of power assisted exercises in the rehabilitation of stroke patients to can improve muscle mass and strength. Professor Robert Copeland, Director of the AWRC, states, “Our mission is to prevent and treat chronic disease through world-class research into physical activity. This will mean re-engineering movement back into our lives which requires a radical re-think in the way we live, work, manage and monitor our health, and travel around our towns and cities. This mission can’t be achieved by a single agency or discipline, and the opening of the AWRC marks the start of an exciting

collaborative journey. By bringing together academic expertise from across Sheffield Hallam University in this world-class facility and creating meaningful partnerships with industry, local communities, local authorities and the health and technology sector, we will address the social, behavioural and economic determinants of health, creating equitable and active communities for all.” Mark Hitchman, Managing Director at Canon Medical Systems UK states, “We are inspired by the research and innovation work underway at AWRC. Using our diagnostic ultrasound systems the teams are able to push the boundaries of what we currently know about the human body and find new ways to help prevent sports injuries, rehabilitate people with chronic illness and make us all fighting fit as our bodies age. ”

Dr Tom Maden-Wilkinson, Lecturer, Health and Wellbeing, Sheffield Hallam University states, “The projects will help us understand a range of issues related to muscle strength – from strength training in older adults to help maintain their independence, to elite athletes and efficiency or injury prevention. The Canon Medical ultrasound is providing us with technology to take huge strides in examining the relationship between muscles, exercise and recovery.” Other AWRC strategic collaborations include Westfield Health, EXOS, the National Centre for Sport and Exercise Medicine in Sheffield, Sheffield Children’s Hospital Charity, Ingesport and parkrun. //

treat chronic disease through co-designed research into physical activity. It was officially opened by the Active Travel Commissioner for Sheffield City Region and Britain’s most successful Paralympian, Dame Sarah Storey. Canon Medical is providing a diagnostic ultrasound system to the AWRC to help gain an insight into health and wellbeing issues ranging from perfor-

Left to right: Ian Watson, Director of Commercial Solutions, Canon Medical Systems UK, Mark Holmshaw, Global Executive Advisor, Canon Medical Systems Europe; and Mark Hitchman, Managing Director, Canon Medical Systems UK attending the opening of the Advanced Wellbeing Research Centre (AWRC) as strategic partners.

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INTERVIEW // MAGNETIC RESONANCE // Vantage Galan 3T, DLR, AI

VISIONS spoke with Prof. Dousset and Prof. Tourdias, from the Bordeaux University, France.

Deep Learning Reconstruction in Magnetic Resonance Imaging Artificial intelligence continues to expand the possibilities brought by medical imaging and advanced healthcare. In particular, Deep Learning Reconstruction (DLR) used in combination with Magnetic Resonance Imaging has the potential to help diagnose diseases earlier, faster and better. In France, Bordeaux University is working with Canon Medical’s DLR solution to fulfill these promises and get the best out of the technology in numerous applications in research and clinical practice.

D From left to right: Valentin Prevost (Canon Medical Systems Corporation), Bei Zhang (Canon Medical

LR has the ability to improve image quality by eliminating noise. Removing noise from images with DLR increases signal to noise ratio, helping to obtain ultra high-resolution images. Based on the experience from Bordeaux University, this has provided the opportunity to see anatomy previously not possible on 3T systems.

Applications in research and clinical work

With the help of Canon Medical, the future has already started at the Bio Imaging Institute (French: IBIO1), a unique structure that serves as an interface between the clinical work performed at Bordeaux hospital and the research done at Bordeaux University.

Systems Europe), Prof. Tourdias (Bordeaux University Hospital), Prof. Dousset (Bordeaux University Hospital), Bruno Triaire and Nobuyasu Ichinose (Canon Medical Systems Corporation).

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“With DLR we can achieve both high resolution images without losing time or signal and reduce the image acquisition time.” Prof. Vincent Dousset, Head of the diagnostic and therapeutic Neuro Radiology department at Bordeaux University Hospital.

IBIO started integrating Canon Medical’s DLR solution in November 2017. The workload progressively increased during the first six months, to find the optimal parameters and fine-tune the “denoising”. The team has been using the system routinely for about a year now and is working on validating the tool scientifically. Prof. Thomas Tourdias, Radiologist at Bordeaux University, uses DLR in almost all his research projects. “DLR helps to remove noise and obtain better image quality, which assists us to collect more information to answer

research questions. Removing noise also helps us to reach a very high resolution that we previously couldn’t achieve, which is very helpful for specific research areas,” he said. DLR can be implemented in a myriad of clinical scenarios, for example to help expedite workflow. “In our daily routine, we are challenged with a growing number of requests and the difficult task of examining all these patients. So probably the major clinical application for DLR is going to help us work faster. Many more patients could undergo examinations when

we decrease the acquisition time,” Prof. Tourdias explained. DLR is easily integrated into the image reconstruction chain. Radiologists only have to plug in the option to improve the image quality. Switching to this new routine is effortless and brings real benefits, according to Prof. Vincent Dousset, Head of the diagnostic and therapeutic Neuro Radiology department at Bordeaux University Hospital. “The first advantage is that we can achieve high resolution images with-

out losing time or signal. The second advantage is the reduction of image acquisition time, as we care less about the signal quality because the noise can be eleminated following the scan,” Prof. Dousset said. DLR is more than just a new tool, it’s a major change in medical imaging history, Prof. Dousset believes. “Because the DLR will allow us to correct afterwards what couldn’t be corrected at the outset, the first application is that we no longer have to improve the signal or the spatial resolution. This is revolutionary in medical imaging history.

This is the main advantage I think: the image “denoising” technique.” In particular DLR has an important clinical impact in anatomical regions that require a very high resolution, for example parts of the hippocampus and the claustrum. “The DLR brings a spatial resolution that I have never seen before in neurologic imaging. I recently pointed out a brain area, for example the claustrum, that is almost invisible on standard MRI images even with very high resolution or high field devices. However, thanks

to the DLR we could highlight this kind of brain anatomy. So, indeed, there is a considerable advantage to using this technique.” Prof. Dousset said. Prof. Tourdias worked at 7T to visualise extremely fine structures of the hippocampus while at Stanford. With DLR, he can now do this task with a 3T. “When we compared the images we realized that by pushing the 3T machine and processing with DLR that we were able to achieve a similar result to what we could achieve with 7T. I think this is the main surprise of the technology.” he said.

“Removing noise also helps us to reach a very high resolution that we previously couldn’t achieve.” Prof. Thomas Tourdias, Radiologist at Bordeaux University and Hospital, Practitioner at Bordeaux University Hospital. Also member of INSERM Unit U1215 Pathophysiology of neural plasticity” at the Magendie Neurocentre.

Original Coronal T2w image.

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Coronal T2w image with DLR.

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3D FLAIR Original image.

A reliable and dedicated multi-purpose Fluoroscopy room. In line with our continued Made for Life philosophy, patients are at the heart of everything we do. Our mission is to provide medical professionals with solutions that support their eﬀorts in contributing to the health and wellbeing of patients worldwide. Our goal is to deliver optimum health opportunities for patients through uncompromised performance, comfort and safety features.

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Low doses, high IQ Mutual benefits

The synergy between the hospital and Canon Medical creates opportunities to find solutions for the patient, also in areas that had never been explored before. Working with Canon Medical enables physicians at IBIO to work with the most advanced technology on the company’s latest MRI scanner for on-going clinical research, but benefits spread beyond the institute, Prof. Tourdias explained. “There is an interest in transferring the technology back to the manufacturer, and we hope that the results of this research will quickly spread to the industry. And then it’s interesting to put together research projects. So, there are multiple facets to our collaboration,” he said. The strong co-operation between Canon Medical and the medical team at IBIO has also placed the institute among the top, most competitive imaging centres in Europe.

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“Canon Medical’s collaboration with Bordeaux University helps us position ourselves internationally among the important European academic teams who work with major medical imaging manufacturers. This is a huge benefit,” Prof. Dousset said. Canon Medical’s co-operation was essential in installing and becoming familiar with the system and more generally with AI. With Canon Medical’s clinical scientists involved all through the process and visiting regularly, the medical team was able to find the optimal settings and make the most of DLR. “There were a lot of questions about DLR’s relevance and benefits, and the different technical parameters that it features. We proceeded to analyse a lot of images, so that we could make choices that had been transcribed by Canon Medical. The manufacturer’s contribution was very significant to DLR’s development at our site,” Prof. Dousset said.

Innovating hand in hand with Canon Medical benefits not only the patient, but also the next generation of radiologists. “It’s very important to integrate the industry in education, to prepare students for their future professions,” he concluded. //

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Reference 1 The Bio Imaging Institute (French: IBIO) project was initiated ten years ago to be the interface between Bordeaux Hospital and Bordeaux University. The building hosts research on both animals and humans, with a particular focus on MR imaging, but there are also on-going projects in X-Ray and optical imaging. The IBIO welcomes several academic teams from Bordeaux University and the French National Centre for Scientific Research (French: CNRS), who work on MRI biologic imaging development and neuroscience studies, as well as industrial teams, such as the Canon team for MR work.

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PRODUCT // COMPUTED TOMOGRAPHY // Aquilion ONE Genesis Edition, AI

AI enhances cardiac CT image reconstruction & reporting at Frimley Health in UK first Canon Medical’s innovation designed to improve clinical image clarity & confidence

he first UK NHS hospital installation of Advanced intelligent Clear-IQ Engine (AiCE), a deep learning reconstruction Artificial Intelligence (AI) algorithm, is now live at Frimley Park Hospital in Surrey. It is integrated into an Aquilion ONE GENESIS Edition CT scanner from Canon Medical Systems UK and being used to improve the reconstruction and reporting of vascular cases by radiologists. The innovative software Advanced intelligent Clear-IQ Engine (AiCE) delivers quick, reliable and high-quality image reconstructions from patient CT scans to assist reporting clinicians with more accurate image information to support diagnosis and treatment plans. Using the deep learning algorithm, the solution is trained to

differentiate ‘noise’ from true signal, reducing distortions, preserving edges and maintaining details in image outputs. At the same time, the innovation is achieving lower doses than ever seen before in routine CT imaging. “From a CT scanning operative point of view, we don’t even know that we’ve entered the world of AI as we don’t need to do anything different when setting protocols before patient examinations, it’s all part of the CT system. So there is no barrier to acceptance or AI change management issues from the installation of a new innovation,” states Carmina Esperanza, CT Lead Radiographer at Frimley Health NHS Foundation Trust. “The advantages to our radiologists of Advanced intelligent Clear-IQ Engine (AiCE) is much sharper images to report on. The

Our global and UK R&D labs are fully engaged in expanding the boundaries of medical imaging with AI to integrate simply into our existing modality equipment. This approach will easily pave the path for UK AI adoption.” The Advanced intelligent Clear-IQ Engine (AiCE) installation on an Aquilion ONE GENESIS Edition CT scanner from Canon Medical Systems UK at Frimley Health NHS Foundation Trust was part of three new CT scan-

ners installed at the Trust replacing incumbent systems. An Aquilion Prime SP CT system was also installed into Frimley Park Hospital for acute work to support A&E and inpatients, plus a further Aquilion Prime SP was installed into Aldershot Centre for Health, an outlying medical centre for outpatient diagnostics. Commenting on the selection of the CT scanners, Carmina Esperanza states, “Canon Medical Systems UK ticked all

the boxes for what we needed to update our CT services. We looked at other providers as part of our replacement evaluation, looking at the scope of the technology, the size of the system and after-sales service, but it was a unanimous decision between the Trust selection panel consisting of radiographers and radiologists. Canon Medical Systems UK is best placed to serve our future needs.” //

benefits to our patient population is confidence that they are gaining the highest standard of care via investment in the latest medical imaging equipment.” “Advanced intelligent Clear-IQ Engine (AiCE) is a deep learning medical imaging innovation borne from the momentum of big data and health collaboration projects where high quality information from real patient datasets is drawn into AI systems to automate routine or repetitive tasks,” states Mark Hitchman, Managing Director of Canon Medical Systems UK. “AI is an exciting future for healthcare, where patients will be able to spend more time with their consulting clinicians who are freed from repetitive or routine image review tasks to focus back onto patient care and specialist cases.

“ From a CT scanning operative point of view, we don’t even know that we’ve entered the world of AI as we don’t need to do anything different when setting protocols before patient examinations, it’s all part of the CT system. So there is no barrier to acceptance or AI change management issues from the installation of a new innovation.” Carmina Esperanza, CT Lead Radiographer Frimley Health NHS Foundation Trust

The first UK NHS hospital installation of Advanced intelligent Clear-IQ Engine (AiCE), a deep learning reconstruction Artificial Intelligence (AI) algorithm, is now live at Frimley Park Hospital in Surrey following the installation of a Aquilion ONE GENESIS Edition CT scanner from Canon

Find out more about our full service offering

Medical Systems UK. Left to right: Iain Burley, Account Manager, Canon Medical Systems UK; Megan Wilkins, Site Lead Radiographer; Bridget Manock, Radiology Services Manager; Mark Foxall, Account Manager, Canon Medical Systems UK; Robert McFaul, Senior Radiographer; Orianna Friday, Senior Radiographer; Carmina Esperanza, CT Lead Radiographer; and Alissa Andrews, CT Deputy Lead Radiographer.

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INTERVIEW // ULTRASOUND // Partnership

Introducing the Children’s Health and Exercise Research Centre A Canon Medical Systems UK Collaboration

“The centre’s aims have been to initiate research in paediatric exercise science and raise the profile of children’s health and wellbeing both nationally and internationally. ” Read more about our diagnostic ultrasound

Dr Guido Pieles, Bristol Heart Institute, Professor Craig Williams, Director of the Children's Health & Exercise Research Centre (CHERC), Tim Palarm, Regional Manager,

Congenital Cardiologist

Canon Medical Systems UK and Curtis Wadey, PhD student at the University of Exeter.

he Children’s Health and Exercise Research Centre (CHERC) is a world-leading research unit based at the University of Exeter. It was founded in 1987 and was the first centre in the world to establish paediatric exercise science as an academic field of study, for which its research received the HM Queen’s Anniversary Prize for Higher Education. The centre’s aims have been to initiate research in paediatric exercise science and raise the profile of children’s health and wellbeing both nationally and internationally. The current research focuses on three

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areas: 1) the prevention of cardiovascular disease in school aged youth; 2) health and wellbeing of young athletes; and 3) physical activity and exercise promotion and prescription for youngsters with chronic medical conditions. These include such groups as youngsters with cystic fibrosis, congenital heart disease and diabetes mellitus. Through its research, teaching, publications and extensive media coverage, the Centre has raised awareness, both amongst professionals and the general public, of children's inactivity and its implications for health and well-being

throughout life. Over the last five years CHERC has developed an excellent relationship with Canon and there has been collaboration on several research projects. The most impactful has been the assessment of cardiac health and fitness at the youth academy for Manchester United Football Club. The project is a collaboration between the Director of CHERC, Professor Craig Williams, Dr. Guido Pieles, a Consultant Cardiologist at the Bristol Royal Hospital or Children and Bristol Heart Institute, the Manchester United Football Academy and Canon Medical. The aim of this project is to investigate

the physiology of the growing athlete’s heart at rest and during exercise. This will advance our knowledge of exercise adaptations in the paediatric athlete. A key aspect of this project is to differentiate between an ‘athlete’s heart’ and a heart that might be potentially abnormal and/or pathological. Due to the success of the partnership Canon Medical has recently co-funded, with the University of Exeter, a PhD studentship (Curtis Wadey). Curtis will be researching cardiac function, health and fitness in paediatric congenital heart disease. This will involve using

state of the art Canon Medical echocardiography equipment, along with other cutting-edge exercise and sport science technologies. Some of the planned outcomes and impact of this research are: 1) to have better definitions for the current physical activity and exercise guidelines for young people with congenital heart disease (which are currently very broad and superficial), 2) to increase our understanding of what constitutes a physiological vs. pathological heart and 3) to understand how young patients respond and adapt to exercise training.

This collaborative project is further complemented by the addition of two other PhD students, Dr Dan-Mihai Dorobantu, an adult cardiologist and Nurul Amir, a specialist in rehabilitation programmes. There are also plans to welcome two experienced research fellows later this year. With this critical mass of researchers, the future is positive for this Canon Medical collaboration! This wouldn’t be possible without the support of both Tim Palarm, Regional Manager and Mark Hitchman, Managing Director of Canon Medical Systems UK who support this programme – thank you. //

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PRODUCT // X-RAY // Alphenix

Sky’s the limit for Royal Bournemouth with Alphenix ceiling-mounted imaging system Future-proofing of services to expand clinical procedures and create scheduling efficiencies

oyal Bournemouth Hospital has installed a ceiling-mounted Alphenix Sky vascular interventional imaging system from Canon Medical Systems UK to expand its range of clinical services and improve department efficiency. The Alphenix Sky was selected to replace an incumbent over-couch fluoroscopy system that was used mostly for barium procedures, arthrograms and hysterosalpingography (HSG). The Alphenix Sky will expand the range of procedures available to clinical staff and be ready to facilitate evolving procedural needs into the future. “We’re very pleased to welcome the new Alphenix Sky to help future-proof our services and ease pressure on other rooms. We are already experiencing better workflow management and scheduling of the room as we now book slots for insertion of Picc lines and it can be a back-up room should we lose capability or capacity in our other fluoroscopy room. This ensures a high level of service continuity for our patients,” states Anne-Marie Jenkins, X-ray and Ultrasound Service Manager at Royal Bournemouth Hospital, part of The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust. She continues, “The new technology makes us ready to expand our capacity for fluoroscopy procedures and Interventional Radiology – enabling us to expand the types of procedures we can undertake to support our clinicians and patients. The system has

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“ The system has been really intuitive to use and we have received really good apps support from the Canon Medical team.” Anne-Marie Jenkins, X-ray and Ultrasound Service Manager at Royal Bournemouth Hospital

Left to right: Gemma Turley, Senior Radiographer; Clare Robbin, Advanced Practitioner; Polly Cutmore, Radiographer; Sharon Boon, Clinical Applications Specialist XR, Canon Medical Systems UK; Ann Marie Jenkins, Imaging Superintendent; Katy Legg, Radiographer; Catherine Bond, Advanced Practitioner; and Iain Burley, Account Manager, Canon Medical Systems UK.

been really intuitive to use and we have received really good apps support from the Canon Medical team.” Daniel Parr, XR Modality Manager at Canon Medical Systems UK states, “It is great to add Royal Bournemouth Hospital to our growing roster of new Alphenix customers. We look forward to supporting them in attaining the very best operational and clinical return on their investment focusing primarily on lowering doses, improving image quality and expanding procedural techniques.” //