UK Visions Edition 7

MAGAZINE FOR UK HEALTH PROFESSIONALS UK Edition // No. 7 // December 2022

AI-assisted Imaging to AI-assisted Diagnosis 52 // MULTIMODALITY

Unlocking Healthcare Data

Exploring the Potential of AI for Clinical Practice

Unveiling the Secret Life of Dinosaurs

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36 // INTERVIEW

56 // COMPUTED TOMOGRAPHY

Artificial Intelligence, enhancing your clinical confidence with high-quality images and applications that help you make informed treatment decisions in real-time, at the point of delivery.

Canon Medical Systems Service Department Opening Hours Christmas and New Year 2022/3 19th - 23rd December 2022 24th December 2022 25th December 2022 26th December 2022 27th December 2022 28th - 30th December 2022 31st December 2022 1st January 2023 2nd January 2023 3rd January 2023

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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. Access to full, previously published, digital editions can be done via the web site: https://uk.medical.canon/ visions-magazine/. Register for the digital or physical edition of VISIONS UK by scanning here: 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.

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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.

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

Editor-in-chief Beth Parrott beth.parrott@eu.medical.canon

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

Design and Layout Origin origincreative.co.uk

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// EDITORIAL

Welcome to the winter 2022 issue of VISIONS UK It is hard to believe that 2023 is nearly upon us. This year has certainly provided us all with a busy dose of normality to be out and about visiting customers, taking part in events with our partners and launching some exciting new healthcare initiatives.

If I had to sum up the last year for Canon Medical Systems UK in one word, it would be ‘innovation’ - and this is the theme for this issue. The world of healthcare today is as exciting as it is challenging. The pace of technical innovation for diagnostic imaging aims to provide a panacea for many of the burdens and bottlenecks in clinical practice. This includes providing quicker appointments and procedure times for patients and supplying tools to help clinicians automate the diagnosis of disease conditions earlier to improve life outcomes.

Artificial Intelligence (AI) and machine learning technologies under our ‘Altivity’ brand are now built into MRI and CT scanners found in hospitals and clinics up and down the country. Indeed, our AI-assisted MRI was in action at the Birmingham 2022 Commonwealth Games supporting athletes’ diagnostic imaging needs as our role of Presenting Sponsor of the Birmingham 2022 Polyclinics.

A full focus on the summer multi-sporting event can be found inside.

Automated applications for imaging that drill into specific disease conditions and assist with diagnosis are also now rolling out. In this issue we introduce you to the Stroke CT package, designed 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.

But it is not just healthcare IT, AI and automation developments that make me cite ‘innovation’ as my key theme for the year. It is also the innovation to be found in the delivery of healthcare services to patients in non-traditional ways, such as the Park Community Arena in Sheffield and at the Games in Birmingham, plus our innovative approach to project management and logistics in getting diagnostic imaging systems to where they are needed, whatever the constraints and limitations. Furthermore, our innovation in environmental, social and governance (ESG) matters are intrinsic to the way we do business with others now and into the future. We’re delighted to announce silver medal status, ranking us in the top 25% of companies by EcoVadis, the most trusted business sustainability rating organisation. This recognises our own and our supply chain sustainability performance.

On a final note, I would like to wish you, your family and your colleagues greetings of the season and a healthy and prosperous new year,

MARK HITCHMAN Managing Director Canon Medical Systems UK

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// CONTENTS

06

Why Sheffield is a City of Opportunity to Champion Community Change in Health & Wellbeing NEWS

03

Editorial

06

Why Sheffield is a City of Opportunity to Champion Community Change in Across the Finish Line: Health & Wellbeing Canon Medical at the

12

NEWS

09

Why Healthcare Data will be the Panacea to NHS Challenges

Birmingham 2022 Commonwealth Games PARTNERSHIP

MULTIMODALITY

12

Across the Finish Line: Canon Medical at the Birmingham 2022 Commonwealth Games PARTNERSHIP

20

Future-Proof Diagnostic Care COMPUTED TOMOGRAPHY

24

By Your Side to Support the Ongoing Educational Aspects of Ultrasound Diagnostic Imaging ULTRASOUND

28

Our Premises Across the UK

30

New MRI Scanner Aims to Deliver Workflow and Productivity Fortitude to UK Healthcare MAGNETIC RESONANCE IMAGING

32

Manchester United Extends Imaging Partnership PARTNERSHIP

36

Exploring the Potential of AI for Clinical Practice HEALTHCARE IT

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44

Leeds Childrens Hospital Opts for Ultimax-i for Paediatric Precision DIAGNOSTIC X-RAY

52

Canon Medical UK Steering the Path from AI-assisted Imaging to AI-assisted Diagnosis MULTIMODALITY

36

Exploring the Potential of AI for Clinical Practice HEALTHCARE IT

44

Leeds Children's Hospital Opts for Ultimax-i for Paediatric Precision DIAGNOSTIC X-RAY

48

Canon Medical UK Backs Sheffield Hatters to Champion Girl Power ESG

52

Canon Medical UK Steering the Path from AI-assisted Imaging to AI-assisted Diagnosis MULTIMODALITY

56

56

Unveiling the Secret Life of Dinosaurs with Latest CT Techniques COMPUTED TOMOGRAPHY

Unveiling the Secret Life of Dinosaurs with Latest CT Techniques COMPUTED TOMOGRAPHY

63

Opening Hours Christmas and New Year 2022/3 SUPPORT

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// NEWS The UK’s first sustainable, carbon-neutral built community arena with multi-purpose sports facility and integrated Medical Diagnostics Centre announced at Sheffield Olympic Legacy Park.

Why Sheffield is a city of opportunity to champion community change in health & wellbeing “If you want to see the future, look back at the past…”

Albert Einstein.

T

he Great British industrial revolution, brimming with innovations, began in Northern England. Cities were epicentres of transformation via the growth of heavy industry such as weaving, steelmaking, and ship building. At the same time, poor health and living conditions, long working hours and rapid population growth from immigration, triggered positive political and social change.

Today, cities such as Sheffield - known for its proud industrial heritage and subsequent decline - are rejuvenating once again through local and national Government regeneration and investment programmes to support communities such as the Levelling Up Fund.

The UK's greenest city

Even before the Government mantra of ‘levellingup’ was heard, the ‘Steel City’ was brimming with new industry,

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engineering and manufacturing. It was the UK’s first ‘National City of Sport’ and boasted Sebastian Coe and Jessica Ennis as sporting alumni; it began thriving in digital-tech incubation and acceleration; it was named the UK’s greenest city with 4.5 million trees, more than any other city in Europe; it features two world leading universities and one of the UK’s busiest and most successful NHS Foundation Trusts; it is the proud location of Sheffield Olympic Legacy Park - the world’s only Olympic Legacy Park outside of a host city; and it has bold ambitions to be a zero carbon city by 2030.

Health inequality

However, still lingering in the background is health inequality.

Sheffield continues to lag behind the England average on most outcomes including life expectancy, healthy life expectancy, educational attainment, unemployment and housing.

Sheffield was the UK's first 'National city of Sport' and boasted Sebastian Coe and Jessica Ennis as SportingAlumni Bleakest is the inequality in healthy life expectancy in Sheffield – 20 years between the most and least deprived men; 25 years for women1.

Canon Medical Systems UK believes that a way to improve people’s overall wellbeing is through proactive health, sport, social engagement, and education; creating a cycle of future health prosperity that boosts a long quality of life. With long links to charitable causes and academic partnerships with health research and development organisations, the city of Sheffield was an obvious choice to build the first community catalyst, a blueprint of sport fused with wellbeing.

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Build progress of the Park Community Arena, developed by Canon Medical Systems UK.

"Keeping people well means striving not just for the individual, but also for towns, cities and society as a whole."

Mark Hitchman, Managing Director of Canon Medical Systems UK.

2023 opening

Located in the heart of the Sheffield Olympic Legacy Park, Sheffield's health and wellbeing centre, the Park Community Arena developed by Canon Medical Systems is taking shape, building towards its 2023 opening.

As a carbon-neutral built community arena with multi-purpose sports facility and integrated Medical Diagnostics Centre, it will champion the purest vision of what community diagnostics should be about.

Mark Hitchman, Managing Director of Canon Medical UK states, “Where you live should not define how long you live.

Keeping people well means striving not just for improvements for the individual, but also for towns, cities and society as a whole. The Park Community Arena will aim to strengthen the community in Sheffield by encouraging healthy, active lives.

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As an affordable and accessible location for local people, it will welcome the diverse communities of South Yorkshire for proactive health, sport, social engagement and education.

“The Park Community Arena will also create an Artificial Intelligence (AI) incubation hub for research and development for health screening and disease prevention for today and into the future. Supported by our sister company, Canon Medical Research Europe based in Edinburgh, we will create, analyse and build new progressive health innovations that will look to diagnose disease earlier.

Prompt detection delivers the greatest change in long-term survival rates and can enable the prescription of simple lifestyle shifts such as diet and exercise before invasive and complicated hospital interventions,” adds Mark Hitchman.

Hope and pride

Renewal and regeneration are at the heart of creating modern healthcare. The city of Sheffield will no doubt become a shining example of how tackling the bleakest of health statistics head on with sport, wellbeing, and healthcare, will create new life certainties, hope, and pride.

Preventative medicine can be the strongest means of creating perpetual health for all. //

Reference 1 NHS Sheffield Annual Report 20/21, https:// www.sheffieldccg.nhs.uk/Downloads/ About%20US/Documents%20Policies%20and%20 Publications/2020%2021%20Annual%20Report%20 including%20Annual%20Accounts%20without%20 front%20page.pdf

INTERVIEW // MULTIMODALITY // AI

Why Healthcare Data will be the Panacea to NHS Challenges Mark Hitchman, Managing Director of Canon Medical Systems UK, explains how healthcare data must be harnessed through specialist digital data and AI acceleration initiatives to improve outcomes, tackle waiting lists and alleviate staff shortages.

I

t is estimated that hospitals produce 50 petabytes of data per year. That’s 50,000 terabytes or the equivalent of a billion tall filing cabinets of information such as text health records, CT or MRI scan images and laboratory results. This huge trove of digital health data holds exciting potential for the advancement

of early disease detection, better patient outcomes and alleviating workforce issues.

By accessing information from healthcare institutions - deidentifying it so that personal information cannot be attributed to a specific person and processing it through safe Artificial

Intelligence (AI) research platforms -technical algorithms can be trained to innovate medical technology and change the way healthcare services are rolled out. This has benefits at the point of patient care, at a department level, and from a national health perspective.

This isn’t science fiction or visionary rhetoric. Partnerships between industry, academia and healthcare institutions are now in place to bring the benefits of health AI to the masses.

1. Early disease detection improves outcomes

The earlier disease is identified, the quicker the patient can access a care pathway for treatment. With current backlogs and long waiting times for appointments, the first time a patient gets seen for diagnostic investigation,

“The earlier disease is identified, the quicker a patient can access a care pathway for treatment."

Mark Hitchman, Managing Director of Canon Medical Systems UK.

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they rely heavily upon accurate first-time scanning with clear image acquisition. The expansion and development of existing frontline diagnostic systems with AI helps to ensure that the optimal image is taken first time for a quick and accurate patient prognosis.

This has been successfully achieved by training AI algorithms and incorporating advanced Deep Machine Learning reconstruction technologies into current imaging systems used daily.

This reduces image noise and boosts

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signal to deliver sharp, clear and distinct clinical images at speed, first time.

Early diagnosis is also better for the overall health economy. For example, identifying small lesions, polyps or nodules early for cancer investigations through the use of AI-assisted diagnostic imaging means that resulting interventions are needed at a much lower unit cost. This can include keyhole or minimally invasive procedures that avoid more costly open surgery, anaesthesia, longer hospital stays and ongoing

AI-assisted diagnostic imaging means that resulting interventions are needed at a much lower unit cost medication. This is better for the health economy and patient recovery.

By gathering data from millions of past clinical cases that have already been verified by experienced and knowledgeable clinicians, AI algorithms can be taught what to look out for.

“By opting for diagnostic imaging that makes the most of the resources available, efficiencies can be gained, error rates reduced and workload capacity augmented."

Mark Hitchman, Managing Director of Canon Medical Systems UK.

2. Tech tools can alleviate burden on existing workforces

Workforces have been squeezed for many years by budget cuts, retirement rates and recruitment challenges.

But by opting for diagnostic imaging that makes the most of the resources available, efficiencies can be gained, error rates reduced and workload capacity augmented.

Automated features are simple med-tech advancements that can help a radiographer with patient positioning, procedural consideration and accurate image acquisition. Automation also assists with radiology reporting tasks, first review triage or flagging scans of concern worklist prioritisation and even diagnosis in routine work. This can help speed up treatment decision making, improving productivity and automatically reducing workload.

At the same time, patient appointment times can be shortened to provide more slots during working hours to help battle the long waiting lists.

In emergency medicine, AI-assisted diagnostic tools can help with heavy workloads. For example, AutoEmergency has been designed to optimise treatment outcomes for A&E cases when speed and accuracy are crucial.

This comprises stroke and chest pain modules that swiftly and automatically categorise images to detect signs of ischemic and haemorrhagic stroke in minutes or triage life-threatening acute chest pain for pulmonary embolism or aortic dissection.

3. Understand more accurately what is needed in proactive healthcare Accelerating the capabilities of AI through analysing UK health data will also deliver huge benefits to patients when it comes to detecting health population problems early and, before symptoms present.

Screening programmes are hugely successful - it is noted that 10,000 lives a year are saved through prevention and early diagnosis.

So, imagine the potential quality of life that could be saved if more people were seen and targeted by understanding disease prevalence in more detail following data analysis by postcode or patient profile.

The power of unlocking data and using AI to identify normal scans quickly among large-scale screening cohorts would also greatly assist the human-power behind radiological reporting. It could speed up the delivery of results to patients and streamline entire initiatives to reach greater numbers of people, separating out inconclusive results to be traditionally reviewed by radiologists.

Unlocking data

Our work in unlocking data is already being advanced through the Safe-Haven Artificial Intelligence Platform (SHAIP) collaborations with industry partners, leading universities and NHS Trusts in Scotland.

To date, real-life patient information has been selected, annotated and federated for machine learning then tested as an AI algorithm back in the hospital environment through a ‘clinical cockpit’.

This progress is to be expanded in 2023 with national scaling and more regional locations added across primary and secondary care including NHS hospital Trusts, Integrated Care Systems (ICS), Community Diagnostic Centres (CDCs) and independent healthcare service providers. This will build on the diversity of data already collected to ultimately build a truly representative picture of the UK health population.

It's here, it’s real and it’s progressive.

Data is the remedy to many ills in our healthcare system. //

Reference 1 World Economic Forum, Four ways data is helping to improve healthcare, 2019, https://www.weforum.org/agenda/2019/12/ four-ways-data-is-improving-healthcare 2 Review of national cancer screening programmes in England, 2019, https://www.england.nhs.uk/ publication/terms-of-reference-review-nationalcancer-screening-programmes-england/

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PARTNERSHIP // SPORTS MEDICINE // Birmingham 2022 Commonwealth Games, Mobile Imaging Solutions, Vantage Orian 1.5T and Ultrasound

L OFFICIA G IMAGIN TER SUPPOR

Across the Finish Line: Canon Medical UK at the Birmingham 2022 Commonwealth Games

C

anon Group prides itself on its expertise and capabilities that have made us one of the global leaders in imaging technologies. As part of our work at Canon Medical Systems UK, we have a long history of working in sports medicine, having partnered with various academic institutions and sporting organisations, such as Manchester United and the Sheffield Sharks for many years. These clinical collaborations help to provide athletes with early sports injury detection, faster rehabilitation, and more detailed clinical sports surveillance, plus they

also help cascade knowledge into wider population health projects and fuel innovation in medical imaging applications for the NHS. So, when the opportunity arose for Canon to become The Official Imaging Supporter, and for Canon Medical UK to be the Presenting Sponsor of the Birmingham 2022 Commonwealth Games Polyclinics, we knew we would be able to provide world-class equipment across our print, camera, and medical imaging to the Birmingham 2022 Commonwealth Games.

Official opening of the Birmingham 2022 Polyclinics. (L-R): Rene Degros, Vice President, Sales and Marketing at Canon Medical Systems Europe, Commonwealth and Olympic gold medallist Tessa Sanderson CBE, Mark Hitchman, Managing Director at Canon Medical Systems UK, Paralympian Zak Skinner, John Crabtree OBE, Chairman of the Board at Birmingham 2022 Commonwealth Games and Perry, Birmingham Commonwealth Games 2022 mascot.

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Our Experience: The Birmingham 2022 Commonwealth Games

The Games provided three Athlete Villages with Polyclinics spread across Birmingham: The University of Birmingham, Warwick, and the Birmingham NEC. At all three locations we delivered a comprehensive package of industry-leading diagnostic equipment where clinicians and athletes could experience the high quality of our imaging systems.

Athletes were assessed for musculoskeletal sports-related issues for bone, muscle, tendon, or joint injury, without the need to be transferred to local hospitals. The polyclinics also provided on-site diagnostic support for elective sports medical assessments, such as cardiac or neurology.

Canon Medical UK’s equipment guaranteed optimal image quality and cutting edge technology for the Games’ clinician-volunteers, and Clinical Application Specialists to use.

This included innovative imaging technologies like the ultrasound scanners’ revolutionary iBeam architecture with unparalleled processing power, as well as our RIS and PACS solution, Vitrea Connection, Speech Recognition, External Reporting Work and Vitrea Vision Diagnosing Viewer.

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Title and explanation of the above image here xxxxx xxxxxx xxxxx xxxx

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Canon Medical UK’s equipment guaranteed optimal image quality and cutting edge technology for the Games’ clinician-volunteers, and Clinical Application Specialists to use

Training and support

To help the clinician volunteers quickly settle into using our advanced equipment, Canon Medical UK provided access to comprehensive training material, made available via the Medical Imaging Academy website. This unique resource is a complimentary e-learning platform with live and on-demand expert training, face-to-face courses and On-Demand hub of invaluable ‘How-To’ guides for healthcare professionals to access 24-7-365. Canon Medical UK also provided a large team of experienced and HCPC accredited Clinical Applications Specialists in addition to the remote support, described above.

Some of the clinician volunteers were trained on Canon’s MR scanner with Artificial intelligent Clear-IQ Engine (AiCE) software. This state-of-the-art Canon proprietary technology offers the ability to combine Compressed Speeder and AiCE which can significantly improve the throughput of the patient. Dr Peter Chapman, a leading Consultant Musculoskeletal Radiologist in the UK, concurred that Canon’s MR with Artificial Intelligence (AI), was an outstanding imaging system that quickly provides exceptional and crystal-clear images.

Alongside our Artificial Intelligence technology, we also provide Healthcare

IT with cloud-based technology.

These developments ensure that Canon Medical UK remain at the forefront of the requirements of the world’s rapidly developing healthcare economy. For the Games, this meant that scans could be accessed securely by athletes’ doctors outside of the site location. It was fantastic to have showcased how our equipment can ensure an interconnected society, something which is increasingly important with the emergence of pop-up imaging facilities, such as within the polyclinics, or within mobile, modular units or buildings outside of a hospital setting, such as community diagnosticcentres.

Athlete care

Commenting on what the technology means for athletes, Zak Skinner, Paralympian said: “The care and services that the Polyclinics offer athletes during competitions provides the immediate support an athlete needs to help with early detection, prevention and faster rehabilitation of sports injuries.”

Polyclinics were located at The University of Birmingham, Warwick and the Birmingham NEC MRI modular unit enabled clinicians to quickly and digitally assess common musculoskeletal sports related issues on-site.

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Over the 12 days of the Games, Canon is proud to say that 737 imaging volunteers had the opportunity to experience our equipment, taking a total of 592 scans Indeed, the speed of diagnosis is key for early prevention and our vast range of technologies enhances this.

For instance, our speech recognition software at the polyclinics enables radiologists to digitally dictate athletes scan results, diagnosis, and rehabilitation advice. This speeds up the process of diagnosis and is a huge strength of Canon Medical UK’s products.

Over the 12 days of the Games, and in support of over 4,500 athletes, Canon Medical UK is proud to say that 737 imaging volunteers had the opportunity to experience our equipment, taking a total of 592 scans. Not only were we able to support those with injuries but we could help prepare these athletes to be in the best physical health before and throughout the competition.

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Our Skill: Project Management & Logistics

Providing this specialised equipment with tight deadlines and within budget is not an easy feat. However, our skills, experience and expertise mean we can confidently deliver complex projects that provide bespoke solutions to the customer’s requirements. This could involve finding a site through to the construction of the building that will house Canon Medical UK’s diagnostic equipment, as well as a sporting arena such as the Park Community Arena, developed by Canon Medical Systems we are building currently. We can,and do, provide bespoke end-to-end solutions.

One challenge that both the building and imaging industries are currently facing is having access to resources.

The pandemic and supply-chain issues have created resource constraints of both the infrastructure and equipment when building modular units. Fortunately, we have access to a dedicated factory in Hull to deploy our resources. This allows us to continue to be flexible, agile and quickly deliver diagnostic imaging equipment, which results in reducing lead times and cost, ultimately meaning greater affordability.

For the Games, due to the location of the site within the University of Birmingham’s Athletes’ Village, the delivery of our MRI unit required expert management. The University campus was an enclosed, off-road site surrounded by large trees, meaning we were unable to place the MRI directly in position from the lorry.

“The MRI Modular buildings are extremely heavy - around 30 tonnes- so project planning is vital."

Ian Watson, UK Director of Commercial Solutions.

MRI modular unit delivery to the University of Warwick pre-Games.

Instead, with our expert knowledge and use of specialist equipment, a self-propelled Modular Transporter, the unit was placed in position with ease.

As this type of equipment is not readily available in the UK, our specialism and foresight ensured the project remained on track.

Speaking about one process of the project’s management, Ian Watson, UK Director of Commercial Solutions, Canon Medical Systems UK explains, “The MRI Modular buildings are extremely heavy – around 30 tonnes – so project planning is vital. The physics behind achieving the best image quality from the MRI scanner is also key. The scanner uses RF technology and to ensure high image quality it is essential that the scanner be shielded from interference from other RF signals.

Therefore, locations away from moving traffic, lifts and substations are critical.”

Overall, Canon Medical UK can support the bespoke diagnostic imaging requirements within any environment due to our match-fit capabilities. This includes supplying equipment in a ‘pop-up’ facility at Birmingham 2022, a relocatable MRI Unit at a hospital,

modular equipment buildings for a community diagnostic centre, as well as the complete project management and build of a sports arena with a diagnostic imaging centre at Sheffield Park Community Arena. Ultimately, the services and complete end-toend solutions that Canon Medical UK provides create better and more open access for those using the sites, meaning outcomes are better and costs are reduced.

Our Mission: Sustainability

On all our projects, we are always conscious of the legacy we leave.

As a company, we are committed to becoming carbon net-zero and undertake several initiatives to protect the planet and promote greater prosperity across the communities we work in.

The Birmingham 2022 Commonwealth Games had an aim to be the first edition with a carbon-neutral legacy.

To support this, Canon Medical UK is offsetting the carbon emitted across the entire lifecycle of our equipment provided, as well as the carbon generated by our community at the three onsite Polyclinics. This includes

the creation of our equipment, transportation to the sites, installation, running and removal of equipment, as well as its onward journey to its next destination.

In addition, all employee travel and accommodation throughout the Games will form part of Canon Medical UK's carbon-offsetting calculations, with a total offsetting amount of 132.6 tCO2e (tonne CO2 equivalent), through our India wind turbine project. Our support of this project aligns with the UN’s seventh Sustainable Development Goal: Affordable and Clean Energy for All. Furthermore, as part of the polyclinic infrastructure at the Games, supporting materials, such as clinic floors and walls from one of the Nightingale Hospitals, were utilised. After the Games, the MRI units and ultrasound scanners were made available to the market to provide additional diagnostic imaging capacity in the community. As well as this, a significant portion of the infrastructure are being repurposed to suit other medical environments. We believe it is imperative to act with the circular economy in mind to support our journey to become carbon net-zero.

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Together we can change the landscape of diagnostic services and, in turn, change the lives of patients everywhere

Canon Medical UK works with local communities and have been working with a renowned professional men’s basketball team, the Sheffield Sharks, to create and run our RESPECT programme. As part of this, we have hosted workshops on cyber-bullying, bullying and health and fitness for disadvantaged communities across the region.

We are delighted to have extended this programme into Birmingham and entering a new partnership with the basketball team, the City of

Birmingham Rockets to support the initiative. In the lead-up to the Birmingham Commonwealth Games 2022, we delivered these workshops to 1,500 school children and facilitated a 3x3-basketball tournament to promote sport, health and fitness.

Canon Medical UK is constantly redefining the world of imaging for the greater good. Through our technology and spirit of innovation, we believe we push the boundaries of imaging possibility ways the industry has never seen before.

Vantage Orian 1.5T MRI scanner housed in a modular unit, featuring Canon Medical UK’s pioneering Advanced Intelligent Clear-IQ Engine (AiCE), a Deep Learning Reconstruction technology.

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Changing the landscape

With this perspective, Canon Medical UK can support the future diagnostic imaging demand within any setting; whether this is at another Commonwealth Games, within another sporting arena or within a hospital or community setting for our treasured NHS, Canon Medical UK can and will deliver. Together, we can change the landscape of diagnostic services and, in turn, change the lives of patients everywhere. //

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.

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.

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

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 ultra high 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.

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.

Did you spot it?

Scan here to find the hidden object.

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PRODUCT // COMPUTED TOMOGRAPHY // Aquilion Prime SP

University Hospital Crosshouse, part of the NHS Ayrshire and Arran region in Scotland, has successfully gone live with two new Artificial Intelligent (AI)-assisted CT Scanners.

Pictured: Fiona Munro (Radiographer).

Future-Proof Diagnostic Care Patient services future-proofed through AI-assisted CT & equipment partnership with Canon Medical Systems UK.

U

niversity Hospital Crosshouse, a busy district general hospital with an Emergency Department (ED) serving the population of East and North Ayrshire in Scotland, has recently installed two new Artificial Intelligent (AI)-assisted CT scanners into its Medical Imaging Department to future-proof diagnostic imaging services for local and regional patients. The innovative Aquilion Prime SP CTs from Canon Medical Systems UK replace ageing eightyear-old scanners from an incumbent provider, and will be instrumental in remobilising COVID-19 related waiting-list backlogs and wider pressures on imaging services.

Future development

Designed to increase clinical capacity, the innovative CT scanners will help meet current imaging needs and accelerate future development plans at the hospital. This will include providing an expanded range of procedures to diagnose clinical

conditions earlier, providing better outcomes for patients and without the need for patients to travel to another hospital up to an hour away.

Caroline Crosbie, CT & MRI Superintendent at University Hospital Crosshouse states, “The innovative Aquilion Prime SP CT scanners mean that we can start making our plans for an improved quality of diagnostic care for patients a reality. For example, to date, patients requiring gated or aortic CT scans would have been referred to NHS Greater Glasgow & Clyde, nearly an hour away. Offering closer-to-home cardiac imaging may help to overcome some patient referral issues such as health inequalities and anxiety. Future plans are to provide high quality CT brain perfusion scans on site as part of the Stroke Thrombectomy service. By having higher grade CT imaging functionality, we can deliver an improved standard of care and a patient centred approach to our local community.”

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The selection of the new CT scanners involved a full tender and market evaluation process. Canon Medical Systems UK was selected for its advanced technology and after-sales service provision. The Aquilion Prime SP CT scanner is powered by an Advanced intelligent Clear-IQ Engine (AiCE) using DeepLearning reconstruction. It produces exceptionally detailed imaging for clinical interpretation at the lowest possible dose to patients. It is ideal for a wide range of patients from paediatric through to bariatric patients and is suited to the 24/7 service for inpatient, outpatient, trauma and stroke workload at busy district general hospitals.

Transition & training

“Transitioning to a completely new CT scanner and interface may seem daunting, but with the support of on-site applications training, our radiographers learned the operation of the system very quickly,” continues Caroline Crosbie.

“We also have access to the Canon Medical Imaging Academy to check any instant queries online and our early experience of telephone aftercare has proven to be quick and responsive to any questions we may have had. The relationship with Canon Medical UK has evolved into a good working relationship.”

Ongoing support

“We are delighted to support University Hospital Crosshouse with its bold step in selecting new CT imaging equipment from Canon Medical UK. Users had to get to know new ways of working with the CT user interface compared to their previous systems but understood the returns they would get for their patients by embracing new standards of innovation. We look forward to supporting its expansion of closerto-home imaging services through ongoing CT applications support,” adds Iain Gray, Account Manager at Canon Medical Systems UK. //

“The innovative Aquilion Prime SP CT scanners mean that we can start making our plans for an improved quality of diagnostic care for patients a reality."

Caroline Crosbie, CT & MRI Superintendent at University Hospital

Left to Right: Katrina McNaughtan (Radiographer), Caroline Crosbie (Cross Sectional Imaging Superintendent CT/MRI), Deborah Clark (Site Superintendent Radiographer), Fiona Munro (Radiographer) and Iain Gray (Canon Account Manager).

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CASE STUDY // ULTRASOUND // Education

Medical Imaging Academy e-learning platform, one of the central pillars of our customer support. https://medicalimagingacademy.co.uk

By Your Side to Support the Ongoing Educational Aspects of Ultrasound Diagnostic Imaging Supporting our customers is at the heart of what we do; the purchase of an ultrasound system is just the start of a partnership journey.

W

e understand the daily pressures facing ultrasound users today – catching up on Covid-related backlogs, changing ways of working to streamline throughput and scheduling in more patient appointments than ever before.

‘Applications for You’ supports you with advanced training and services, all of which are completely free of charge.

Systems configuration and customisation Sessional and departmental support l Systems training courses, attracting CPD points l Advanced clinical training l On-going access to clinical experts l Connection to InnerVision remote diagnostics and support, via a secure network l l

At Canon Medical Systems UK we can help you to manage the load. From the simplicity of personal Account Management and accessible Clinical Applications support to face-to-face education events and e-learning resources, our commitment to you is for the life of your system.

Applications for you – helping you get the most from your equipment every day

Canon Medical UK ultrasound users will have access to highly skilled Clinical Applications Specialists who are HCPC, or equivalent, registered. We know how challenging it is to stay on top of the latest developments in clinical care, and to get the most out of your ultrasound systems. We also understand the potential costs of keeping staff fully up to date and trained.

But we also go further.

The power of ‘in-person’ ultrasound educational events

Since 2016, we have been providing a national programme of ultrasound educational events. Initially introduced as a means of launching a new ultrasound platform, we quickly realised how important these study days were to our customers and decided to continue providing them on an annual basis.

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"The day was very interesting and useful. The speakers were all very enthusiastic and kept me focused on the subject they were presenting."

Michelle Sharpe, Bolton NHS Trust.

Manchester Educational Event, 2022.

Ultrasound educational events with highly regarded speakers, bringing education to you.

This year we have delivered nine such events in Belfast, Birmingham, Cambridge, Cardiff, Cobham, Exeter, Glasgow, Manchester, and York. Hosted geographically close to our customers, these events provided between 50-60 places at no cost to the delegate or their Trust / Health Board.

And you don’t need to be a Canon Medical user to access these events.

The sessions were designed to bring education to you.

Each event provided 4 lectures delivered by highly regarded speakers who are experts in their field. Subjects covered over the years have included; MSK, vascular, abdominal, bowel, appendix, foetal cardiology, gynaecology, obstetric scanning, delivering difficult news, professional development and more. In 2022, we are proud to have provided complimentary education, eligible for CPD points, to almost 500 ultrasound users.

We continue to grow the range of courses and events that we offer, to reflect the dynamic nature of ultrasound clinical practices and the changing needs of ultrasound users.

On-Demand education and guidance anytime, anywhere

In 2020, we expanded our clinical educational offering into online education. The need for this was precipitated by the pandemic but has proved to be so successful that the Medical Imaging Academy resource is now one of the central pillars of our customer support.

We provide a range of ‘On-Demand Education’, including lectures across a wide variety of clinical disciplines from highly regarded speakers, and live and pre-recorded webinars, all attracting CPD points. These lectures are complimentary to access and can be watched at your convenience on a variety of devices.

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We also offer ‘How-to Guides’ that are short video tutorials explaining the main features of our ultrasound systems across different scanning situations. This rich video library gives instant access to visual, step-by-step guides that may be viewed, reviewed and re-visited whenever you need to refresh your knowledge. These are now supported by a series of ‘Top Tips’: short five-minute videos, providing key tips for scanning and using a variety of technologies from our experienced and fully qualified Clinical Applications team.

Helping you build strength and resilience for years to come

It is difficult to quantify the value of ongoing clinical education, particularly in view of the huge demands being placed on healthcare professionals right now.

Time is precious, and resource is scarce.

As a provider of clinical diagnostic equipment, it is our stated intention to be the Best Customer Partner across all diagnostic imaging modalities. To do this, we are committed to being responsive to the needs of our customers and to provide them with easy access to quality, complimentary education that prioritises their learning.

This supports the individual, in addition to empowering and engaging imaging teams to help underpin service strength and build resilience for years to come. //

"Expected a high level and was not disappointed! The smooth transitions between the moderator and speakers was great.

Sonographer, St Mary's Hospital, London.

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Our Premises Across the UK 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

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3

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5

1

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PRODUCT // MAGNETIC RESONANCE IMAGING // Vantage Fortian

The Vantage Fortian MRI system has been designed to move patients more efficiently through diagnostic imaging appointments, from waiting-room to scan-room to home.

New MRI Scanner Aims to Deliver Workflow and Productivity Fortitude to UK Healthcare AI-assisted imaging and automation features will help reduce the time required for MRI procedures.

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new MRI system designed to move patients more efficiently through the diagnostic imaging journey, from waiting-room to scan-room to home, has been introduced into the UK healthcare marketplace. The Vantage Fortian MRI scanner from Canon Medical Systems UK features innovative workflow solutions, image enhancement and accelerated scan technology, which together contribute to reducing the time required for procedures.

The Fortian MRI builds on Canon Medical’s range of ‘AI-assisted’ diagnostic imaging solutions. It incorporates machine learning and deep learning technology to enhance image quality by removing noise and restoring SNR, automating many scan procedures, and confirming set-up steps to save time and reduce errors.

Using Advanced intelligent Clear-IQ Engine (AiCE) technology, it delivers noise-free images, especially when the procedure needs high-resolution images, highly accelerated scan time, and even both at the same time. AiCE is applicable to all anatomies and covers 96% of all MR procedures for 2D and 3D acquisition.

Everyone recognises that MRI scans generally take longer and require a more complex workflow than other modalities. So, our engineers have been focused on finding solutions that can meet today’s new demands and ensure that MRI facilities and their patients can move more and wait less.”

Workflow challenges

Vanessa Ellis, MRI Manager at Canon Medical Systems UK states, “With productivity and workflow features at its core, the Vantage Fortian is a welcome addition to our range of MRI systems. In a climate of quicker, easier and closer-to-home appointments for patients, we believe that the Vantage Fortian will provide greater fortitude for clinics, hospitals and community diagnostic centres looking to provide a high standard of care at the same time as speeding up patient throughput.” //

“Vantage Fortian was developed specifically with workflow and productivity in mind,” says Thierry Munier, European Director Magnetic Resonance at Canon Medical Systems Europe. “We have closely observed and listened to radiologists and technologists who face the challenges of ever-increasing patient loads, increasingly complex patient and healthcare system needs, and limited or reduced resources.

Faster throughput

"Vantage Fortian was developed with workflow and productivity in mind."

Thierry Munier, European Director Magnetic Resonance at Canon Medical Systems Europe.

Prostate – HR Anatomical Sequences using Vantage Fortian.

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PARTNERSHIP // MANCHESTER UNITED // Magnetic Resonance, Ultrasound, Computed Tomography, AiCE

Manchester United, mens first team playing against Arsenal in the Premier League 2022.

Manchester United Extends Imaging Partnership Canon Medical Systems and Manchester United are celebrating ten years of sports medicine and imaging partnership by extending their agreement, ensuring the continued provision of specialist diagnostic imaging equipment, supporting proactive and reactive imaging delivery for its professional male and female footballers.

S

ince 2013 Canon Medical Systems’ equipment at the Club’s Carrington Training Complex has ensured the continuity of specialist cardiac, musculoskeletal (MSK) and general sports medicine using the most advanced systems available. As part of the partnership extension Canon Medical Systems will provide upgrades to the existing range of Healthcare IT (HIT), CT, MRI and Ultrasound diagnostic imaging systems to advance the level of care that can be provided to players and enhance ongoing research projects that will benefit wider global patient communities.

Altivity, Canon Medical’s deep learning & machine learning AI powered technologies, will be included in the upgrade to the existing Vantage Galan 3T MRI via Canon Medical’s Advanced intelligent Clear-IQ Engine (AiCE).

This will improve the clarity and detail in the resulting image outputs providing a greater level of information for sports medicine interpretation and clinical decision making. The ability to combine 2D and 3D Compressed SPEEDER will further accelerate the speed of MRI scanning, giving swift imaging results.

AiCE offers the clarity and quality that can, in some cases, be comparable to that of high-end 7 Tesla systems.

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“Together, for over a decade, we have helped support proactive and reactive imaging for injury prevention, identification and rehabilitation" Mark Hitchman, Managing Director of Canon Medical Systems UK

Sequence enhancements for improved MRI workflow will also be applied to improve the acquisition of dynamic, high-quality images. The Vitrea Enterprise system will be enhanced with cutting edge MRI image analysis software packages as well as an MRI and Ultrasound fusion navigation package helping to examine muscle and tendons simultaneously improving the understanding of MSK injuries.

Mark Hitchman, Managing Director of Canon Medical Systems UK states, “This extension to our capacity as ‘Official Medical Systems Partner’to Manchester United will take our long-term relationship to even greater depths.

Together, for over a decade, we have helped support proactive and reactive imaging for injury prevention, identification and rehabilitation to help have a positive impact on player availability and care.”

He continues, ”Key advancements that the imaging systems have helped expand include the important introduction of annual cardiac screening of all players from the Academy youth teams upwards to proactively check for heart abnormalities, which is essential for elite athletes under high physical pressure to pre-empt, for example, sudden cardiac arrest. Also included is a programme of exploratory work into diagnosing and monitoring for

Chronic Traumatic Encephalopathy (CTE), a brain condition that can be caused by repeated blows to the head and repeated concussion; and finally further research projects with academia to develop knowledge beyond sports into areas such as congenital heart disease. The success of these initiatives is reliant on harnessing the power and productivity of medical imaging innovations.”

Victoria Timpson, CEO of Alliances and Partnerships at Manchester United states, Player care and performance is incredibly important at Manchester United, across all of our teams and age groups, so having a partnership with a leading medical systems innovator who understands this and can deliver the most advanced range of diagnostic imaging systems is a huge advantage. By continuing our relationship with Canon Medical Systems, we can ensure our men’s, women’s and academy players have access to the very best standard of care from the most advanced medical systems on the market at our on-site dedicated Medical Imaging Centre, the Carrington Training Complex.” //

“Player care and performance is incredibly important at Manchester United across all our teams and age groups" Victoria Timpson, CEO of Alliances and Partnerships at Manchester United Vantage Galan 3T MRI situated at Carrington Training Complex.

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INTERVIEW // HEALTHCARE IT // Automation Platform, Neurology, AiCE, AI, Altivity, ICH, LVO, CT Brain Perfusion

VISIONS spoke with Dr. Anton Meijer, Neuroradiologist, (Right) and Dr. Ruud Becks, Radiologist (left), at the Radboudumc in Nijmegen, the Netherlands.

Exploring the Potential of AI for Clinical Practice Radboud University Medical Centre (Radboudumc) in Nijmegen, the Netherlands, has been at the forefront of medical imaging for decades. With a strong team of experts, its Department of Medical Imaging leads the world in many elements of research across all imaging modalities. Over the years, it has worked together with Canon Medical in evaluating new technologies and techniques. Most recently, it’s Diagnostic Image Analysis Group (DIAG) has been involved in the development and implementation of advanced imaging techniques that feature AI-solutions, in collaboration with Canon Medical. Dr. Anton Meijer, Neuroradiologist, and Dr. Ruud Becks, Radiologist, explain what their evaluation of Canon’s Automation Platform has already shown.

Focus on stroke

Alongside clinical work, the neuroradiologists at Radboudumc collaborate on research projects to study various neurovascular and neurodegenerative diseases with clinical partners in Neurology and Neurosurgery Departments. One key focus is on the use of advanced neuroimaging tools to improve detection, diagnosis, and treatment of stroke.

In acute stroke, imaging needs to be performed and interpreted immediately, so that the right

treatment for each patient can be determined and implemented fast.

“In a stroke center such as ours, a 24/7 service is needed for a fast and accurate diagnostic work-up of patients presenting with an acute neurological deficit.

This is necessary to identify treatment pathways and improve the clinical outcome for individual patients,” explained Dr. Becks. “However, this puts a great demand on our neuroradiology service, with the need for advanced imaging techniques, such as brain CT perfusion and 4D-CTA.”

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Left: Dr. Ruud Becks, Radiologist, Radboudumc.

Right: Dr. Anton Meijer, Neuroradiologist, Radboudumc.

Potential for powerful processing

The greatest demands in acute stroke imaging workflow concern the automated processing of brain CT perfusion, and in supporting the detection of intracranial hemorrhage and large vessel occlusions. Timely and adequate treatment in stroke is crucial to achieve vessel revascularisation as soon as possible and to minimalise the extent of brain tissue damage.

Radboudumc carries out specialist neuroimaging techniques which are made possible through the Centre’s Canon Medical CT systems, including an Aquilion ONE / PRISM Edition wide-detector CT, and an Aquilion Precision high-resolution CT scanner.

“Our Canon CT systems enable us to perform state-of-the art, dynamic, and high resolution imaging of

neurovascular anatomy and pathology,” said Dr. Meijer. “And with a dedicated Vitrea Advanced Visualization workstation for data-processing, we can read these advanced imaging studies easily. Deep learning based image reconstruction (AiCE) is routinely used in our clinical practice, and contributes to superior imaging quality with lower noise and improved tissue differentiation. This also enables a reduction in radiation dose.”

“Automated processing of brain CT perfusion can offer time savings and provide crucial information in order to confirm the diagnosis of ischemic stroke and to estimate tissue viability,” added Dr. Becks. “Support in the detection of intracranial hemorrhage and large vessel occlusions is of added value in treatment decision-making in the acute setting, especially with regards to intravenous thrombolysis and mechanical thrombectomy.”

“Abnormalities can be subtle but are clinically relevant, e.g. a small amount of hemorrhage, or an occlusion of a smaller middle cerebral artery branch.

There is a great need for workflow support and for making advanced imaging studies easy to read,” remarked Dr. Meijer. “This could be achieved by the implementation of an automated workflow and integration of AI-tools, such as the Automation Platform.”

Promising results

Figure 1: Non-contrast brain CT

Figure 2: Head CTA demonstrating a short

demonstrating a small amount of

segment occlusion of a middle cerebral artery

subarachnoidal hemorrhage in

branch on the left side. The Automation

the central sulcus on the right side.

Platform could aid in the detection of such

The Medical Imaging Department is currently evaluating Canon’s Automation Platform (AP) for CT and has found it so promising that it is planning to implement it into its clinical workflow.

a vessel occlusion, which is of clinical relevance as this would be target for mechanical thrombectomy.

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“We anticipate a faster and improved workflow in acute stroke imaging with

Automation Platform, Powered by Altivity Canon Medical’s Automation Platform (AP) is an AI-based, zero-click solution that uses deep learning technology to streamline workflow for fast, actionable results every time. From scanner to clinical decision, support is provided by leading-edge deep learning technologies that process and deliver images for accurate triage, worklist prioritization and treatment decisions.

the AP, as well as support for the radiologist in making the correct diagnosis and to aid the clinicians in treatment decision-making,” said Dr. Meijer.

Data sharing and cross-hospital workflow are of equal importance in order to facilitate treatment decision-making.

“Quick access to the imaging studies is important for the neurologists and

neuro-interventionalist for the decision to treat the patient with intravenous thrombolysis, or to transfer the patient to the angio-suite for mechanical thrombectomy,” explained Dr. Meijer.

“Efficient communication with exchange of imaging studies between hospitals is of relevance for the decision whether or not to transfer a patient to a specialized stroke center.”

“Canon’s AI-tools provide key information for worklist prioritization

Figure 3: Brain CT perfusion of the patient in Figure 2 demonstrating a perfusion deficit in the left hemisphere with a pattern of infarct core with surrounding penumbra.

In parallel with the AP, Canon has developed the Stroke CT Package - a suite of AI-based applications designed to streamline strokerelated workflow. By automatically consolidating results into a single summary and alerting for abnormalities, the AP helps to support fast triage to facilitate treatment decisions. The Stroke CT Package helps the specialist to swiftly analyze and evaluate images, and detect the signs of ischemic and/or hemorrhagic stroke in minutes. This ‘one-stop’ solution provides access to information required to administer life-saving treatment for patients.

and to support the radiologist in reading the CT studies. We particularly like the AP’s Insight Results which provide a quick and clear overview of the imaging findings of NCCT, CTA, and CT perfusion,” added Dr. Becks.

“A unique perfusion algorithm is now also available with AP - Bayesian perfusion. This is a probabilistic estimation of the perfusion values and is also delay insensitive. This computation method is less sensitive to noise and enhance the diagnostic liability of ischemic stroke detection.

In addition, the Bayesian method can be combined with the AI based image reconstruction algorithm 'AiCE' from the acquisition side to reduce the noise even more,” said Dr. Meijer.

“The Bayesian algorithm provides superior quality CT perfusion maps, with excellent differentiation between grey and white matter structures.

It has been demonstrated that it can be reliably used for patient selection

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“We anticipate a faster and improved workflow in acute stroke imaging with the Automation Platform, as well as support for the radiologist in making the correct diagnosis and to aid the clinicians in treatment decision-making.”

Dr. Anton Meijer, Neuroradiologist, Radboudumc.

based on tissue viability estimates, which is of relevance in the extended time windows (up to 24 hours after onset of symptoms).”

Easy-to-use

The added value of ease-of-use provided by the AP is potentially highest for less experienced colleagues, such as general radiologists and radiologists in training.

“Automated detection of pathology on imaging studies can also support worklist prioritisation, where a study is highlighted when an abnormality is detected. These studies can be read with priority by the radiologist,” remarked Dr. Meijer.

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“The initial test feedback from the radiologists who are experienced in stroke imaging is that the AP is really easy and intuitive to use and requires little training. These aspects are important and will be tested further as we roll out the solution to other staff who will use the solution in earnest in a clinical setting,” said Dr. Meijer. “It is crucial that the AP is implemented in clinical practice, so we can share our ‘real-world’ experiences.”

Managing expectations

It is important that users are well instructed about the intended use of an AI-tool in order to manage expectations.

Dr. Anton Meijer is a radiologist at the Department of Radiology of Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands, with specialization in neuro-, head and neck, and emergency radiology. He participates in clinical and research projects in imaging in neurovascular and neurodegenerative diseases.

“For example, the LVO-detection tool is trained for the detection of large vessel occlusions in the anterior circulation on conventional CT angiography.

This means that distal vessel occlusions, and vessel occlusions in the posterior circulation (e.g. basilar artery thrombosis) cannot be detected by the AI-tool. Therefore, the AI-tool does not replace the CT angiography evaluation by a radiologist, and does not replace the radiologist supervising a resident.

The results of the AI-tool need to be verified by the radiologist, and should be overruled in case of a false-negative or false-positive result,” said Dr. Meijer.

“The end-users should be familiar with the fact that AI-models can fail to generalise when applied in clinical practice with heterogeneous populations and imaging protocols, which can result in a lower than expected diagnostic performance.

Furthermore, interaction with

“ Automated processing of brain CT perfusion can offer time savings and provide crucial information in order to confirm the diagnosis of ischemic stroke and to estimate tissue viability.”

Dr. Ruud Becks, Radiologist, Radboudumc.

Dr. Ruud Becks is a Radiologist at the Department of Medical Imaging of the Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. He is currently completing a fellowship in neuroradiology with special interest in neurovascular imaging and protocol optimization. In cooperation with Dr. Anton Meijer, Dr. Becks is involved in the evaluation of different AI-solutions in Stroke.

The new entrance of Radboudumc.

existing systems and human-AI interactions may provide different results than reported performance based on prior validation studies. It is therefore advised that the usage and the performance of the Automation Platform is monitored, to ensure that it meets the demands of the users and to further improve its performance and to incorporate new imaging features (e.g.

ASPECTS and collateral scores).”

Over the last decade, the Medical Imaging Department at Radboudumc has developed a close collaboration

with Canon Medical Systems in the development and clinical implementation of new hardware and software imaging solutions, mainly in the field of CT. These are applied to different organ systems, including the abdomen, thorax, musculoskeletal and brain, in collaboration with clinical and preclinical experts in the field.

“Our primary focus has been evaluating the Stroke CT Package in the AP, but there are great opportunities to integrate a similar workflow for other

organ domains, such as cardiovascular imaging, traumatology, and oncological follow-up,” said Dr. Meijer. “I think one thing to recognise is that AI is going to change practice and I think in neuroradiology, acute stroke is one of the main subjects in which AI will definitely contribute. In the end, I think it will really improve the speed and the quality of the diagnosis in acute stroke, but will not replace the radiologist.” //

This article is a reprint of the European VISIONS Magazine edition #39

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PRODUCT // DIAGNOSTIC X-RAY // Ultimax-i

Leeds Children’s Hospital has successfully gone live with the new Ultimax-I from Canon Medical Systems UK. Emily Keyte, Radiology Team Manager.

Leeds Children’s Hospital Opts for Ultimax-i for Paediatric Precision Transition to new radiography/fluoroscopy system cited as ‘easy’.

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he precision of paediatric fluoroscopy examinations at Leeds Children’s Hospital, one of the UK’s largest specialist hospitals for children from birth to young adults, has been enhanced by the installation of a new multi-directional C-arm from Canon Medical Systems UK. The Ultimax-i replaced an end-of-life system from a different vendor and has delivered upgraded and diverse functionality for a range of paediatric examinations.

Emily Keyte, Radiology Team Manager for General and Paediatric Radiology at Leeds Teaching Hospitals NHS Trust

states, “The Ultimax-i is a valuable new addition to our range of diagnostic imaging tools serving patient referrals from across Yorkshire. It is predominantly used for paediatric fluoroscopy examinations which include contrast swallows, micturating cystograms and non-GA paediatric interventional examinations. Its light-beam diaphragm functionality is key for us, ensuring precision in centring and collimation for our paediatric patients. The new ability to do ‘Fluro Loops’ allows us to review and store dynamic fluoroscopy sequences directly through PACS to support regional video fluoroscopy services.

“Light-beam diaphragm functionality is of note for us, ensuring precision for our paediatric patients.”

Emily Keyte, Radiology Team Manager for General and Paediatric Radiology at Leeds Teaching Hospitals NHS Trust.

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The precision of paediatric fluoroscopy examinations at Leeds Children’s Hospital has been enhanced by the installation of a new multi-directional Ultimax-i from Canon Medical Systems UK. Pictured L to R: Dr Imran Kasli, Paediatric Consultant Radiologist, Emily Keyte, Radiology Team Manager, Ruth Rowe, Canon Account Manager, Dan Brearley, Canon Clinical Applications Specialist, Sophie Hardy, Radiographer and Daisy Barker, Radiographer.

"It is our aim to deliver innovative new functionality smoothly and instantly to benefit patients receiving treatment, and for the staff operating the systems."

Ruth Rowe, Account Manager at Canon Medical Systems UK.

Optimum image quality

The virtual collimation on the Ultimax-i provides optimum image quality and dose limitation. It comes as part of the DoseRite suite of dose management technologies designed to minimise patient X-ray exposure at the same time as maintaining optimum image quality. The large flat panel detector generates 4 field-of-view levels, fine pixel pitch and high signal-to-noise ratio whilst ensuring low-dose patient coverage and high-resolution imaging for improved visualisation.

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Emily Keyte continues, “In addition to refreshing our fluoroscopy and radiography capabilities with the Ultimax-i, Canon Medical UK worked in partnership with our wider team on the room re-modelling.

This included the introduction of comforting sensory lights to provide a calm, ambient environment for patient examinations of all ages.

Furthermore, the training provided

by Canon Medical UK on the new system was great – it was easy to understand and is an intuitive system to use."

Ruth Rowe, Account Manager at Canon Medical Systems UK adds, “It is really pleasing to hear that the Leeds Children’s Hospital team has transitioned easily to Canon Medical UK having worked with a different system for many years. It is our aim to deliver innovative new functionality smoothly and instantly to benefit patients receiving treatment, and for the staff operating the systems. Our proven mix of in-person apps training and online knowledge accessed through the Medical Imaging Academy is part of this successful handover process.” //

INTERVIEW // ENVIRONMENTAL, SOCIAL AND GOVERNANCE // Sheffield Hatters

Canon Medical UK Backs Sheffield Hatters to Champion Girl Power Female basketball team, the latest regional sporting organisation to benefit from philanthropic funding to activate community & wellbeing initiatives.

C

anon Medical Systems UK has announced a new Corporate Social Responsibility (CSR) initiative with its sponsorship of a community focused organisation promoting sports, health and wellbeing. Sheffield Hatters, a semi-professional female basketball team, is run by volunteers and ranks third in the women’s British Basketball League. It has been provided with financial support to go towards funding its role-model initiative where elite players support local schools with

basketball coaching, run inter-school tournaments and provide teams for local young women.

This new sponsorship complements Canon Medical UK’s existing sports and community fusion initiative with Sheffield Sharks, the men’s professional basketball team in Sheffield. This will ultimately see both basketball organisations move to a new permanent home in 2023 at the Park Community Arena developed by Canon Medical UK.

Sporting pioneers

“Sheffield Hatters Basketball Club has been a pioneer in women’s sport since its inception as the first female basketball team 60 years ago,” states Mark Hitchman, Managing Director of Canon Medical Systems UK. “It is the most successful basketball team in the UK with over 65 titles with both players and coaches going on to represent Great Britain and England on the international stage. By extending our support of diverse community programmes we hope to help a wide range of women between the ages of 6 to over 60 to feel part of an inclusive sporting family. This will empower more people into sports to increase levels of activity for mental and physical wellbeing.”

“Sheffield Hatters Basketball Club has been a pioneer in womens sport since it's inception."

Mark Hitchman, Managing Director of Canon Medical Systems UK. Betty (bottom right, holding the trophy), founder of Sheffield Hatters in 1961, with one of the original Hatters team in the 1960s.

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“Giving them belonging, helping them to take positive paths in life and encouraging them to embrace the feel-good factor that basketball can bring.”

Sarah McQueen, Charitable Trustee at Sheffield Hatters.

Sarah McQueen, Charitable Trustee at Sheffield Hatters states, “We are so very grateful for the sponsorship from Canon Medical UK. We are a voluntary-run basketball team with many of our players working full time in addition to playing basketball at an elite level. All financial support we receive goes straight into encouraging young women to try basketball or

Under 12s team. As a team the under 12s will compete in local central venue leagues that run monthly.

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become part of the extended ‘Hatters Family’. Our sporting community has a strong role-model ethos at its core, which has helped thousands of young girls and women over the years, giving them belonging, helping them to take positive paths in life and encouraging them to embrace the feel-good factor that basketball can bring.” //

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, face to face 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.

Medical Imaging Academy

VISIONS 07 // 51

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INTERVIEW // MULTIMODALITY // AI, CT, MRI

AiCE, the world’s first MR Deep Learning reconstruction technology, producing stunning MR images that are exceptionally detailed and with low-noise properties.

Canon Medical UK steering the Path from AI-Assisted Imaging to AI-assisted Diagnosis Solving the challenges in healthcare with faster, confident decision making.

A

I in clinical diagnostic imaging practice began with the introduction of Canon Medical Systems UK’s AI-assisted imaging, firstly through CT, and now MRI, using a Deep Learning reconstruction AI algorithm called Advanced intelligent Clear-IQ Engine (AiCE).

This differentiates ‘noise’ from true signal to clean up images resulting in high-quality scans free from distortion. It 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 for CT. It is now being used by dozens of hospitals across the UK bringing benefits to patients.

“Artificial Intelligence in imaging is about solving many of the

challenges in modern healthcare.

This includes providing the tools to help clinicians make confident decisions faster when faced with growing backlogs; to help simplify workflows that can optimise staffing and equipment resource deployment; and about reducing the stress and exhaustion on health professionals,” states Mark Hitchman, Managing Director at Canon Medical Systems UK.

Speed and Accuracy

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 stated, “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.”

At Wycombe Hospital, part of Buckinghamshire Healthcare NHS Trust, the Deputy Lead MRI Radiographer gave feedback on The AI-assisted MRI 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.”

“Artificial Intelligence in imaging is about solving many of the challenges in modern healthcare.”

Mark Hitchman, Managing Director at Canon Medical Systems UK.

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“Great strides are being made on the visionary future of AI." Mark Hitchman, Managing Director of Canon Medical Systems UK

Gathering up data to teach AI and cement its place in daily clinical practice

“Great strides are being made on the visionary future of AI,” continues Mark Hitchman. “Behind every deeplearning innovation there is lots of data - this is what builds the algorithms and feeds the machines with knowledge.

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 turning great AI ideas into daily clinical practice reality. 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. 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.”

He continues, “Canon Medical UK is very proud to have a home-grown hub of AI research and development via Canon Medical Research Europe based 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.” //

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Excellent image quality with CT AiCE Deep Learning Reconstruction relative to Hybrid IR approaches – lower noise, finer grain size, and sharper images.

AiCE, the world’s first MR Deep Learning Reconstruction technology, producing stunning MR images that are exceptionally detailed and with the low-noise properties you might expect of a high SNR image.

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INTERVIEW // COMPUTED TOMOGRAPHY // Aquilion ONE / PRISM Edition, Dinosaurs

In the photo: Canon Medical's Aquilion ONE / PRISM Edition.

Scanning a part of a 125 million-year-old dinosaur’s skeleton.

Unveiling the Secret Life of Dinosaurs with Latest CT Techniques Canon Medical is helping a team of researchers in Belgium examine a 125 million-year-old dinosaur’s skeleton, offering unique insights into the behavior and health of those ancient animals who mysteriously disappeared 66 million years ago.

Dinosaurs were fierce creatures who roamed the Earth over 200 million years ago. But just as most other life forms on this planet, they had their share of diseases, including cancer, infections, and maybe even common arthritis, a researcher at the Belgian Museum of Natural Sciences in Brussels believes.

Paleontologist Filippo Bertozzo is in charge of digitalising the museum’s impressive dinosaur collection, which includes 30 iguanodons excavated in a coal mine in Bernissart close to the

border with France nearly 150 years ago. Bertozzo is investigating one of the largest specimens of the group, a seven-meter long individual presenting with an unusual set of vertebrae.

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“With dinosaurs, we only have bone, there’s no blood, muscle or genome.

Sometimes, with an inner view with MR, CT or another medical imaging method, we can get new information.”

In a recent interview with VISIONS, Bertozzo explained how he first came across the odd piece when working on his PhD a few years ago. "I studied dinosaurs’ lesions, pathologies, tumors and infectious diseases, especially in animals connected with Iguanodons, those large herbivorous dinosaurs who lived in the Lower Cretaceous," he recalled. "I noticed a specimen who presented with a potentially very interesting disease in two vertebrae.

Instead of being separated, as they usually should, the vertebrae were encapsulated in a bony overgrowth below the vertebral body." Back then it was impossible to take the piece without dismantling the whole skeleton. But now with his new role at the Brussels museum, Bertozzo has been able to further investigate this curious anatomic part. He also met with Anne Schulp, Professor of

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Vertebrate Paleontology at Utrecht University and researcher with Naturalis Biodiversity Center in Leiden, the Netherlands who regularly cooperates with Canon Medical and uses the facility in the headquarters in Zoetermeer, The Netherlands.

Prof. Schulp contacted John van Gulik, European Clinical Market Manager CT at Canon Medical Systems Europe, who invited the young researcher to image the piece on the Aquilion ONE / PRISM Edition scanner in Zoetermeer. The interpretation of the CT scan will help Bertozzo confirm his suspicions.

"I still have to get to the bottom of it, but I think it’s arthritis spondylitis," he said. "Imaging expands the possibilities for paleontologists to understand what happened to a dinosaur and make a more accurate diagnosis.

Most of the time, we need to have an internal view of the disease. With dinosaurs, we usually have only bone, there's no blood nor genome, and soft tissues are extremely rare. Bones from the outside don’t always tell you what the pathology was. Sometimes, with an inner view with MR, with CT or another medical imaging method, we can get new information."

Potential impact in paleontology

"The new results could help improve our understanding of dinosaurs’ lifestyle, which remains elusive to this day," Bertozzo explained. "Behavior has always been in the realm of speculation because we only had fossils and you can’t understand how dinosaurs lived only with bones.

But now with paleopathology, we’re starting to have more and more data that give us more clues."

From left to right: Pascal Godefroit (Operational Director “Earth and History of Life”, Belgium Museum of Natural Sciences, Brussels), Anne Schulp (Professor of Vertebrate Paleontology Utrecht University and researcher Naturalis biodiversity Center, Leiden, The Netherlands), Ravi Somaroe (European Clinical Specialist CT, Canon Medical Systems) and Filippo Bertozzo (Paleontologist, Belgium Museum of Natural Sciences, Brussels)

For example, researchers recently found out that Triceratopses, the famous three-horned dinosaurs, were sparring against each other just as rhinoceroses do. "Pathologists found fractures and perforations in the shields made by other specimens’ horns." .

Researchers now know that the Pachycephalosaurus, a dinosaur who had a very thick head, was head-to-head fighting with his peers, just like sheep or other animals with horns or antlers.

“Paleopathology is fascinating.

It’s a photograph in the ancient life of these dinosaurs.”

Recent research has also shown that Tyrannosauruses were biting each other in the lower jaw, possibly for mating or territoriality. Bertozzo’s findings will add to the already amazing story of the Bernissart Iguanodons’ fossils, which miners first took for gold due to the formation of pyrite, a shiny, yellow mineral that formed on ancient worms after their deaths and preserved

fossils while giving them a gold-like appearance - a phenomenon commonly known as fools’ gold.

The Bernissart Iguanodons have a special place in paleontology history and they are regarded as the first significant discovery in terms of our perception of those mysterious creatures.

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John van Gulik (European Clinical Market Manager Computer Tomography) analysing the acquired CT images of the vertebrae.

“Behaviour has always been in the realm of speculation because we only had fossils. But now with paleopathology, we’re starting to have more and more data that give us more clues.”

"Before the Bernissart dinosaurs were found, people didn’t really have a precise idea of what dinosaurs looked like," Bertozzo explained. "They had found dinosaur scatter material in England before, but Belgian dinosaurs are a bit more important in the realisation of what they were.

Paleopathology is fascinating, a photograph in the ancient life of these dinosaurs." There’s no doubt that Canon Medical can help push future advances in that field. //

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Filippo Bertozzo is a paleontologist and scicommer. He is currently working at the Royal Belgian Institute of Natural Science (RBINS) as a postdoc researcher on the BRAIN-BELSPO project, aiming to digitize the holotype of Iguanodon bernissartensis and the skeleton of Mantellisaurus atherfieldensis.

In 2009, Bertozzo enrolled at the course of Natural Sciences at the University in Bologna, and joined his first dinosaur expedition with Dr. Fabio Marco Dalla Vecchia and the Institut Català de Paleontologia in the Tremp Basin on the Pirenei Mountains, digging Maastrichtian hadrosaurids. He was later offered the possibility to review the Ouranosaurus skeleton, the same dinosaur that had triggered his interest in paleontolgy as a child, for his thesis.

After graduating, he enrolled at the Organismic Biology, Evolution and Paleobiology (OEP) Master Program in Bonn, Germany under the supervision of Prof. Martin Sander. His Master’s thesis focused on the paleohistological analysis of pneumatized bone in sauropod dinosaurs, in which he identified a new soft-tissue called “pneumosteum”. With Prof. Sander, he joined an expedition to the Nevada Desert in 2015, digging and moving the skeleton of a giant ichthyosaur found some years before in the Augusta Mountains. Recently, this skeleton has been described as Cymbospondylus youngorum.

After one year spent as a researcher at the Vrije Universiteit Brussels, Belgium Filippo moved to Belfast, Northern Ireland, to complete his PhD program on ornithopod paleopathology with Prof. Eileen Murphy, Dr. Alastair Ruffell and the external supervision of Dr. Pascal Godefroit from RBINS. His project, founded by the Marie-Curie Horizon 2020 Program, aimed to build a large database of fossilized lesions and diseases from the ornithopod collections of several museums. He completed his doctoral degree in September 2021.

He had the privilege to study the famous skeleton of Parasaurolophus walkeri exhibited in Toronto, suggesting that the peculiar morphology of his back was caused by a traumatic impact with an external object. Through their analysis, Bertozzo and his team were able to reconstruct the neck morphology of the species and the other hadrosaurs, proving the potential of the field of paleopathology.

3D Global illumination and Sagittal MPR of the vertebra of the Iguanodon Dinosar clearly showing the fused vertebrae and Pyrite degradation.

Visit the website of the museum.

This article is a reprint of the European VISIONS Magazine edition #39

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