Visions UK Edition 6

MAGAZINE FOR UK HEALTH PROFESSIONALS UK Edition // No. 6 // July 2022

Birmingham 2022 Commonwealth Games 12 // PARTNERSHIP

Official Imaging Supporters of The Games

Gold Medalist, Canon Medical UK Ambassador

Diagnostic Imaging in the Rise of Women’s Football

12 // PARTNERSHIP

48 // INTERVIEW

18 // MAGNETIC RESONANCE

MAGAZINE FOR UK HEALTH PROFESSIONALS UK Edition // No. 6 // July 2022

Birmingham 2022 Commonwealth Games 12 // PARTNERSHIP

Official Imaging Supporters of The Games

Gold Medalist, Canon Medical UK Ambassador

Diagnostic Imaging in the Rise of Women’s Football

12 // PARTNERSHIP

48 // INTERVIEW

18 // MAGNETIC RESONANCE

As part of the Canon Group, Canon Medical Systems UK will provide exceptional image-quality technologies to support the Birmingham 2022 Commonwealth Games as ‘Official Imaging Supporter’. From cameras to print hardware and diagnostic imaging, every system provided will enhance the clarity of imaging at the multi-sport event.

This VISIONS magazine is a publication of Canon Medical Systems Ltd 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/latest-news. 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.

Aquilion ONE PRISM, Aquilion ONE GENESIS, Aquilion Lightning, Aquilion, Aquilion ONE, Alphenix, Xario, Vantage Orian, Vantage Elan, Vantage Galan, SEMAR, Aplio, InnerVision and Made for Life are trademarks of Canon Medical Corporation.

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

Editor-in-chief pressenquiries.uk@eu.medical.cano

Editor Claire Walker claire.walker@eu.medical.canon

Design and Layout Deep deep.co.uk

© 2022 by Canon. All rights reserved.

Follow us:

2 // VISIONS 06

// EDITORIAL

Welcome to VISIONS UK, Summer 2022

It is just weeks until the Birmingham 2022 Commonwealth Games are off the starting blocks, bringing together 6500 athletes and officials from 72 nations and territories to compete in 19 different sports including eight para sports.

It is so exciting, not only for those taking part, but also for future generations that such an event will undoubtedly inspire.

The fact that it’s being held in the heart of England is another major bonus for us here in the UK and I hope that some of you have tickets to go along and watch the different events.

Canon Medical UK will be there in our capacity as ‘Presenting Sponsor of the Birmingham 2022 Polyclinics’ providing MRI, ultrasound and X-Ray to assist the athletes with any injury concerns or proactive health surveillance. So, it seems very apt that this new issue of VISIONS UK is dedicated to sports.

collaboration with Sheffield City Council, Sheffield Olympic Legacy Park, Sheffield Sharks, PCA Ltd and Living Care. The new Canon Medical Park Community Arena is anticipated to open in 2023 and will be a net-zero carbon built community arena with multi-sports facilities and integrated diagnostic imaging centre to improve health and wellbeing.

We are also delighted to announce the renewal of our relationship with the Queen of athletics – Tessa Sanderson CBE. As an Olympic and Commonwealth Gold medallist for javelin and having held business and trade roles, Tessa is perfect as our 2022 Business Ambassador. This means she will be visiting the Commonwealth Games with us and also spearheading wider communication of how valuable sports diagnostic imaging is from her personal and professional experience.

Inside you’ll find the latest update on our relationship with Manchester United. The piece inside explains how the dedicated Canon Medical Imaging Centre is helping to better understand female-based sporting injuries, rehabilitation and research to help propel women’s football further. We also include an update on our unique relationship with Sheffield Sharks professional basketball team and how its schools outreach initiative supporting disadvantaged young people is helping put self-respect back into the community.

Sports Medicine is at the heart of our pedigree. Around the world our teams are providing and innovating imaging systems to continually expand knowledge and gather research about the impact intense physical pressure has on the body through sports. This helps sporting organisations and individual athletes achieve their potential, while also unlocking data and information that can be applied to the development of medical equipment in mainstream healthcare. This will help improve wider population health outcomes and potentially save lives.

Our investment in South Yorkshire has also gone a step further recently. We are very proud to announce a unique

We hope you enjoy the latest issue and the full summer of sport ahead!

MARK HITCHMAN Managing Director Canon Medical Systems UK

VISIONS 06 // 3

// CONTENTS

08

A New Chapter of CT Imaging COMPUTED TOMOGRAPHY

03 06

Editorial News CSR

12

Canon Medical Systems UK Gets Set for Birmingham 2022 Commonwealth Games PARTNERSHIP

08

A New Chapter of CT Imaging COMPUTED TOMOGRAPHY

12

Canon Medical Systems UK Gets Set for the Birmingham 2022 Commonwealth Games PARTNERSHIP

16

Artificial Intelligence Imaging Collaboration Could Speed Up Triage of Covid-Suspected Cases AI

18

Diagnostic Imaging in the Rise of Women's Football MAGNETIC RESONANCE

24

Research Partnership Buoyed by Canon Medical UK Investment ULTRASOUND

32

Our Premises Across the UK SUPPORT

34

Canon Medical Park Community Arena Announced at Sheffield Olympic Legacy Park PARTNERSHIP

18

Diagnostic Imaging in the Rise of Women's Football MAGNETIC RESONANCE

4 // VISIONS 06

34

Canon Medical Park Community Arena Announced at Sheffield Olympic Legacy Park PARTNERSHIP

48

38

Taking the Baton as Canon Medical UK's Business Ambassador INTERVIEW

Inspiring Positive Societal Gain Through Basketball CSR

42

80% of Canon Medical UK Customers Feel Cared About and Supported CUSTOMER SURVEY

44

Countess of Chester Hospital's Purpose-Built Pacing Theatre X-RAY

48

Taking the Baton as Canon Medical UK’s Business Ambassador INTERIEW

50

Diagnostic Imaging Insights Accelerated

by Artificial Intelligence AI

56

French Radiologists Join Forces to Reduce MRI Scan Time with the Vantage Galan MAGNETIC RESONANCE

50

Diagnostic Imaging Insights Accelerated

by Artificial Intelligence

63

Upcoming Education Calendar 2022 MEDICAL IMAGING ACADEMY

AI

VISIONS 06 // 5

// NEWS

Canon Medical UK’s Puppy Partner – Support Dog ‘Conan’ Canon Medical UK are proud sponsors of Support Dogs, a national charity that transforms the lives of people with a range of serious medical conditions through its extraordinary canine heroes. Canon sponsor Conan, the Support Dog puppy in training, who has just celebrated his first birthday.

How is Conan’s Support Dogs training going?

Reaching his first year means that Conan undertook a 12 month assessment to look at how he is progressing in key areas of training such as; sociability, confidence in restricted areas and on public transport, how to manage distractions, his motivation for training, handling skills and how he is doing with basic commands.

His report stated – Conan did incredibly well in his assessment. He has made great improvement from his 6-month assessment, especially with confidence levels. A lovely dog with a calm nature, quite a sensitive soul and very smart. He enjoys task work and picks up cues quickly.

As a result, we are pleased that Support Dogs currently feel Conan would fit their Disability or Epilepsy programmes.

Conan has a few more months left with living with his puppy socialiser before hopefully joining full time training this autumn.

Want to learn more about this partnership? Scan here.

We are proud to support other organisations, which include The Sheffield Sharks, Sheffield Hatters Women’s Basketball Club and CO2 Balance.

6 // VISIONS 06

Register Now to the Medical Imaging Academy

A complimentary e-Learning platform with CPD certification Registration and access to the Medical Imaging Academy is complimentary and open to everyone in the medical imaging industry. Regular visitors can enjoy constantly evolving On-Demand education videos, How-To Guides, webinars and be the first to book online to specially designed, socially distanced training courses and hands-on practical workshops.

Scan here Start your journey today. Log on to www.medicalimagingacademy.co.uk and register for 24/7 access.

PRODUCT // COMPUTED TOMOGRAPHY // Aquilion Prime

Causeway Hospital, part of Northern Health and Social Care Trust in Northern Ireland, has successfully gone live with its new Aquilion Prime SP CT scanner from Canon Medical Systems UK. Pictured: Lesley Thompson, CT Radiographer.

A New Chapter of CT Imaging Local and national service team from Canon Medical Systems UK praised in guiding new customers to achieve faster workflow and improved imaging processes

C

auseway Hospital in Coleraine, County Londonderry, part of Northern Health and Social Care Trust in Northern Ireland, has successfully gone live with its new Aquilion Prime SP CT scanner from Canon Medical UK. The system, situated near to the emergency department, will provide trauma and out-of-hours related scanning and will also support general and cardiac outpatient appointments.

The transition to the new CT has been smooth with radiography staff adjusting well to the new features of the AI-assisted scanner.

Powered by Advanced intelligent Clear-IQ Engine (AiCE), which was the world’s first CT scanner to use such Deep-Learning reconstruction technology, it has helped to speed up

processes to create time savings and improve the quality of diagnostic images for clinical interpretation.

“Every step of the new CT journey with Canon Medical UK has been hassle free,” states Rachel Brown, Trust Lead CT Radiographer at Northern Health and Social Care Trust “From the start of the relationship in selecting and ordering the new CT system, to the system installation and user training, through to the after-sales service support we are now receiving, it has been a smooth ride. The locally based engineers bent over backwards to make sure everything went as planned at set-up stage and the access to the national support team is easy and always prompt.”

VISIONS 06 // 9

Left to Right: Nick Slim (Canon Product Specialist), Jason McNabb (Team Lead NI), Rachel Brown (CT Lead Northern Trust), Lesley Thompson (Radiographer), Anton Cisnero (Radiographer), Alan Totten (Canon FSE), at Causeway Hospital, part of Northern Health and Social Care Trust in Northern Ireland.

“We feel well supported and ready to provide the local community with a higher standard of imaging care into the future.”

Rachel Brown, Trust Lead CT Radiographer at Northern Health and Social Care Trust

She continues, “Our imaging team has adjusted quickly to the new integrated features of the CT scanner and is impressed with the improved image quality. This has helped to speed up our processes giving us time savings while also providing accurate diagnostic images with huge dose savings for patients. We feel well supported and

10 // VISIONS 06

ready to provide the local community with a higher standard of imaging care into the future.”

“It is great to hear another positive experience from our customers,” states Billy Erwin, Account Manager at Canon Medical UK. “A relationship with Canon Medical UK goes far beyond just the

installation and training on a new piece of kit. We are dedicated to building long-term imaging partnerships that ensure local, national and international teams are at the ready to respond to specific requests or provide ongoing proactive training and development through our Medical Imaging Academy.” //

CASE STUDY // BIRMINGHAM 2022 COMMONWEALTH GAMES // Partnership

L OFFICIA G IMAGIN TER R SUPPO

Canon Medical UK Gets Set for the Birmingham 2022 Commonwealth Games

T

he Race is On!

With Canon Medical UK’s passion for sports medicine, and following many months of preparation, we are on track to install our state-of-the-art diagnostic imaging equipment to three specialist Polyclinics for the Birmingham 2022 Commonwealth Games.

The specialist Birmingham 2022 Polyclinics – Presented By Canon Medical UK can be found within the three Athletes Villages, located at The University of Birmingham, The University of Warwick, and The NEC Hilton Birmingham Metropole Hotel.

Canon Medical UK will provide the latest, groundbreaking medical imaging modalities including diagnostic ultrasound, digital radiography X-Ray, alongside MRI scanning all with full health IT connectivity – creating unparalleled diagnostic services to support over 4,500 athletes from 72 nations and territories with early detection, prevention and faster rehabilitation of sports injuries.

12 // VISIONS 06

Canon Medical UK are pleased to announce that we will be partnering with Paralympic athlete Zak Skinner and Olympic gold medalist Tessa Sanderson, who will host the official Ribbon Cutting Ceremony for the opening of the Polyclinics on 21st July 2022.

The Power of Polyclinics

As a leading supplier of high-quality medical imaging equipment, we are thrilled to be showcasing the power, durability and flexibility of our relocatable MR units at Birmingham 2022. In recent years, we have witnessed a growing need to expand and reform the provision of diagnostic services in the UK, and this demand has intensified since the onset of the Covid-19 pandemic.

To align with our ongoing commitment to the NHS Community Diagnostic Centre programme deployment, Canon Medical UK will be providing the Games with relocatable, modular buildings. This is a great example of how we can create pop up imaging centres with our equipment outside of a hospital setting – which

can be redeveloped, redeployed and reused to meet the specific needs of each community or environment.

By increasing scanning capacity to the communities through the provision of relocatable and modular buildings, Canon Medical UK will facilitate medical transformation across the NHS in 2022 and beyond.

The diagnostic modular MR units provided to the Polyclinics will be available for sale or rent following the Games, to increase the circular economy of our equipment and support our sustainability goals.

Changing the Landscape of Diagnostic Imaging

Canon Medical UK’s Polyclinic equipment will provide a comprehensive package of specialist, industry-leading healthcare solutions – to change the global landscape of athlete diagnostic imaging.

MRI At two of the Polyclinics, we will be installing our latest Vantage Orian Premium 1.5T MR scanner

VISIONS 06 // 13

with Advanced Intelligent Clear-IQ Engine (AiCE) – the world’s first MRI Deep Learning Reconstruction technology utilising artificial intelligence to producing stunning, exceptionally detailed MR images.

Our groundbreaking AiCE technology is trained to restore low SNR MR data to match the properties of high SNR images, enabling uncompromised clinical confidence at such a career crucial time for the Birmingham 2022 athletes.

Alongside AiCE, our MR systems include non-contrast imaging applications resulting in a safer, more reliable examination for athletes and their supporting teams. Putting athletes’ comfort at the forefront of the Polyclinics, our Pianissimo technology reduces noise in and around the MRI environment to ensure a comfortable experience and accurate imagery.

Whilst the Organising Committee for the Birmingham 2022 Commonwealth Games are providing specialist volunteer radiographers to run the MR services, Canon Medical UK's clinical application specialists for MR, Ultrasound and HIT will be on hand to assist the users to get the best possible images from our technology and utilise our solutions to provide fast, accurate diagnosis.

Ultrasound To unlock sleek, crystal-clear imagery and outstanding clinical precision, Canon Medical UK are also supplying three Aplio i800 Prism Edition Ultrasound Systems to the Games. The Ultrasound scanners’ revolutionary iBeam architecture with unparalleled processing power provides exceptional imaging clarity and definition while significantly enhancing penetration. The increased power and sensitivity of our scanners will facilitate the evaluation of the athletes’ musculoskeletal structures, including early detection of potential injuries to subcutaneous tissue, muscle, tendons, ligaments and nerves.

14 // VISIONS 06

Vitrea Connection Supporting our portfolio of medical equipment for the Games, Canon Medical UK are also providing our RIS and PACS solution, Vitrea Connection, Speech Recognition, External Reporting Work and Vitrea Vision Diagnostic Viewer.

This Vitrea Connection platform facilitates automatic messaging tools to work in tandem across the digital patient ecosystem where data is stored and archived – to augment the data collection process. Our Vitrea Vision Diagnostic Viewer, EasyViz, also streamlines patient data with a customisable user interface to keep records organised. Both solutions offer granular detail and flexibility to provide users with seamless, coordinated data access and a better reading experience.

The Polyclinics will be supported by speech recognition software, enabling radiologists to digitally dictate athletes’ scan results, diagnosis and rehabilitation advice – increasing speed and efficiency.

Leaving a Lasting Legacy

Championing our “Made for Life” philosophy, Canon Medical UK are committed to giving back to our local community, to leave a lasting legacy following the Games and inspire generations to come.

Canon Medical UK are working in association with the professional basketball team, Sheffield Sharks, to deliver an exciting programme, ‘RESPECT’.

Extending the existing RESPECT programme out into Birmingham and surrounding areas, we will address inactivity in over 1,500 young people by hosting Healthy Schools Visits to educate students about the importance of healthy lifestyles, as well as School Basketball Coaching Workshops to encourage passion for

Harnessing over 100 years of medical imaging expertise, we are thrilled to be supporting Birmingham 2022

Manchester United Women's Team in training

sport. Rounding off the project, we will also host “The Canon Medical UK Basketball Tournament”, inspiring students to unite and compete in a unique local event.

Our ongoing RESPECT programme aims to improve chances for local young people to break away from a cycle of disadvantage, encourage participation in physical activity through an understanding of healthy lifestyles and bolster awareness of the community to promote pride amongst the local community.

As well as championing the youth, diversity and humanity of the Birmingham region and the Commonwealth with our RESPECT Programme, Canon Medical UK are proud to be known as the Carbon Zero Heroes of the medical technology sector.

Not only have we offset all the carbon dioxide (CO2) used from our Ultrasound, X-Ray, CT and MRI systems installed into UK hospitals over the past 5 years, but throughout the Birmingham 2022 Commonwealth Games we will offset all the CO2 used to deliver, install, power and remove our diagnostic equipment.

We are also carbon offsetting all Canon Medical UK's employee travel and hotel stays throughout the Games, contributing towards a better, greener future.

Canon Medical UK’s offsetting pledge will support Birmingham 2022’s wider commitment in becoming the most sustainable Games in modern history – achieving a carbon neutral legacy.

Having gained official partner status from the United Nations’ Division for Sustainable Development Goals, our commitment to educating local

communities and bolstering green credentials underpins the 17 goals, helping achieve a better and more sustainable future for all.

Harnessing over 100 years of medical imaging expertise, we are thrilled to be supporting the Birmingham 2022 athletes and their staff with the materials they need to maintain wellbeing and bolster career longevity.

We hope to educate people from across the Commonwealth and the wider public of the importance of clinical sports surveillance – fuelling innovation for future generations in support of the NHS and health services across the globe.

Canon Medical UK is proud to be the Official Imaging Supporter of the Birmingham 2022 Commonwealth Games, and wishes all competitors the best of luck! //

VISIONS 06 // 15

RESEARCH // X-RAY // Artificial Intelligence, COVID-19

Artificial Intelligence Imaging Collaboration Could Speed Up Triage of Covid-Suspected Cases Three-minute Chest X-ray test using AI producing encouraging results

A

n artificial Intelligence (AI) programme created

by Bering Limited and a study conducted by iCAIRD, Scotland’s Industrial Centre for AI Research in Digital Diagnostics, has yielded promising results. To speed up Covid-19 diagnosis in patients who presented respiratory symptoms in hospital Emergency Departments (ED), chest X-rays have been used in a stimulated clinical test setting.

The iCAIRD studyi, funded by Innovate UK, was in partnership with NHS Greater Glasgow and Clyde, using Canon Medical Research Europe’s Safe Haven Artificial Intelligence Platform (SHAIP), as well as datasets from the Glasgow Safe Haven. The study used a new AI algorithm giving an accurate Covid-19 result in a test environment in under three minutes with performance on par with four certified radiologists.

“This is another welcome development demonstrating the potential for AI to support clinicians ensuring patients are getting the highest quality and most-relevant treatment,” states Prof David Lowe, Joint Clinical Lead of the West of Scotland Innovation Hub and an Emergency Medicine Consultant at Queen Elizabeth University Hospital.

“Through testing in a safe environment, we have been able to see that this algorithm can identify Covid-19 on Chest X-rays that were routinely taken during initial clinical assessment.

This could not just help with the treatment of patients but may also speed up the process of isolating infected patients.”

Dr Mark Hall, Radiology Consultant at NHS Greater Glasgow & Clyde added, “We continue to see the positive potential impact AI could have on radiology, from reducing waiting times to improving accuracy and reducing pressures on staff. Ongoing research highlights the impor-

16 // VISIONS 06

tance of using developments in AI to enhance diagnosis and treatment. The level of accuracy may allow consultants to make even more informed decisions as we have a greater pool of data to use. There can often be a misconception that AI input will mean the patients gets less time with doctors, but this is not the case. Technology like this may help to speed up processing high numbers of similar cases, while retaining accuracy, allowing for more time with patients and more complex cases.”

“Covid-19 along with many chronic diseases continually put pressure on our UK health services. Research and development into how we can speed-up diagnostic imaging is therefore incredibly important,” states Mark Hitchman, Managing Director of Canon Medical Systems UK. “There are also broader benefits of having AI research situated in the UK via our sister company Canon Medical Research Europe. It means that the AI algorithms developed using the Safe Haven Artificial Intelligence Platform are specific in terms of demographics, meaning more readiness for UK patient population deployment.”

The Canon Medical Research Europe AI Centre of Excellence includes a team of data sciences, clinical analysts and software engineers based in Edinburgh who collaborate with the universities of Glasgow and Aberdeen and NHS hospitals including Queen Elizabeth University Hospital Glasgow and Aberdeen Royal Infirmary. The team is developing a set of tools to help clinicians to create novel AI solutions using UK patient data for machine learning, together with infrastructure for data scientists to develop, train and validate algorithms without patient data ever leaving the hospital environment.

Image courtesy of iCAIRD

“Collaboration with academia, NHS and industry is vital for the safe collection of usable data, its annotation and testing, plus deployment into active AI research,” states Ken Sutherland, President of Canon Medical Research Europe. “Our work in Edinburgh underpins many exciting AI research projects in automation, decision support and ultimately precision medicine. We recently celebrated our 100th patent and are proud to play a key role in advancing NHS access to the exciting opportunities of AI.” //

Reference i Drozdov, I., Szubert, B., Reda, E. et al. Development and prospective validation of COVID-19 chest X-ray screening model for patients attending emergency departments. Sci Rep 11, 20384 (2021). "https://www.nature.com/articles/s41598-021-99986-3"

“This is another welcome development demonstrating the potential for AI to support clinicians” Prof David Lowe, Joint Clinical Lead of the West of Scotland Innovation Hub and an Emergency Medicine Consultant at Queen Elizabeth

VISIONS 06 // 17

18 // VISIONS 06

INTERVIEW // MAGNETIC RESONANCE , SPORTS MEDICINE // Manchester United Football Club, Vantage Galan 3T

Fig 1: Manchester United Football Club introduced a professional women’s team in 2018.

Diagnostic Imaging in the Rise of Women’s Football

D

r. Eddie Craghill, Women’s Team Support Doctor at Manchester United, discusses how a deeper understanding of femalebased sporting injuries, rehabilitation and research using front-line medical imaging can help propel women’s football even further.

Women’s football has been growing in popularity in the UK over the past decade. It is exciting to see and helping to inspire new generations when it comes to sporting participation, performance and equality.

Its resurgence can be charted, in part, back to the success of Team GB Women who reached the quarter finals of the London 2012 Olympics Games; to England reaching the semi-finals of UEFA Women’s Euro

in 2017; and to the creation of a FA Women’s Super League ahead of the 2018-19 season. Greater television exposure of the sport is also playing its part in reaching out to encourage and grow a dedicated supporter base.

This will escalate further this year with the UEFA Women’s Euro 2022 tournament to be held in England.

At Manchester United, the Women’s Professional Football team was introduced in 2018 (Fig 1), winning the FA Women’s Championship in the inaugural season. It now competes in the FA Women’s Super League, a top tier of women’s football. But behind the scenes there is also a commitment to expand female sports exercise knowledge and to gain greater awareness about gender nuances to support the rise of our female players.

VISIONS 06 // 19

Understanding & exploring gender differences in football injuries

One of the key known areas of difference between the male and female footballer is the nature of injury. For example, two to ten times more females than men are likely to experience an anterior cruciate ligament (ACL) injury, which has been studied in detail over recent years1, 2, 3. ACL injuries happen suddenly and without warning and can mean being out of the game for 9-12 months. These injuries are common in football due to the frequent and instant deceleration on the pitch from cutting, pivoting or landing on one leg.

By using ultrasound, CT or MRI, we can see the extent of commonly occurring (Fig 2) or unique injury on site within our dedicated Medical Imaging Centre4 at the Manchester United Carrington Training Centre without any of the confidentiality issues of transferring a patient to a local hospital. Figure 3, for example, shows a T2 weighted image of the coronal view of the right knee showing an acute pivot shift injury with an acute lateral condylar bony contusion which is highly indicative of an associated ACL tear. The female athlete was examined using a Canon Medical Vantage Galan 3T MRI.

Top Right Fig 2: Canon Medical Vantage Galan 3T MRI acquired Axial PD Fat Supressed image of the right ankle demonstrating a grade 1/2 tear of the anterior talofibular ligament (ATFL).

Bottom Right Fig 3: Coronal PD Fat Saturated image of the right knee showing an acute pivot shift injury with an acute lateral condylar bony contusion, which is highly indicative of an associated anterior cruciate ligament (ACL) tear acquired using Canon Medical Vantage Galan 3T MRI.

20 // VISIONS 06

Manchester United Women's Team in training

The known predisposition in female football players has no singular cause, but is thought to be a mixture of anatomical differences, including: the intercondylar notch, a groove at the bottom of the femur where it meets the knee, which is larger in men than in women; increased knee valgus, the Q angle formed between the quadricep muscles and the patella tendon; hip-width differences affecting knee alignment; gender biomechanics such as joint flexibility, hormones and menstrual cycles; plus potentially gender differences in early football training.

The risk of re-tearing a previously healed ACL is also higher. Therefore, to safeguard our players’ ongoing ligament health, and to avoid further time off the pitch, we would increase

the frequency of ultrasound or MRI examinations on that individual.

Furthermore, the amount of known research in this area means that we can be preventative at the outset with all our female players.

The value of dedicated research work in female sport

An ACL injury is a key example of how concentrated research and knowledge development over the years has enabled a greater understanding of how to avoid and monitor such injuries.

As a result, we now look to strengthen all female players’ muscles that support the knee such as quadriceps and hamstrings, plus undertake landing control as part of our preventative strategies. This has helped in bringing down the number of ACL injuries by

looking at recent FA Women’s Super League injury data.

Another area of injury prevention and monitoring is concussion. Again, a lot has been written about the long-term effects of head injuries through head contact in football in male players, particularly its links with memory loss and Alzheimer’s Disease. So, practical exploratory work in a sports setting into diagnosing and monitoring for Chronic Traumatic Encephalopathy (CTE) using diagnostic imaging in our female players is a real focus, alongside our men.

Indeed, recent studies suggest that female athletes are not only more suspectable to concussion than males, but also sustain more-severe

VISIONS 06 // 21

“It’s early days for professional women’s football but we’ve come a long way already.”

Dr. Eddie Craghill, Women’s Team Support Doctor at Manchester United

concussions5. There is, therefore, a need for more research in this area which we are very fortunate to be able to do within our imaging suite using AI-assisted CT and MRI technologies.

A greater understanding through focused research would play a part in establishing concussion treatment protocols for clubs and the FA which would be of immense benefit to all.

These injury examples highlight the importance of ongoing collaboration, discussion and sharing of research in sports medicine. It will help create further understanding of how the female body, which has been studied less than male football counterparts, has injury weakness areas and how it needs to be monitored. For us, it is very important to build up a bank of ‘normative’ historical data of our female players having only had a professional female team for four years. Our data on male players is superb, which has been down to the day-to-day medical team and the links we have to industry, healthcare and academia.

But now, as we progress with a women’s team, we need to gain appropriate baselines in our female players to

22 // VISIONS 06

compare and establish where we are now to help us develop in the future.

This is gaining in momentum.

Even in recent times, despite the Covid19 pandemic, we were able to keep going with our annual cardiovascular profiling and monitoring of players using ultrasound echocardiograms. It means we now have four years’ worth of valuable data and, if needed, can correlate any future cardiac concerns, themes or safeguarding with Covid-19 infection data of players.

On the ball with proactive sporting health

It’s early days for professional women’s football but we’ve come a long way already. It is exciting how much interest there is from supporter communities, inspiring young girls, through to the growth of professional female clubs in the league. As leaders in football medicine and with our good fortune of having a hospital-grade diagnostic imaging centre on site at our training complex, we owe it to the future of female football to stride ahead in exploring health equality.

Yet, there is so much more we can still do, from exploring deeper menstrual monitoring to minimise symptoms and maximise energy availability, to the use of bone-density imaging and expanding involvement in AI-based health projects. Whatever the outcome in the next match, female footballers can be assured that we’re on the ball with proactive sporting health. //

References 1 Anterior cruciate ligament rupture: differences between males and females. Sutton KM, Bullock JM. J Am Acad Orthop Surg. 2013 Jan;21(1):41-50. doi: 10.5435/JAAOS-21-01-41.

2 ACL Injury prevention in female athletes: review of the literature and practical considerations in implementing an ACL prevention program. Voskanian N. Curr Rev Musculoskelet Med. 2013;6(2):158-63 3 The female ACL: Why is it more prone to injury?.

J Orthop. 2016;13(2):A1-A4. 2016. doi:10.1016/ S0972-978X(16)00023-4 4 Provided by Canon Medical Systems UK 5 Sport-Related Concussion in Female Athletes: A Systematic Review. N.K. McGroarty, S.M. Brown, M.K. Mulcahey.

Orthopaedic Journal of Sports Medicine. 2020. https://doi.org/10.1177%2F2325967120932306

VISIONS 06 // 23

PRODUCT // ULTRASOUND // Research

Research Partnership Buoyed by Canon Medical UK Investment Knowledge of how the heart adapts to exercise and disease to be expanded by investment in research scholars and cardiac investigation techniques

T

he aim of the Sports Cardiology & Research Partnership, a team of leading UK academics and medical institutions, is to advance the detection of serious cardiac disease. A new round of investment announced by Canon Medical Systems UK to appoint additional research scholars and expand echocardiography ultrasound and cardiac MRI investigation techniques will push its quest forward.

In the last year, the research team, comprising of experts from the University of Bristol, Bristol Heart Institute, the Children’s Health & Exercise Research Centre/University of Exeter (CHERC), and the Institute of Sport, Exercise and Health (ISEH) at University College London (UCL), has shaped international discussion on cardiac adaption in paediatric athletes, and exercise recommendations in children and

Patient set-up for cardiopulmonary exercise testing in combination with an echocardiogram.

24 // VISIONS 06

adults with congenital heart disease.

This has been through the publication of scientific papers1, guidelines and participation in global conferences.

New studies are ongoing to quantitively assess the cardiac function during exercise of highly trained sports stars of the future.

With Canon Medical UK’s support, the Sports Cardiology & Research Partnership has been able to generate one of the world’s largest datasets on the cardiovascular profile of young football players from the world’s leading football clubs and academies.

Early data was presented to the 2021 International Olympic Committee World Conference on Prevention of Injury & Illness in Sport, while other research is currently under peer review with several leading journals.

“By understanding how the heart works in the highly trained athlete, we are able to apply these findings to those with congenital heart disease, with the aim of being able to detect potentially serious adverse outcomes earlier and promoting a healthy lifestyle to those with underlying heart disease,” states Dr Nathan Riding, Senior Research Associate at the Institute of Sport, Exercise and Health and Canon Medical UK

(Left to right) Dr Lynsey Forsythe, Research Fellow; Nurul Amir, PhD Student; Tim Palarm, Regional Manager – Ultrasound Sales at Canon Medical Systems UK; Curtis Wadey, PhD Student; Dr Dan Dorobantu, PhD student & Cardiologist; and Professor Craig Williams, Director of CHERC.

funded scholar. “Congenital heart disease affects approximately 1% of all live births but as surgeries are improved, and prognosis gets better, the number of children transitioning into adolescence and adulthood is increasing. By encouraging exercise adherence, our aim is to improve quality of life and life expectancy.”

Dr. Riding continues, “One hour of exercise per day is the recommended amount of activity time for a child without heart disease, yet just 23% of boys and 20% of girls aged 5 to 15 meet these targets. Children with congenital heart conditions are also failing to meet these activity guidelines, further impacted by a lack of formal exercise rehabilitation programmes which would be beneficial to them. At the opposite end of the spectrum, child athletes, especially those in sporting academies, may now be undertaking up to 16 hours per week of training, yet with unknown consequences on the heart. Our research is important for so many young people, from so many walks of life.”

Mark Hitchman, Managing Director of Canon Medical Systems UK states, “Unlocking knowledge from the

26 // VISIONS 06

body through research is essential to evolve our understanding of how to improve mainstream health and wellbeing. Our increased investment in sports cardiology will not only benefit the sporting community, but also wider healthcare. We will be able to fine-tune our diagnostic imaging applications and health IT for cardiology and reshape procedures and protocols that can help improve people’s long-term outcomes.”

“Unlocking knowledge from the body through research is essential” Mark Hitchman, Managing Director of Canon Medical Systems UK To further the early identification of pre-existing cardiac conditions, the Sports Cardiology & Research Partnership and Canon Medical are also continuing the roll out of the world’s first mobile cardiac laboratory.

This is providing cardiovascular screening for athletes and sports people. In partnership with the

Institute of Sport, Exercise and Health at UCL, where the programme is led

by Profs. Guido Pieles and Mathew Wilson, the mobile lab is able to look into heart health using the latest medical imaging and analysis tools to identify pre-existing cardiac conditions that may predispose an athlete to sudden cardiac death.

The Sports Cardiology & Research Partnership is led by Professor Guido Pieles, the team cardiologist for Manchester United, Prof Graham Stuart, a Football Association expert consultant cardiologist, and Prof Craig Williams, director of CHERC. The research centres at Bristol, Exeter and ISEH London are using state of the art echocardiographic equipment by Canon Medical Systems. //

References 1 Pieles, G.E., Gowing, L., Ryding, D., Perry, D., McNally, S.R., Stuart, A.G. and Williams, C.A., 2021. Characterisation of LV myocardial exercise function by 2-D strain deformation imaging in elite adolescent footballers. European Journal of Applied Physiology, 121(1), pp.239-250. Sharma, C., Dorobantu, D.M., Ryding, D., Perry, D., McNally, S.R., Stuart, A.G., Williams, C.A. and Pieles, G.E., 2022. Investigating the Accuracy of Quantitative Echocardiographic-Modified Task Force Criteria for Arrhythmogenic Ventricular Cardiomyopathy in Adolescent Male Elite Athletes. Pediatric Cardiology, 43(2), pp.457-464.

Introducing our Research Experts and Scholars Professor Craig Williams Craig Williams is Professor of Paediatric Physiology and Health and is the Director of the Children's Health and Exercise Research Centre (CHERC) based at the University of Exeter. CHERC is a world leading research centre for the study young people's exercise, health, fitness and activity and its international eminence in paediatric exercise science was recognised by the award of a Queen’s Anniversary Prize for Higher Education.

The Prize, the first to be awarded in the exercise and sport sciences was presented by HM The Queen. Professor Williams's department recently came top of the Research Excellence Framework timeshighereducation.com/news/ref-2021-

Professor Guido Pieles Professor Guido Pieles is a Consultant Adult and Paediatric Sports and Congenital Cardiologist and an international expert in the care of elite and amateur athletes currently leading the sports cardiology department at Aspetar Sports Medicine Hospital Doha. He served as an expert at the English Football Association sports cardiology advisory group and is member

An international expert in the care of elite and amateur athletes of the Association of European Pediatric and Congenital Cardiology (AEPC) Sports Cardiology working group, and Pediatric

sport-and-exercise-sciences-leisure-andtourism. He has over the last 25 years been a strong advocate for promoting physical activity and exercise programmes for

Professor Williams’s department recently came top of the Research Excellence Framework children and young people with chronic medical conditions and is keen to establish paediatric rehabilitation programmes within healthcare pathways.

liaison officer at the European Society of Cardiology (ESC) Sports cardiology Nucleus and hold honorary research positions at UCL and the University of Bristol. Prof Guido´s passion for research focuses on developing innovative imaging methods to monitor cardiac performance and improve cardiac care of elite athletes and increase the exercise and sports participation of children and adult with and without heart disease. He has attracted funding in this field from leading research charities and councils such as British Heart Foundation, UK NIHR and UK MRC and leads an innovative research partnership programme with Canon Medical UK to innovate imaging of the heart.

VISIONS 06 // 27

Prism Edition

Intelligent healthcare made easy With Canon Medical Systems suite of intelligent, forward-thinking technologies it’s now easier than ever to deliver safe, precise diagnoses to every patient. While Aplio’s smart, AI-driven algorithms allow you to create simple and streamlined workflows, they can also help to provide fast and accurate results for a more personalised treatment of your patients.

Standard Plane Detection

Automatic Identification

Contact us for more information: sales.uk@eu.medical.canon 01293 653700 uk.medical.canon

SCAN ME

Single-Click Measurements

Dr Nathan Riding Nathan is currently a senior research associate at the University of Bristol, in collaboration with Canon Medical UK, and investigating cardiac function in exercise of paediatric children and athletes.

His previous role was at Aspetar sports

medicine hospital where his work focused on the cardiac screening of athletes. Here he has screened over 20,000 athletes and was a member of the International recommendations for ECG interpretation in athletes.

Dr Dan Dorobantu Dan is a cardiologist with an interest in cardiac diseases affecting children, currently undergoing his PhD at the Universities of Exeter and Bristol, under the supervision of Prof. Craig Williams and Prof. Guido Pieles. His projects aims

to improve the understanding of heart function adaptation to exercise in healthy children, young athletes and people with congenital heart disease, using state of the art cardiac imaging techniques such as speckle tracking imaging.

Curtis Wadey Curtis is a PhD student funded by the University of Exeter and Canon Medical UK and is based at the Children’s Health and Exercise Research Centre at the University of Exeter.

Curtis researches the importance of and the best strategies to improve cardiorespiratory fitness in paediatric and adult congenital heart disease populations.

Dr Lynsey Forsythe Lynsey is a cardiac physiologist and an accredited echocardiographer. She is currently working as a research associate in sport and exercise cardiology at Bristol Royal Hospital for Children. Lynsey is leading a Heart Research UK (HRUK) funded trial in physical activity and exercise intervention for young people with congenital heart disease alongside cardiologist Professor Graham Stuart and Professor Craig Williams, director of the

children’s health and exercise research centre at Exeter University.

In 2018 Lynsey completed a PhD in Sports Cardiology at Liverpool John Moores University funded by Cardiac Risk in the Young (CRY). Through CRY and other healthcare providers Lynsey continues to deliver cardiac screening services to young people and elite athletes from a number of sports and organisations.

VISIONS 06 // 29

Virtual Non Contrast

Monochromatic

Iodine map with fusion

Deep Intelligence Innovate. Illuminate. Initiate.

Introducing the all-new Aquilion ONE / PRISM Edition.

Combining the power of Deep Learning Spectral Reconstruction with our Advanced intelligent Clear-IQ Engine (AiCE), we have created a CT system that is designed for deep intelligence.

By seamlessly integrating AI technologies, you can now access all the tools you need to automate your workflows, while capturing vital diagnostic information that will help define your patient’s medical care journey.

With Aquilion ONE / PRISM Edition, the possibilities are endless – for you, your patients and your business. It’s time to innovate with technology, illuminate clinical insights and initiate new business opportunities for a brighter, smarter future. https://eu.medical.canon/prism

30 // VISIONS 06

Nurul Amir Nurul is a third-year PhD student at the University of Bristol. Her work currently focuses on physical activity levels and cardiac rehabilitation for children with congenital heart disease. She has also been a sports injury and rehabilitation lecturer at University Teknologi MARA, Malaysia for the past 5 years. Previously, Nurul

worked as a Sports Therapist at the National Sports Institute of Malaysia where she designed, prescribed, and conducted a musculoskeletal rehabilitation training program for injured athletes and paralympic/disabled athletes of various sports.

Nuno Duarte Nuno is a senior cardiac physiologist with special expertise and interest in the cardiac assessment of athletes and patients with congenital heart disease. Nuno trained in Portugal, where he started his career as a Cardiac and Pulmonary Physiologist. In 2014, he moved to Jamaica where he helped to develop the first Heart Institute of the

Caribbean. Since his arrival to England in 2016 he has been actively working together with Prof Pieles at elite sports clubs, such as Manchester United FC, and with his research team in exercise related projects. He is currently the lead for echocardiography and stress echocardiography at the Bristol Royal Hospital for Children.

Dr Jack Gibb Jack is a paediatric cardiology trainee working at Bristol Royal Hospital for Children. He is interested in how exercise can modulate makers

of cardiovascular disease in patients with inherited cardiac conditions, namely Marfan syndrome and bicuspid valve aortopathy.

Professor Graham Stuart Professor Graham Stuart is consultant cardiologist and electrophysiologist (congenital and inherited heart disease) at the Bristol Royal Hospital for Children and the Bristol Heart Institute. He is honorary associate professor in sports and exercise cardiology at the University of Bristol. Graham has a clinical and research interest in the effect of exercise on the heart. He is on the Medical Advisory group of the Noonan Association and the Downs Heart group. He is Principle Investigator/

co-investigator of a number of research studies looking at exercise prescription, exercise physiology and various aspects of inherited cardiac conditions. Graham has been a cardiology advisor to the Rugby Football Union, Football Association and English Cricket Board. He is an enthusiastic (but rather slow) endurance athlete. In 2022 he rowed across the Atlantic in 41 days. He is a proud grandfather and looks forward to at least one of his grandchildren lifting the Rugby World Cup for Scotland in a few years time.

VISIONS 06 // 31

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 653700

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

Midlands Training & Distribution Centre Training facility and storage 1, Redwood Court, Campbell Way, Dinnington, Sheffield, S25 3NQ

5

Stevenage Training & Distribution Centre 4 & 5 Eastman Way, Pin Green, Stevenage, SG1 4SZ

32 // VISIONS 06

2

3

4

5

1

VISIONS 06 // 33

INTERVIEW // PARK COMMUNITY ARENA // Partnership

The UK’s first sustainable, carbon net-zero built community arena with multi-purpose sports facilities & integrated diagnostic centre announced at Sheffield Olympic Legacy Park.

The Park Community Arena will be developed

by Canon Medical Systems UK.

Park Community Arena Announced at Sheffield Olympic Legacy Park UK’s first sustainable, carbon net-zero built community arena with multi-purpose sports facilities & integrated Medical Diagnostic Centre to improve health and wellbeing in South Yorkshire

C

anon Medical Systems UK has announced a unique health and wellbeing collaboration with Sheffield City Council, Sheffield Olympic Legacy Park, BBraun Sheffield Sharks basketball franchise, PCA Ltd and The LivingCare Group.

The new ‘Park Community Arena’ is anticipated to open in 2023 as the UK’s first affordable carbon net-zero built sports, healthcare and community arena featuring an integrated Medical Diagnostic Centre.

Based at the heart of the Sheffield Olympic Legacy Park, the new, sustainably built arena will offer a flexible sporting facility, featuring three full-size basketball courts, and designed to hold 2500 spectators. It

will be the new home for the Sheffield Sharks and the Sheffield Hatters (women) professional basketball teams and the arena will be available to wider sporting, education, and community organisations. Working with local educational partners, it will establish a leading UK basketball academy and programme, serving the spectrum of elite to recreational basketball players. The flexible arena also offers huge potential for wider sporting, business, and community events and is set to play its role in boosting the region’s visitor economy collaborating with partners across Sheffield Olympic Legacy Park to support research, innovation, education, and community participation.

VISIONS 06 // 35

“People of all ages will benefit from having a range of cutting-edge facilities right on their doorstep as Sheffield leads the way in sustainable innovation and medical research.”

Councillor Mazher Iqbal, Executive Member for City Futures: Development, Culture and Regeneration at Sheffield City Council

To the north end of the arena, Canon Medical will open a Medical Diagnostic Centre to bring healthcare closer to people and boost access to health screening and disease prevention.

This is in synergy with national health strategies1 to create ‘one-stop-shops’ for healthcare checks, scans and tests outside the traditional hospital environment to overcome Covid-19 pandemic backlogs, improve earlier diagnosis and contribute to NHS carbon net-zero ambitions by reducing patient journeys. It will be managed

by LivingCare and be available to the wider community in conjunction with South Yorkshire and Bassetlaw Integrated Care System and local NHS providers. The Medical Diagnostic Centre will feature advanced Canon Medical imaging systems including AI-assisted CT and MRI, diagnostic ultrasound, digital X-ray and include consulting rooms, a minor surgery operating theatre and an Endoscopy suite. Bringing all these modalities together will be Canon Medical’s healthcare information technology augmented with machine learning and AI to improve productivity and accuracy of diagnosis.

The Medical Diagnostic Centre will provide the region’s first specialist Sports Diagnostic Imaging Centre that will translate elite-level health, injury, and rehabilitation learnings to routine clinical practice. This will enable early detection, prevention and faster

36 // VISIONS 06

rehabilitation for sports injury and illness, as well as provide pre-season medicals and sports injury services to professional, elite, semi-professional and committed athletes.

Mark Hitchman, Managing Director of Canon Medical UK states, “We are so excited to announce the Park Community Arena, a pioneering carbon net-zero built sports, healthcare and community arena for the people of South Yorkshire. It will increase affordable access to sports and community events and provide a home for the BBraun Sheffield Sharks and Hatters basketball teams to play, train and expand their valuable RESPECT and RESPECT TOO community outreach programmes for local young people.”

“The Medical Diagnostic Centre at the Park Community Arena will play a part in expanding healthcare capacity for local people where they can attend minor surgery appointments or have diagnostic scans and other tests as part of a health prevention and early detection programme. This close-to-the-community approach in a non-clinical environment will be better for people that may be anxious of hospitals or benefit from the excellent transportation links to the Sheffield Olympic Legacy Park,” Mark Hitchman continues. “It will be an advanced healthcare facility featuring the latest Canon Medical innovations

that are designed to deliver detailed diagnostic imaging to assist clinicians with confident and earlier diagnoses to improve the long-term health outcome for patients. It will also be a hub for our research and development teams working in cooperation with neighbouring academia to continue progress on developing healthcare innovations for the future.”

Luke Minshall, Director of Strategy & Partnerships at LivingCare, states, “This is a great opportunity for the community of Sheffield to have its healthcare provision expanded and we are delighted to be involved.

The Park Community Arena will provide a central and accessible location for general imaging referrals from professional sports clubs to health insurance companies, as well as offering the NHS and its patients additional capacity for scans and imaging procedures closer to home.”

“A pioneering carbon net-zero built sports, healthcare and community arena” Mark Hitchman, Managing Director Canon Medical UK

Yuri Matischen, Chairman of PCA Ltd and the Sharks, states, “Sheffield Olympic Legacy Park is already synonymous with encouraging physical wellbeing, is home to 2000 pupils and students and has great transport links making it the ideal location for the community arena. It will provide the new permanent home for the Sharks and Hatters allowing basketball to transform and flourish, and be an accessible and inspirational home for other sports clubs from the area’s diverse communities. We are truly excited to be working with Canon Medical, LivingCare and all partners on Sheffield Olympic Legacy Park to extend the City’s sporting reputation and inspire young people to be physically active.”

Councillor Mazher Iqbal, Co-Chair of the Transport, Regeneration and Climate Policy Committee at Sheffield City Council adds, “We are proud

to be working with our partners at Sheffield Olympic Legacy Park to create these exciting new facilities, which will provide world-class healthcare for local people and strengthen our communities. As well as providing a brand-new home for the Sheffield Sharks and creating another flexible events space for the city, these additions to Sheffield Olympic Legacy Park will boost the local economy – increasing footfall and bringing new opportunities to the surrounding areas. People of all ages will benefit from having a range of cutting-edge facilities right on their doorstep, as Sheffield leads the way in sustainable innovation and medical research.”

Richard Caborn, Chair of the Sheffield Olympic Legacy Park, states, “Canon Medical has been a valued partner in the development of Sheffield Olympic Legacy Park since day one.

Its community ethos and engagement

initiatives resonate with our Olympic legacy aims. The new Park Community Arena will further extend the health and wellbeing collaboration possibilities with our two Sheffield Teaching Hospitals, our university partners and elite sports facilities to create a flourishing international centre for diagnostic imaging located in the North of England.”//

References 1 Diagnostics: Recovery and Renewal – Report of the Independent Review of Diagnostic Services for NHS England, November 2020, Sir Mike Richards.

Left to Right: Zahira Naz, Co-Chair Finance Sub-Committee, Sheffield City Council, Mazher Iqbal, Co-Chair of the Transport, Regeneration and Climate Policy Committee at Sheffield City Council, Chris Low, Chief Executive, Olympic Legacy Park, Mark Hitchman, Managing Director, Canon Medical Systems UK, Armit Sidhu, CFO, Living Care, Richard Caborn, Chairman, Sheffield Olympic Legacy Park, Yuri Matischen, Director, PCA Limited & Chairman of the Sharks, Steve Feldman, Director, Living Care, Ian Watson, Director of Commercial Solutions, Canon Medical Systems UK, Helen White, Managing Director, Living Care, Sarah Williams, Director of Patient Safety and Clinical Effectiveness, Living Care, Sarah Backovic, Managing Director, PCA Limited, Luke Minshall, Director of Strategy and Partnerships, Living Care, Armit Sidhu, Finance Director, Living Care, Maiko Davison, Operations and Marketing Director, Canon Medical Systems UK

VISIONS 06 // 37

38 // VISIONS 06

INTERVIEW // CORPORATE SOCIAL RESPONSIBILITY // Basketball, Sheffield Sharks, Sports Medicine

Sheffield Sharks basketball team player, training with young adults who are part of the Canon Medical supported RESPECT TOO programme.

Inspiring Positive Societal Gain Through Basketball Putting Self-RESPECT back into forgotten communities

B

asketball is the second most popular sport played in the UK by young teenagers, after football, and is particularly popular among Black, Asian and Minority Ethnic (BAME) communities. Its popularity has risen since the London 2012 Olympic Games, in part due to a Sports England funding uplift, but also because it represents valuable engagement to young people from diverse and disadvantaged backgrounds.

The upcoming Birmingham 2022 Commonwealth Games will also provide a further platform for raising accessibility of the game when it takes centre stage in a high-octane 3x3 basketball format at an outdoor venue at Smithfield in the centre of Birmingham.

The importance of basketball beyond sport

Sheffield, once known as the heart of the industrial north, is now an

ethnically diverse community with around 19% from black or minority ethnic groups such as Pakistani, Caribbean, Indian, Bangladeshi, Somali, Yemeni and Chinese communities.

It is a city that lags behind other areas in the UK when averages are compared, including the difference in life expectancy which between the best and worse off is 20 years. It is also an area identified as one of the first to receive UK Government 2022 ‘levelling-up’ regeneration funding to help start narrowing the gap in health, education, housing and job outcomes.

But even before a national strategy was announced to help disadvantaged or ‘forgotten’ communities, a ‘home-grown’ focus on citizenship and wellbeing through the sport of basketball was forging strong gains and societal links.

VISIONS 06 // 39

Sheffield Sharks ‘dropping dimes’ with its community outreach initiative

Sheffield Sharks, the city’s professional basketball team that ranks third in the British Basketball League 2020/21, has not only been scoring its way up the league in play on the courts, but also rolling out a successful community outreach programme for local school children.

For the last 8 years close to 10,000 10-11-year-old primary school children at 16 inner-city Sheffield schools have been positively impacted by the RESPECT programme. This provides a fusion of fun basketball sessions with the players and citizenship workshops covering online safety and personal health topics.

More recently, RESPECT TOO, a Canon Medical Systems UK sponsored initiative for young adults aged 14-15 years at risk of county-lines drugs trafficking, violence and gangs, has been created. This provides vulnerable

“What sets us apart is our desire to use sport to create better individuals and a better local community.”

Mike Tuck Captain of the Sheffield Sharks team young people with a weekly workshop for six weeks about choosing the right path in life. The sessions are run with the help of Sheffield Sharks’ basketball players, many of whom have come from tough city backgrounds in the UK and USA, and can share their real-life experiences of overcoming obstacles and creating a positive future.

The RESPECT TOO course includes socially oriented topics such as anger management, self-identity, behaviour & conduct, communication, healthy lifestyles and creating future goals.

“We are heavily intertwined with our local community through basketball, and it is our duty to make a positive impact with the young people in our

city. We want to step in and help where parents or family networks may be lacking to give guidance to young people growing up in tough economic, academic and social situations,” states Marko Backovic, Head of Community at BBraun Sheffield Sharks Basketball Club.

“The RESPECT initiatives give Sheffield schools greater support in delivering PSHE topics than they can achieve themselves with staff and budget constraints in the education system.

Plus, our unique delivery of courses by our players ensures kids are inspired and their attention engaged. We wouldn’t be able to do any of this without the funding from Canon Medical UK and I firmly believe that this is keeping people out of gangs and ultimately prison.”

Basketball continues to grow in popularity within the UK

Two RESPECT TOO students from a Sheffield-based school shared their thoughts on why the programme has been useful to them.

“It was interesting to listen to what the players have been through when they were my age as it helped me to think about my behaviour too,” states Ashantai, a Year 9 student.

“There was an incident at school that could have got me banned from coming to the final RESPECT TOO session, but what I had learnt made me stop and think about my actions more and control my behaviour,” adds Lindo, a Year 9 male student.

40 // VISIONS 06

Sheffield Sharks work closely with the children from the RESPECT programme, both on the court and in the classroom.

“As a result of the RESPECT initiatives we are told by teachers that some young people who were not expected to get any GCSEs, have made considerable positive changes to their attitudes and are now on track to go on to college,” Marko adds.

Teaching self-respect for a healthier future

Katy, a teacher at one of the participating RESPECT TOO schools in Sheffield adds, “Our students have benefitted a lot from the initiative coming off the school site, for one, and meeting professional sports people. They’ve really enjoyed playing on the courts with the players and the classroom activities teach them to understand the way they conduct themselves. Schemes, such as these, give them a broader view of the world, beyond the school setting,

to see different environments and give a wider range of influences.

A big part of the programme is about behaviour and conduct at school – this helps the students to self-reflect. It is a great way for children to consider how they behave, and not just being repeatedly told within behavioural programmes of a school setting, but by external sports people that they look up to and respect.”

Mike Tuck, Captain of the Sheffield Sharks team and former Canadian and England international player concludes, “There probably isn’t any other team in the UK basketball league running something as unique as the RESPECT programmes. They continue to grow and will be a catalyst to help further children beyond Sheffield as we look to take content online. We’re not a big, fancy sports club making

millions, but we keep true to ourselves by interacting directly with our fans and public to set good examples.

What sets us apart is our desire to use sport to create better individuals and a better local community.” //

References 1 Basketball: Does the sport get the respect and support it deserves? Sky Sports, Sept 2020, https://www.skysports.com/more-sports/ news/36244/12069769/basketball-does-the-sportget-the-respect-and-support-it-deserves 2 Sheffield City Council, Population & Census, https:// www.sheffield.gov.uk/home/your-city-council/ population-in-sheffield 3 NHS Sheffield Clinical Commission Group, Annual Report 20/21, p.43, https://www.sheffieldccg.nhs. uk/Downloads/About%20US/Documents%20 Policies%20and%20Publications/2020%20 21%20Annual%20Report%20including%20 Annual%20Accounts%20without%20front%20 page.pdf 5 Canon Medical – https://global. medical.canon/products/magnetic-resonance/ Vantage_Elan-Compact

VISIONS 06 // 41

CUSTOMER SURVEY // ALL MODALITIES // Results 2021

80% of Canon Medical UK Customers Feel Cared About and Supported Imaging equipment partnerships built by listening and responding to needs

T

ime is short and pressures are high – yet by having quality diagnostic imaging equipment in place, demands of busy working days in the health service can be eased. Over 80% of respondents to a new Canon Medical Systems UK customer satisfaction survey felt that they were understood and genuinely cared about, with the products, service and support they have chosen enabling them to do their jobs as well as possible. This is four out of five sonographers, radiographers, imaging service managers and radiologists feeling that they have an imaging partner that understands the current challenges of healthcare, the NHS and its patients.

Product performance was cited as the key reason NHS and independent healthcare users and decision makers selected Canon Medical UK as an imaging partner, with quality of equipment and support being the most valuable elements of the relationship.

Customer service and clinical training also scores highly in the independently run bi-annual customer survey, with

42 // VISIONS 06

‘responsiveness’ and ‘easy to do business with’ frequently mentioned.

There has been a shift in tone since the last survey of this kind in 2018, reflecting the impact of the Coronavirus pandemic stretching frontline diagnostic imaging personnel. An onus on working to alleviate common pain points experienced by imaging departments, as well as preparing for the future via healthcare innovation is now key. This could include expansion of remote support services to preempt equipment breakdowns early; innovation in applications enabling more patients to be seen during the working day; the development of AI-assisted technology for greater image quality at low dose to enhance clinical confidence first time without retakes; and automation of routine workflow steps, freeing up time to focus on more complex procedures or cases.

"Focusing on what is important to our customers, now and into the future, is at the heart of Canon Medical UK’s

company philosophy. We are listening and responding with quality imaging innovations that help speed up processes or create time efficiencies, at the same time as ensuring equipment is reliable and uptime is kept high. Indeed, our customers still rate our service and support highly, with 91% of customers getting the technical support they need,” states Mark Hitchman, Managing Director at Canon Medical Systems UK. "Our employees go the extra mile – they are trained to offer the best knowledge and expertise in their respective fields. Training and education remain important to ensure that our customers can use their imaging equipment to full potential and benefit daily from the depth of functionality available on new and evolving product solutions. We are also developing our online education offering to ensure that our customers have access to a wide variety of resources that will assist them in their ongoing professional development,” adds Mark Hitchman. //

PRODUCT // INTERVNENTIONAL X-RAY // Alphenix Sky

Countess of Chester Hospital's PurposeBuilt Pacing Theatre Enhanced image quality, lower dose and quicker procedures to meet the increasing needs of ageing patient population in the area

C

ardiac rhythm management and bradycardia pacemaker implantation services have been enhanced for patients at the Countess of Chester Hospitals NHS Foundation Trust following the installation of a new Alphenix Sky ceiling-mounted C-arm.

The bespoke pacing theatre, a turnkey project with Canon Medical Systems UK, included the replacement of a 15-year-old incumbent system with the latest interventional imaging technology to improve image quality, reduce dose and speed up procedures. The remodelling of the room also included lighting modifications to the right and left to enable greater versatility of pacing on both sides of the patient.

“Chester has a growing ageing population and our pacemaker workload is increasing year-on-year by about 7%. We do approximately 400 cases every year which makes us one of the bigger centres in the area.

We’re also seeing an increased need of subpectoral pacemaker implantation, burying them a bit deeper, which previously meant patients were sent elsewhere for the procedure. Now, we have the set-up to do it here at the Countess of Chester Hospital in the Cath Lab with the Alphenix Sky. This is better for the patient as it potentially means a closer-to-home appointment. This is just one example of how by having the latest imaging equipment, we’re ready to seize new service opportunities that will improve patients’ experience and outcomes

VISIONS 06 // 45

Left to Right: Polly Taylor, Senior Radiographer, Amber Clarke, Staff Nurse, Sian Jones, Staff Nurse, Helen Myers, Healthcare Assistant, Gareth Buckingham, Cath Lab Manager, Jeanette Lovatt, Staff Nurse, Dennis Caulfield, Consultant Cardiologist, Marc Ivison, Canon Medical UK Service Engineer, Raquel Domingues, Clinical Cardiac Physiologist

“By having the latest imaging equipment, we’re ready to seize new service opportunities that will improve patients’ experience and outcomes into the future.”

Gareth Buckingham, Cath Lab Manager at the Countess of Chester Hospital into the future,” states Gareth Buckingham, Cath Lab Manager at the Countess of Chester Hospital.

“Having a new and productive pacing theatre adjoined to our cardiology day unit also really assists with our patient flow. We try and pace within 24 hours of referral as this is a ‘get it right first time’ objective for our region. A good, robust fixed C-arm has enhanced the image quality and quickened clinical interpretation.

Improving quality was our aim, and this is what the Alphenix system has

46 // VISIONS 06

helped us deliver, adding further potential to keep evolving in tune with the future of healthcare,” adds Gareth Buckingham.

“The Canon Medical turnkey team was excellent to work with. The project was planned well in advance and collaboration with the wider hospital teams, such as IT networking, was superb. We had a good plan and kept on schedule, which was essential as we had to plan and share any downtime with endoscopy or theatre,” concludes Gareth Buckingham.

“We have had a long relationship with the Countess of Chester Hospital and the enthusiasm of this Alphenix project has been fantastic as the hospital team embraced the new features, functionality, and versatility to tailor services for their patient cohort. We look forward to supporting them drive their dedicated pacing theatre forward and expanding the depth of work undertaken,” states Colin Murray, Account Manager at Canon Medical Systems UK. //

INTERVIEW // PARTNERSHIP // Tessa Sanderson

Taking the Baton as Canon Medical UK’s Business Ambassador Six-time GB Olympian and the first black British woman to win Olympic gold, Tessa Sanderson CBE champions the role of diagnostic imaging in sports medicine

O

lympic and Commonwealth Games gold medallist for javelin, Tessa Sanderson CBE, has been re-appointed as Canon Medical Systems UK Business Ambassador for 2022.

She will be representing the Canon brand during its role as ‘Official Imaging Supporter’ at the Birmingham 2022 Commonwealth Games, while also spearheading

wider communication of how valuable sports diagnostic imaging is from her personal and professional experience.

Tessa has over 26 years’ track and field sporting experience at the highest possible level and has gained many accolades and held many business, trade and sporting roles. These include Vice Chair of Sports England,

Sports Reporter with Sky News and Commander of the Order of the British Empire (CBE), the highestranking order of the British Empire awarded by the Queen in recognition of her positive work.

“The role of medical imaging in sports and exercise medicine is invaluable today,” states Tessa Sanderson. “The polyclinics, with Canon Medical imaging systems inside, at the Birmingham 2022 Commonwealth Games will be a fantastic opportunity for athletes from around the world to have medical imaging examinations.

In some cases, many simply won’t have access to this sort of care in their home countries. This will help with understanding injury, rehabilitation stages and learning more about the impact of sports on their bodies.”

“When I was injured in 1981 by rupturing my Achilles Tendon, I was out of action for two years. At that time, there wasn’t the depth of sports medicine diagnostic imaging we see today to provide a quick and detailed diagnosis to get the right treatment.

Taking time out of training and competition is not a good thing for

48 // VISIONS 06

“Her role will be incredibly valuable to help us communicate the importance of diagnostic imaging” Mark Hitchman, Managing Director of Canon Medical Systems UK

professional and upcoming sports people. Today, there is so much more access and innovation through MRI, X-ray and ultrasound to understand injury, prevention and rehabilitation to get people back into their careers as fast as possible. This is so important in modern sports,” Tessa adds.

Mark Hitchman, Managing Director of Canon Medical Systems UK states, “Tessa Sanderson’s re-appointment as Canon Medical UK Business Ambassador is most welcome for this incredible, multi-sporting calendar year in the UK. She brings a unique energy to our organisation that fuses the important elements of sports, business and health. Her role will be incredibly valuable to help us communicate the importance of diagnostic imaging to both elite and community-based sports people and clinicians.”

The Birmingham 2022 Commonwealth Games will take place from 28 July to 8 August 2022 with around 6,500 athletes and officials from 72 nations and territories competing in 19 sports including eight para-sports across 15 competition venues. //

VISIONS 06 // 49

Fig 1. Carotid Angiography using AI-assisted CT: Low-dose Ultra Helical CT Angiogram of the Carotids and Circle of Willis for stroke work-up.

AI-assisted CT provides clear visualisation of contrast enhanced vessels and surrounding soft tissue for fast and confident rule-out of occlusion.

INTERVIEW // MULTI-MODALITY // Thought-Leadership, AI

Diagnostic Imaging Insights Accelerated by Artificial Intelligence Mark Hitchman

Mark Hitchman, Managing Director of Canon Medical Systems UK, highlights the exciting AI innovations in diagnostic imaging and discusses the need for home-grown data to power advancements in the future

A

rtificial Intelligence (AI) in healthcare is big news.

Nearly every day there is a new study or research result announced, powering the potential advances in how we diagnose, treat and prevent healthcare conditions in the future. It stirs the imagination and is an exciting exploration to be part of, but it also has to be a manageable process, realistic and scalable.

With every positive news story on the advances of AI in healthcare, there is also the counterbalance that questions when we will realistically be able to use these advancements in clinical practice. Our response is that AI is already here.

It's being used in many hospitals and clinics up and down the UK, perhaps without the radiographers even realising, as it works seamlessly behind the scenes.

There is no plan to shock and awe the healthcare community, it has been through enough in the last few years.

So our approach is to calmly and carefully introduce the advancements embedded within our imaging systems and visualisation software via familiar user interfaces and training plans. Diagnostic imaging evolution is happening every day and it is making a difference to clinical confidence and workflow efficiency.

AI helps with decision support, it’s not about replacing clinicians The reality of today’s AI in action is about solving many of the acute problems in the modern healthcare environment. It is about providing the tools to help clinicians make confident decisions

faster when faced with growing backlogs. It is also about simplifying workflows that optimise staffing and equipment resource deployment that ultimately deliver time efficiency gains that can be passed onto better patient care. Whether this is being able to see an extra 3-5 patients in the worklist per day to keep on top of waiting lists, or to provide extra time for radiographers to spend with patients needing reassurance and comfort during a stressful examination, the benefits are clear.

AI in imaging is also about reducing the stress and exhaustion on health professionals. Replacing radiologists or oncologists with AI is not an option, the human element is needed more than ever. But AI can provide an effective decision support tool to help triage reporting cases and speed up decision making.

The journey of AI in imaging began with the introduction of AI-assisted imaging firstly through CT and now MRI via a Deep Learning reconstruction AI algorithm that differentiates ‘noise’ from true signal to clean up images resulting in high-quality scans free from distortion.

This helps to preserve edges, improve textures and maintain details to assist with clearer clinical interpretation.

It also reduces the need for image retakes and is at a much lower patient radiation dose than offered before (Fig. 1, 2 & 3).

This technology is now in place in dozens of hospitals across the UK, and from conversations with the imaging community, it is clear that the benefits to patients, processes and people are helping daily diagnostic service life.

VISIONS 06 // 51

Fig 2. Image obtained using AI-assisted CT demonstrating excellent visualisation of detail in small vessels enabled by lownoise and high-resolution characteristics. The patient arrived in the Emergency Department hypertensive with atypical chest pain.

Helical Gated Chest CTA was conducted to rule out acute coronary syndrome and/or Aortic dissection.

“Dose reduction for paediatric patients is amazing.

The 16cm detector can achieve a volume scan in 0.5 seconds on a head” At Wycombe Hospital, part of Buckinghamshire Healthcare NHS Trust, the Deputy Lead MRI Radiographer gave feedback on the AI-assisted MRI (Fig. 4) stating that, “the Advanced intelligent Clear-IQ Engine Deep Learning reconstruction technology “produces great images that are detailed and low in noise. This reduces scan times and produces valuable diagnostic images first time”.

Improved diagnostic accuracy is also cited as one of the benefits at NHS Lothian’s Royal Hospital for Children and Young People in Edinburgh using an AI-assisted CT. Along with making complex paediatric examinations easier, it speeds up scans and reduces dose for young patients. The CT Radiographer told us that, “Dose reduction for paediatric patients is amazing. The 16cm detector can achieve a volume scan in 0.5 seconds on a head which is really helpful when examining young patients – we no longer need anaesthetics or strategies to try and keep them still for as long. The fast speed really helps us perform the procedure quicker and is better for the small person concerned”.

Similar feedback has been received about the Advanced intelligent Clear-IQ Engine powered CT from a major acute teaching hospital in Scotland, the Royal Infirmary of Edinburgh. The CT/MRI Superintendent stated, “As radiographers we can become blasé about the imaging equipment we use on a daily basis, but the arrival of our new CTs reminded us of the amazing innovation going into medical imaging today. Our cardiologists have been blown away with how quick a cardiac CT is acquired using the wide detector, as well as the image quality achieved at such low doses”.

52 // VISIONS 06

AI-assisted diagnosis of key diseases But AI has far more potential to demonstrate in imaging. More recently, we have started rolling out AI and automation applications for imaging that drill into specific conditions.

Take, for example, strokes. These occur once every five minutes in the UK. It is the fourth single leading cause of death and responsible for 35,000 deaths annually. Great results have been achieved in bringing these figures down over the years due to expanding research, medical innovations and awareness campaigns but ‘time is brain’ has always been a ubiquitous phrase and it is still relevant today.

The quicker clinicians can identify and treat a patient with a stroke, the better the outcome from death or long-term neurological damage.

The automation of stroke diagnosis using AI in diagnostic imaging has the potential to streamline stroke-related workflow by automatically consolidating results into a single summary and alerting for abnormalities. It can help to swiftly analyse and categorise images to detect signs of ischemic and haemorrhagic stroke in minutes. This has the potential to provide access to information that can speed up the administration of life-saving treatment.

Gathering up data to teach AI and cement its place in daily clinical practice Great strides are also being made on the visionary future of AI, the stuff that medical futurists dream of. Behind every deep-learning innovation there is data,

lots of it. This is what builds the algorithms and feeds the machines with knowledge.

This is a great use, recycling you could say, of the information our healthcare establishments have been collecting for years.

Only a few years ago it was estimated that 97% of the 50 petabytes of data produced by hospitals per year went unused.

The big data sources include patient medical records, CT or MRI scan images, pharmacy records, laboratory results and all the other sub-sectors of the healthcare ecosystem.

It is the decanting of this relevant healthcare data safely, which is pseudonymised to ensure protection of patients’ personal details, that is key to accelerating the pace of

Fig 3. Brain perfusion right occlusion using AI-assisted CT: Low-dose whole brain dynamic 4D CTA DSA and perfusion, enabled by wide-area CT and Advanced intelligent Clear-IQ Engine (AiCE) DLR. The 4D CTA shows a blood flow interruption of the right MCA-M3 segment. Perfusion maps display reduced cerebral blood flow and increased MTT in M3 territory corresponding to the vascular abnormality.

VISIONS 06 // 53

Fig 4. AI-assisted MRI producing images that are detailed and low in noise. This reduces scan times and produces valuable diagnostic images first time.

54 // VISIONS 04

“Our new CTs reminded us of the amazing innovation going into medical imaging today.”

CT/MRI Superintendent, Royal Infirmary of Edinburgh

turning great AI ideas into daily clinical practice reality.

Each AI application needs up to 100,000 data sets or even more to learn from along with a development process involving human clinical evaluation.

We are very proud to have a home-grown hub of AI research and development in Canon Medical Research Europe in Edinburgh. This group of software engineers and architects collaborates with 15 partners in the UK across academia, the NHS and industry via its Safe-Haven Artificial Intelligence Platform (SHAIP). This means, in essence, that the data being used to develop future AI innovations is gathered from UK specific data sources, making the development accurate and specific to our patient populations, at the same time as working closely with colleagues in Japan, China, Europe and the USA.

AI is here today and scaling ready for a smarter tomorrow AI is only as good as the data it is built from, which means that when trying to get solutions to market to start helping patients and speeding up the way healthcare is delivered post-Covid, collaboration is key. Federated learning, that is, not moving patient data outside the firewalls of the institutions they reside in, is a growing methodology and requires the involvement of lots of proactive parties.

We all play a role in the acceptance and belief in AI. From welcoming its place within the health environment to driving the creation of new ideas and tech-partnering to make concepts a reality. It is the here and now to deliver improved imaging insights and its future is certain to power the reshaping of tomorrow’s clinical services. //

The team is responsible for building a set of services and web applications that include useful tools for clinicians to select and annotate patient data for machine learning, together with infrastructure for data scientists to develop, train and validate algorithms within the hospital environment. Once an algorithm has been created using SHAIP, it can be deployed into a Clinical Cockpit to allow effortless demonstration to clinicians.

Many projects including stroke and Covid are fully underway and wider work in progress includes oncology, congenital heart disease, ultrasound, interventional angiography and diagnostic support.

References i Brain Research UK, https://www.brainresearchuk.org.uk/ neurological-conditions/stroke accessed January 2022. ii AUTOStroke, https://eu.medical.canon/products/healthcare_it/ auto-stroke-solution.html

VISIONS 06 // 55

Left: Dr. Jean-Christophe Sananes Right: Pr. Vincent Dousset

56 // VISIONS 06

INTERVIEW // MAGNETIC RESONANCE // Vantage Galan 3T

VISIONS spoke with Dr. Jean-Christophe Sananes, President of GIE R2 Gironde and Pr. Vincent Dousset, Director of IBIO

French Radiologists Join Forces to Reduce MRI Scan Time with the Vantage Galan 3T An original alliance using Canon MRI scanners in France has given birth to a new set of sequences to explore the human brain with 3T MRI in just six minutes. This unique collaboration between researchers and clinicians may help tackle MRI access issues in daily practice and could be extended to other clinical applications to improve patient care, two renowned experts told VISIONS. A pioneering cooperation in France

researchers started to develop new sequences with the equipment, they opened a new path for the two entities to cooperate more closely, according to GIE R2 Gironde President Dr. JeanChristophe Sananes.

GIE R2 Gironde, a company that utilizes the expertise of more than 180 radiologists, and IBIO, a prestigious research institute in the Bordeaux region, have known each other for a long time. They have also both recently installed the Vantage Galan 3T MRI scanner. When IBIO

“In daily clinical routine, we need fast sequences that use AI and denoising techniques,” he said. “We were very interested in those sequences that IBIO had been working on.”

When the finest clinicians and researchers work together with the same breathtaking equipment, great things can happen.

In late 2020, the organizations decided to join forces to apply the sequences

VISIONS 06 // 57

“One of the main questions is how to develop sequences that can be translated into clinical daily practice. That's why we chose to collaborate with GIE R2 Gironde, whom we've known for a long time, to test the sequences.”

Prof. Vincent Dousset, Director of IBIO, Research institute in the Bordeaux region, France.

developed by IBIO in clinical practice, to help expedite diagnosis and follow-up of patients with MRI. Through the Bordeaux University Foundation, a PhD candidate was hired to help implement this work in daily practice in order to bring optimal benefit to patients.

GIE R2 Gironde, Bordeaux, France.

58 // VISIONS 06

Canon’s Vantage Galan 3T scanner combines some of the most powerful gradients in the world with game changing image improvement techniques such as the Advanced intelligent Clear-IQ Engine (AiCE) software, an AI-based solution that identifies and removes noise from

images. With this cutting-edge equipment, IBIO managed to create incredibly fast sequences to boost MRI and spread its use in clinical practice. But these kinds of advances need help to make it into the daily routine setting, IBIO Director Prof.

Vincent Dousset explained.

every possible sequence technique.

“We also drew on other techniques, such as the Fourier transform, and everything we had at hand to optimize sequences. We also applied the AiCE innovative solution available on the Vantage Galan 3T to remove noise from the images.”

The outcome is a significant gain in time, offering the ability to scan patients in just five minutes in 2D1 and six minutes in 3D2. Because all the basic sequences have been included in the combination, patients do not have to be scanned again in the case someone else reads the study later.

Canon's Vantage Galan at the GIE R2 Gironde.

“One of the main questions that researchers are confronted with is how to develop sequences that can be translated into clinical daily practice,” he said. “That’s why we chose to collaborate with GIE R2 Gironde, whom we’ve known for a long time and totally trust, to test the sequences.”

as easily as CT, in order not to miss anything and go fast.”

Bringing research and clinical practice under one roof is somehow atypical in France, but the approach is starting to pay off. GIE R2 Gironde and IBIO are about to present results that could help shorten and harmonize MRI examinations of patients with brain disease.

The goal was to reduce scan time and the team worked on refining

With Canon’s help, Prof. Dousset and his team condensed six basic sequences - a T1, T2, FLAIR, TOF, T2* and diffusion into the same rapid MRI examination to scan all of the brain pathologies.

“The effect is doubled. We can examine patients very rapidly and if there’s an additional reading, there’s no need to recall patients,” Prof. Dousset said.

The experience in daily practice has impressed Dr. Sananes. “We’ve been using the Welcome Pack on our Vantage Galan 3T for three months and we’re extremely surprised and happy to obtain all the information about the brain in just six minutes,” he said.

“We've developed a large set of very short sequences with high resolution that can be applied to screening most brain diseases as a routine protocol.

It’s called the Welcome Pack and it enables to expedite and standardize MRI examinations of the whole brain,” Prof. Dousset said.

The Welcome Pack1: a new tool to help radiologists using MRI Working in a timely fashion is the radiologist’s dilemma when scanning with MRI. “We need to standardize MRI examinations and perform them in a short time, as we do with CT,” he said. “We thought of which basic sequences would be necessary to perform MRI exploration of the brain

Dr. Sananes at the GIE R2 Gironde.

VISIONS 06 // 59

T1

DWI b1000 3 mm

T2*

T2 Fat Sat

3D FLAIR Deep Learning Reconstruction

TOF Willis TOF Circle of Willis

Figure 1: 6 sequences including 3D FLAIR and TOF

Besides brain imaging, a number of applications could benefit from IBIO’s fast sequences, including neck and MSK pathologies.

Ax DWI/b1000 : 28 sec, 3D FLAIR : 100 sec, 3D TOF : 59 sec

DWI b1000

3D FLAIR

T2*w

3D T2w Fat Sat

TOF Willis TOF Circle of Willis

Figure 2: Typical 3D Welcome Pack Images on one volunteer. Total scan time: 6 min 21 sec.

3D T1W: 66 sec, 3D FLAIR: 100 sec, 3D T2W FatSat: 73 sec, Ax DWI/b1000: 88 sec, Ax T2*W: 96 sec, 3D TOF: 119 sec

“We’ve run tests and use it more and more often. The machine offers very high quality and optimized images. The Welcome Pack brings us a very interesting rapidity without degrading image quality.”

60 // VISIONS 06

For Prof. Dousset, being able to test his team’s research in the clinical setting may pave the way for other interesting projects using fast acquisition and image denoising techniques.

“Hopefully we can prove the efficiency of such techniques over already established ones with this project, and look forward to more initiatives in the future,” he said.

Potential future applications

Ax T1W : 20 sec, Ax T2*W : 36 sec, Co T2W FatSat : 33 sec

3D T1w

“The solution is very innovative and answers a very strong demand from clinicians who are refrained in their diagnosis by waiting times or the difficulty of obtaining MRI exams. Thanks to those fast sequences, we could unleash MRI’s potential to answer clinicians’ needs and improve care, notably for semi-urgent patients,” he said.

Such fast sequences may well enable to design and implement new workflows that shorten MRI waiting times and improve MRI access for both clinicians and patients, Dr. Sananes suggested.

Dr. Sananes would also like to take the Welcome Pack down to the pelvis and the abdomen. “This is a delicate region to image with 3T because of artifacts that are triggered by movement. AI’s role is to get rid of those artifacts.

Prostate MRI is all set to take off with AI-boosted MRI,” he said.

Research is all about pushing the frontiers. MRI already enables the ability to do functional imaging, but advances must be made to improve image quality, Prof. Dousset said.

“The prostate, spinal cord and other organs and regions remain complicated to assess. There’s also a lot of work to be done to image the pituitary gland and vessel wall pathologies, which are quite frequent.

Image quality needs to be improved to properly visualize atherosclerosis or aneurysm risk.”

With Canon Medical Systems’ unmatched support, radiologists have a strong ally to accompany their endeavors.

“The solution is very innovative and answers a very strong demand from clinicians. Thanks to those fast sequences, we could unleash MRI's potential to answer clinicians' needs and improve care, notably for semi-urgent patients.”

Dr. Jean-Christophe Sananes, GIE R2 Gironde President

“Our cooperation with Canon Medical Systems scientists has been extremely positive in our collaboration with IBIO. It’s rare and brings real advances,” Dr. Sananes said.

scends the usual French public-private scheme, to develop techniques that improve patient care,” Prof. Dousset concluded. //

“We’ve received excellent technical support from Canon. We have a shared vision of research that enables us to go further and push this idea that tran-

References 1 Welcome Pack: a standardized brain MR examination with six sequences in less than 5 minutes. Vincent Dousset, M.D., Ph.D. (PU-PH) Director of IBIO University of Bordeaux and University Hospital of Bordeaux; https://global.medical.canon/products/ magnetic-resonance/aice-customer-experience 2 3D Welcome Pack with Advanced intelligent Clear-IQ Engine (AiCE): a standardized 3D brain MR examination with 6 sequences in 6minutes.

Vincent Dousset, M.D., Ph.D. (PU-PH) Director of IBIO University of Bordeaux and University Hospital of Bordeaux; https://global.medical.canon/products/ magnetic-resonance/aice-customer-experience

Patrice Coudray (Canon Medical), Bruno Triare (Canon Medical), Dr. Sananes, Professor Dousset.

VISIONS 06 // 61

Can You Spot The Anomaly?

Pencil shaving

Exceptional Image Quality Can You Spot The Anomaly? One, two, three, four, have you seen it yet? Five, six, seven, what about now? Eight, nine, ten...

That can be all the time you have to make a life and death decision on behalf of a patient.

The decisions you make are based on what you see. What you see can save a life, what you miss, can have devastating consequences.

That’s why Canon have always believed in the power of uncompromising excellence in image quality. The same way our photography allows us to discover the world around us, our medical imaging can uncover what’s really going on inside.

Scan here to discover more

We’re obsessed with detail, applying the same legendary expertise at the same World Class standard.

It’s not just our class beating specification that separates us from the competition. It’s more than that. It’s our ambition.

We are committed to producing superior diagnostic medical imaging solutions that positively impact the working lives of medical professionals and the millions of patients they treat worldwide.

The pursuit of providing the perfect image for our customers, one that is capable of saving life itself, forms part of our DNA. It’s a pursuit that started over 100 years ago and will continue for a hundred more.

Our imaging technology brings ultrahigh resolution, 4k detection – meaning your images are crystal clear, minimising any room for error. Each pixel reveals the very finest detail so that you can detect even the smallest anomalies critical in life and death situations.

We know that every pixel matters and we won’t compromise. We are Canon Medical, we are the experts in medical imaging and we are with you every step of the way.

Did you spot it?

The answer is a pencil shaving.

Upcoming Education Calendar 2022 Can’t make a certain date? Sign up to the Medical Imaging Academy, where you can watch recorded events online and earn CPD points: medicalimagingacademy.co.uk

July 2022 13th - 17th ECR Location: Vienna, Austria Duration: 4 day event Register here: myesr.org/registration

Medical Imaging Academy

September 2022

November 2022

5th Evelina Foundation Course in Fetal Cardiology Location: London, UK Duration: 1 day event Find out more: uk.medical.canon/courses

12th Wessex Diagnostic Venous Ultrasound Imaging Course Location: London, UK Duration: 1 day event with 7 CPD credits available Register here: uk.medical.canon/ education/events

22nd - 23rd BSCI Location: Bath, UK Duration: 2 day event Register here: bsci.org.uk/ meetings-and-courses/meetings 27th - 28th Wessex Diagnostic Vascular Ultrasound Imaging Course Location: Birmingham, UK Duration: 2 day event with 14 CPD credits available Register here: uk.medical.canon/ education/events

December 2022 6th - 8th BMUS Location: Cardiff City Hall, UK Duration: 3 day event Register here: bmus.org/ annual-scientific-meeting-2022 Sign up to the Medical Imaging Academy to view future events: medicalimagingacademy.co.uk

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 denceininy your our investment. investment.

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

uk.medical.canon