UK Edition // No. 5 // December 2021

MAGAZINE FOR UK HEALTH PROFESSIONALS UK Edition // No. 5 // December 2021

The Gateway to On-Demand Knowledge 24 // THE MEDICAL IMAGING ACADEMY

Birmingham 2022 Commonwealth Games Supporter

AI-assisted MRI at High Wycombe Hospital

Cardiac Collaborations in the Sporting Spotlight

12 // PARTNERSHIP

22 // MR

42 // SPORTS MEDICINE

When time is precious, knowledge is key. This is the philosophy behind the newly refreshed online Medical Imaging Academy by Canon Medical Systems UK, delivering a myriad of CPD accredited training, education and problem-solving content to customers and wider industry.

Canon Medical Systems Service Department Opening Hours Christmas and New Year 2021 / 2022 08:00 – 20:00 Normal working hours 20th – 23rd December 2021 08:00 – 16:00 Office opening hours 24th December 2021 25th December 2021 Closed 09:00 – 17:00 Emergency weekend support only 26th December 2021 09:00 – 17:00 Bank Holiday telephone support plus CT SOS 27th – 28th December 2021 09:00 – 20:00 Office opening hours 29th – 30th December 2021 09:00 – 17:00 Office opening hours 31st December 2021 09:00 – 17:00 Emergency weekend support only 1st – 2nd January 2022 09:00 – 17:00 Bank Holiday telephone support 3rd January 2022 08:00 – 20:00 Normal hours resume (Scotland Bank Holiday) 4th January 2022

The 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 Edition, Aquilion Prime SP, Aquilion ONE / GENESIS Edition, Aquilion Lightning, Alphenix, Xario, Vantage Orian, Vantage Elan, Vantage Galan, Aquilion, Aquilion ONE, 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 https://uk.medical.canon/ marketing@uk.medical.canon

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

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

Design and Layout Deep deep.co.uk

© 2021 by Canon. All rights reserved.

Follow us:

2 // VISIONS 05

// EDITORIAL

A warm welcome to VISIONS UK readers

In this issue we focus on the benefits of the online Medical Imaging Academy. We know that your time is precious, even more so as we head into winter with its associated pressures, so our online, 24/7 and complimentary library resource is here to help as a guiding light. With how-to guides, live and on-demand education, plus a wide range of detailed information, it will assist and support knowledge building when you need it most.

Collaborating closely is at the heart of what we do. So, we will also update you with news and views from all our imaging modalities, plus highlight some of the latest partnerships that we have been involved with.

We’re delighted to have been appointed ‘Official Imaging Supporter’ for the Birmingham 2022 Commonwealth Games.

This builds on a decade of sports medicine partnerships and will involve the creation of three specialist Sports Imaging Hubs to provide early detection, prevention and faster rehabilitation of sports injuries. Interestingly these diagnostic imaging hubs closely resemble what we have recently come to know as Community Diagnostic Centres (CDC), so this event is also a great opportunity to see how we can deploy - in extremely short time - fully functioning diagnostic suites into the community.

We have also been involved in the launch of a new ‘Mobile Cardiac Laboratory’ in partnership with Professor Guido Pieles, The Institute of Sport Exercise & Health (ISEH), plus HCA Healthcare Ltd. It will be available to all athletes at Birmingham 2022 and is also currently being used at sporting events to provide specialist cardiac performance evaluations using ECG and 4D echocardiography diagnostic ultrasound. In fact taking imaging out to the community, generally, is very much on-point right now.

Just as we can’t predict the weather, we still really don’t know the impact COVID will continue to have on UK healthcare.

But we can be ready to adapt to what comes our way. This may mean thinking differently and innovating quickly. An excellent article in this issue champions just that attitude and gives food for thought on how to renew our energies to face the unexpected and pull together in adversity.

I hope you draw strength from this issue and take away some ideas of how innovation can help overcome some of the greatest challenges that continue to face UK healthcare.

We continue to be by your side,

MARK HITCHMAN Managing Director Canon Medical Systems UK

VISIONS 05 // 3

// CONTENTS

08

Sky is the Limit INTERVENTIONAL X-RAY

03

A Warm Welcome

06

News

08

12

16

18

NEWS

Sky is the Limit INTERVENTIONAL X-RAY

Canon Medical Systems UK off the Starting Blocks for Birmingham 2022 Commonwealth Games

12

Canon Medical Systems UK off the Starting Blocks for Birmingham 2022 Commonwealth Games PARTNERSHIP

PARTNERSHIP

Deep Intelligence CT to Support Cardiac Caseload COMPUTED TOMOGRAPHY

The Radiology Quest

MULTI-MODALITY

22

24

30

MRI High Wycombe MAGNETIC RESONANCE

Unlock Knowledge, Anytime, Anywhere MEDICAL IMAGING ACADEMY

Our Premises Across the UK SUPPORT

32

A Green Guide for UK Diagnostic Imaging

CSR REPORT

38

Collaboration in Precision Biopsy Research Aims to Improve Cancer Care Patient Pathways

ULTRASOUND

18

The Radiology Quest MULTI-MODALITY

4 // VISIONS 05

32

A Green Guide for UK Diagnostic Imaging CSR REPORT

42

Cardiac Collaborations in the Sporting Spotlight SPORTS MEDICINE

42

Cardiac Collaborations in the Sporting Spotlight

SPORTS MEDICINE

46

Keeping You...

Running Always

SERVICES

48

A Seamless Transition that Boosts Productivity

MAGNETIC RESONANCE

52

Future-Proofing Imaging Capacity

COMPUTED TOMOGRAPHY

56

Intelligent Healthcare Made Easy

AI

52

Future-Proofing Imaging Capacity

58

A Vision for the Future Inspired by Challenges of Today

COMMERCIAL SOLUTIONS

COMPUTED TOMOGRAPHY

© 2021 CANON MEDICAL SYSTEMS

VISIONS 05 // 5

// NEWS Meet Canon Medical Systems UK’s Newest Member – Support Dog Conan Canon Medical UK and Support Dogs are continuing an invaluable partnership, as the company sponsor Support Dog puppy Conan through his next two years of training.

So, who are Support Dogs?

They are a charity who provide specialist dogs to support families affected by autism, epilepsy or a wide range of medical disabilities. This includes: 1.2 million hours of assistance to individuals across the UK, reducing 93% of care needs within the last year, changing 94% of their lives for the better, helping to save the NHS millions of pounds through this charity – just to name a few of the incredible benefits this charity provides.

What does Conan’s journey look like?

For the next 14 months, he will be living with his puppy socialiser, as he starts his long journey to becoming a lifesaving support dog for someone with epilepsy, autism or a physical disability. During this time, Conan’s schedule includes getting used to his surroundings, building confidence, learning to be independent, exposure to traffic, whistle training, as well as enjoying some toy time and play with his socialiser family.

Want to learn more about this partnership? Scan here.

Carbon Zero Heroes – Solar Panel Fundraising Project 2 Between 2020-2021, Canon Medical UK have been working closely with carbon offsetting partner CO2balance, to raise funds for a remote hospital in Uganda for solar panels, which will provide essential electricity for lighting, powering fridges to store vaccines in and more. The employees of CMSUK came together in a series of fundraising events to reach this goal – from one Regional Service Manager cycling over 200 miles from dawn to dusk, to bake sales, raffles and beyond.

With the success of hitting this target, a second solar panel fundraising project has begun. Individuals have already started to support this incredible cause, with an ‘at home pub quiz’, world car free day, recycling week and lots of green initiatives.

Want to find out more and help support this worthy cause? Scan here.

6 // VISIONS 05

Can You Spot The Anomaly?

Gemstone

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 gemstone.

PRODUCT // INTERVENTIONAL X-RAY // Alphenix Sky

(L to R): Jordan Niblock, Senior Radiographer; Bashir Siddiqi, Staff Nurse; Andy Mayes, Clinical Product & Applications Specialist VL/XR, Canon Medical Systems UK; Helena Hill, Interventional Radiology and Fluoroscopy Manager.

Sky is the Limit North Manchester General Hospital selects Alphenix Sky to future-proof its interventional imaging services. Dose and workflow optimisation benefits will help hospital to see more patients

A

n Alphenix Sky ceiling-mounted C-Arm interventional imaging system from Canon Medical Systems UK has been selected by North Manchester General Hospital to replace an incumbent system and steer non-vascular services into the future.

The versatility of the Alphenix Sky will give the interventional team more flexibility of movement and

positioning during examinations with 270° unrestricted access around the patient and 201cm full patient coverage without needing to move the individual or table. The system’s innovative Dose Tracking System will also provide enhanced dose awareness, estimating skin dose in real time and displayed as a 3D colour map on a patient graphic. This helps imaging teams exclude regions of previous high exposure.

VISIONS 05 // 9

An Alphenix Sky ceiling-mounted C-Arm interventional imaging system from Canon Medical Systems UK has been selected by North Manchester General Hospital.

“We’re delighted with the Alphenix Sky – it has broadened the procedures we can do, helped speed up patient throughput and provides much better image quality...”

Helena Hill, Interventional Radiology and Fluoroscopy Manager North Manchester General Hospital

“We’re delighted with the Alphenix Sky – it has broadened the procedures we can do, helped speed up patient throughput and provides much better image quality than we had been used to,” states Helena Hill, Interventional Radiology and Fluoroscopy Manager at North Manchester General Hospital. “We have a long-standing, hugely positive experience with Canon Medical UK so we know that we’ve got a great product and many years of outstanding service support ahead of us to meet our patient service needs.”

“Looking to the future of interventional imaging equipment replacement isn’t only about selecting a system that meets the needs of today, but it is also about thinking ahead to ensure you can evolve with the changing needs of a department and patient cohort,” states Daniel Parr, Interventional X-ray & HIT Modality Manager. “The Alphenix Sky provides versatility and flexibility that will future-proof patient services at North Manchester General Hospital and also has the assurance of Canon Medical’s Apps for Life and Service support teams in the background to keep it running smoothly.”//

VISIONS 05 // 11

PARTNERSHIP // BIRMINGHAM 2022 COMMONWEALTH GAMES // Partnership

Canon Medical Systems UK off the Starting Blocks for Birmingham 2022 Commonwealth Games Specialist Sports Imaging Hubs to be set up at three Birmingham 2022 athlete villages

B

uilding on a decade of sports medicine partnerships to elite sports and premier league football, Canon Medical Systems UK is ramping up plans to provide three specialist ‘Sports Imaging Hubs’ to athletes and their support teams at the Birmingham 2022 Commonwealth Games.

Canon Medical UK will provide the very latest medical imaging modalities including AI-assisted CT and MRI, diagnostic ultrasound and digital radiography X-ray with full health IT connectivity to the NHS Trust supporting the event, or to preferred sports medicine clinicians overseas.

The Sports Imaging Hubs will provide early detection, prevention and faster rehabilitation of sports injury and surveillance. They will be located at three locations for three weeks across the Birmingham 2022 Villages to support over 4,500 athletes and their support staff.

A newly launched ‘Mobile Cardiac Laboratory’ by Professor Guido Pieles, the Institute of Sport, Exercise & Health, HCA Healthcare Ltd and Canon

Medical UK will also be available to athletes at Birmingham 2022.

It will provide specialised cardiac performance evaluation using ECG techniques and resting and exercise stress 4D echocardiography using Canon Medical’s ultrasound system.

This helps to provide in-depth assessment of cardiac anatomy and function to identify pre-existing cardiac abnormalities and offer advice for optimal sports medicine management and follow-up.

Mark Hitchman, Managing Director of Canon Medical UK states, “The partnership with Birmingham 2022 Commonwealth Games builds on a similar relationship we had at Glasgow in 2014. This time our focus is far more on preventable imaging than pure reactive injury assessment.

Understanding the way the heart works, or identifying weaknesses in cartilage or joints is so important in elite sports as our long-term research with other sporting organisations has shown. This not only safeguards the future health of elite sports people, but it can also assist with training programmes or injury rehabilitation.”

VISIONS 05 // 13

Left to right: Adrian Corcoran, Chief Information Officer, Birmingham 2022 Commonwealth Games, , Ian Reid, Chief Executive Officer, Birmingham 2022 Commonwealth Games, Peter Raper, Commercial Partnerships Project Director, Birmingham 2022 Commonwealth Games and Vice President Major Events and Strategy, Sport Five, Yuichi Ishizuka, President & CEO, Canon EMEA, Ian Watson, Director of Commercial Solutions, Canon Medical Systems Ltd. Mark Hitchman, UK Managing Director, Canon Medical Systems Ltd.

“Understanding the way the heart works, or identifying weaknesses in cartilage or joints is so important in elite sports as our long-term research with other sporting organisations has shown.”

Mark Hitchman, Managing Director of Canon Medical UK He continues, “The most important element of being involved with sports events and organisations is how it can help the wider health systems in the future. A greater understanding of how the body works under pressure is giving clinicians greater insight and knowledge that can be applied to health projects more broadly. It also enables us to refine and develop specialist medical imaging applications that are then utilised by the NHS and

14 // VISIONS 05

other healthcare organisations. This is why every pixel matters to us – because continuous development of medical imaging will help transform the healthcare of the future and enable people to live longer, fuller lives.”

Ian Reid, CEO at Birmingham 2022, said: “We’re delighted to be working with Canon Medical UK as part of their partnership as our Official Imaging Supporter for Birmingham 2022 and

are in no doubt that their industryleading medical imaging technologies will help make the Birmingham 2022 next summer’s biggest sporting event. Using Canon Medical’s global expertise, the Sports Imaging Hubs will be an incredible resource for our athletes to help detect or prevent sports injuries, offering the very latest medical facilities for world-class athletes.”

Under the ‘every pixel matters’ banner, Canon Medical UK will work in synergy with Canon EMEA to provide their exceptional image-quality technologies to support the Birmingham 2022 Commonwealth Games. From cameras to print hardware and medical imaging: every system provided will enhance the clarity of the sporting event. //

Canon Medical Systems UK is ramping up plans to provide three specialist ‘Sports Imaging Hubs’ to athletes and their support teams at the Birmingham 2022 Commonwealth Games.

Mark Hitchman, Managing Director of Canon Medical Systems UK pictured with the official mascot of Birmingham 2022 Perry.

16 // VISIONS 05

PRODUCT // COMPUTED TOMOGRAPHY // Aquilion ONE / PRISM Edition

Deep Intelligence CT to Support Cardiac Caseload Golden Jubilee National Hospital in Scotland selects deep intelligence CT to support cardiac caseload. New generation AI-assisted technology from Canon Medical Systems UK to underpin specialist congenital adult cardiac services

T

he Golden Jubilee National Hospital, a major diagnostic imaging unit and centre of excellence in heart and lung services in Clydebank, Scotland, has updated its cardiac CT scanning equipment. The new Aquilion ONE / PRISM Edition CT scanner with Deep Intelligence replaces a competitor CT system and introduces next generation reconstruction technology to assist with supporting high cardiac imaging caseloads.

The Canon Medical CT scanner includes the Advanced intelligence Clear-IQ Engine (AiCE) that helps to see through imaging noise using Deep Learning Reconstruction AI technology to deliver sharp, clear and distinct images at speed and low dose. It also features a 16cm wide area detector to obtain an entire heart image in a single rotation. It will be used at the Golden Jubilee National Hospital to support routine cardiac imaging work, complex congenital cardiac cases along with a wide variety of general CT examinations and interventional work utilising the newly designed Hybrid Touch Panel Controls.

“We are delighted with the new Aquilion ONE / PRISM Edition CT scanner. It is easy to operate and our radiologists have been delighted with the fantastic quality of cardiac

images at low dose to support our heart and lung patient services,” states Julie Morrison, CT Lead Radiographer at the Golden Jubilee National Hospital. “The CT system met our brief for all specifications. The wide area detector will enable us to obtain an entire heart in a fraction of a second and the AI-technology further enhances the ability to gain low dose, high quality images at speed. We feel ready for the future.”

Lee Simpson, Regional Sales Manager for Scotland and the Northern Region at Canon Medical Systems UK states, “It is great news to welcome a new customer to our UK CT community. We now look forward to supporting all their technical and knowledge development needs into the future to ensure they get the very best return on their CT investment.” //

“...the AI-technology further enhances the ability to gain low dose, high quality images at speed.

We feel ready for the future.”

Julie Morrison, CT Lead Radiographer The Golden Jubilee National Hospital

The Golden Jubilee National Hospital, a major diagnostic imaging unit and centre of excellence in heart & lung services in Clydebank, Scotland, has updated its cardiac CT scanning equipment with a new Aquilion ONE / PRISM Edition CT scanner.

VISIONS 05 // 17

REPORT // MULTI-MODALITY // Adopt and Adapt, COVID-19

The Radiology Quest The COVID-19 crisis has put our NHS under extraordinary pressure. As we move beyond the initial response, which interrupted elective diagnostic services to make way for the surge in COVID-19 patients, the recovery of diagnostic imaging services is now a top priority

H

owever, it is important to acknowledge that imaging services were under pressure before the pandemic took hold. Work had already begun via the NHS Long Term Plan and Transforming Imaging Services initiatives under which NHS Improvement (NHSI) was updating the ageing installed base of CT and MRI scanners. What is new is that in this new climate there is greater emphasis on the urgency for increased capacity and the provision of COVID-secure environments to encourage patients back into the healthcare system and restore service levels.

Adopt and adapt means thinking differently and innovating quickly

Radiology has always been, and will continue to be, a key element of a patient’s journey. It goes well beyond the initial investigation of symptoms, to confirmation of diagnosis, monitoring and the progression of a condition over time. As treatments become increasingly more targeted and sophisticated, the use of both CT and MRI has become routine in patient pathways.

18 // VISIONS 05

Driving innovation and change in the busy healthcare environment is challenging. The day-to-day service delivery in a large organisation continues at pace under extraordinary pressure. To then introduce and adopt new innovation is a significant undertaking. So, what are the key steps that NHS radiology can continue to take to adopt and adapt in this new COVID-era?

Firstly, it is time to think differently; to think beyond the walls of the traditional hospital establishment.

Physical space on the hospital estate has to date been the insurmountable barrier to service expansion.

Today, solutions exist that create new imaging rooms quickly and without causing existing capacity downtime.

This use of mobile, relocatables and community locations will greatly help expansion. For example, 15 relocatable CT units were mobilised

by Canon Medical Systems UK as part of NHS England’s COVID-19 recovery plan, and were placed in unused car parking spaces, ambulance bays or small garden areas.

VISIONS 05 // 19

The CT systems utilise ‘InnerVision’, the remote diagnostics software solution that can predict, diagnose or fix system issues immediately without the need for engineers to visit hospital sites in person. This was particularly useful to keep systems monitored and resolve issues during COVID-19 restricted physical access.

“Year-on-year demand for CT scans has grown significantly and is unlikely to decrease given the changes required in cancer pathways and diagnostic techniques.”

Helen Lancaster, Director of Operations at South Warwickshire NHS Foundation Trust Mark Kon, Consultant Thoracic Radiologist & Clinical Director of Radiology at Bradford Royal Infirmary states, “The relocatable CT scanner allows us to keep ‘Green’ patients (without suspected COVID-19) separate from ‘Red’ (suspected COVID-19 patients), mirroring the cohorting we have on the wards. Although our teams of radiographers were divided into red and green at the start of the

20 // VISIONS 05

pandemic, they shared a common CT control room. Having an entirely separate scan facility means there is much less risk of cross infection.”

selection and procurement process; they also liaised closely with suppliers to ensure the timeline commitments were both understood and met.

Helen Lancaster, Director of Operations at South Warwickshire NHS Foundation Trust states, “Yearon-year demand for CT scans has grown significantly and is unlikely to decrease given the changes required in cancer pathways and diagnostic techniques. With the added considerable impact that the COVID-19 pandemic has had on our Trust’s capacity to perform many diagnostic procedures, the implementation of the CT scanner at Stratford Hospital is significant in ensuring our patients are seen and treated as soon as possible.”

From a supplier perspective, installing large, complex imaging equipment is dependent on an intricate network of interconnected companies that all need to work collaboratively and be customer driven. Allocating units, appointing builders and securing installation slots whilst meeting the unique requirements of each project is not without its challenges. Two-way partnership working is essential.

The importance of internal and external collaboration

Secondly, embracing the spirit of collaboration within the NHS organisation and partners is key.

The procurement and installation of CT and MRI scanners are important and demanding projects that require input from many stakeholders across multiple organisations, often taking the best part of a year to complete.

Collaborative teamwork to date has been key to making advancements.

For example, NHSI and NHS Supply Chain have been instrumental in supporting Trusts with an accelerated

Linda Horsfall, National Sales Manager at Canon Medical Systems UK, concludes, “Unity at a time of crisis enabled the NHS to fight back against coronavirus. It serves as a good example of how, looking ahead to the recovery and renewal of imaging services and the continued success of the Adopt and Adapt initiative, we need to all work together - from collaborating on new ideas within the NHS environment, to championing each stage of the radiology industry supply chain. Linking hands and pulling together is the only way we will facilitate faster adoption of new ways of working, adapt to unpredictable environments and encourage service innovation to make significant positive differences to patients.”//

Delivering exceptional care to everyone.

Canon Medical partners with Manchester United Football Club to aid in the prevention and management of injuries via leading-edge imaging that supports accurate diagnosis and treatment. Through high performance partnerships such as these, Canon Medical aims to assist in the transfer of knowledge and expertise that allows everyone to maximize their sporting enjoyment, whether amateur or professional.

CANON MEDICAL SYSTEMS UK https://global.medical.canon https://uk.medical.canon/ ©Canon Medical Systems Corporation 2021. All rights reserved.

Canon Medical offers a full range of diagnostic medical imaging solutions.

22 // VISIONS 37

INTERVIEW // MAGNETIC RESONANCE // Vantage Orian 1.5T, AiCE, Compressed SPEEDER, Pianissimo

AI-Assisted MRI Reduces Scan Times & Provides Quality Images During Imaging Modernisation Project Vantage Orian MRI passes test as ‘workhorse’ to support imaging overhaul at Buckinghamshire Healthcare NHS Trust

B

uckinghamshire Healthcare NHS Trust has praised the robustness and reliability of its Canon Medical Vantage Orian 1.5T MRI at Wycombe Hospital to underpin a major imaging modernisation project. The MRI is currently playing a ‘workhorse’ role in delivering reliable and continuous patient scanning as the Trust updates its MRI equipment across the hospital sites.

“It’s an unusual time for us at the moment, running a single hospital MRI and temporary relocatable MRI unit, but we feel fortunate to have

the Vantage Orian MRI in place.

It is providing fantastic all-round diagnostic support for MSK, neuro and cardiac workloads. Its resilience is really being tested and it has coped brilliantly with the additional volume of patients,” states Gemma Walsh, Deputy Lead MRI Radiographer at Buckinghamshire NHS Trust.

“The Vantage Orian promises advanced productivity and it doesn’t disappoint,” continues Gemma Walsh.

“The Advanced intelligent Clear-IQ Engine (AiCE) Deep Learning recon-

struction technology produces great MR images that are detailed and low in noise. This reduces scan times and produces valuable diagnostic images first time.”

“The proof of a sound diagnostic imaging innovation is when it is put to the test,” states Vanessa Ellis, MR Modality Manager at Canon Medical UK. “We’re delighted that the Vantage Orian at Wycombe Hospital is standing up to its current workload challenges and will help the Trust fulfil its exciting plans for a new and futureproofed imaging service.” //

VISIONS 05 // 23

PRODUCT // MEDICAL IMAGING ACADEMY // Education

Unlock Knowledge, Anytime, Anywhere Welcome to the Medical Imaging Academy

W

hen time is precious, knowledge is key. This is the philosophy behind the newly refreshed online Medical Imaging Academy by Canon Medical Systems UK, delivering a myriad of CPD accredited training, education and problem-solving content to customers and wider industry.

The Medical Imaging Academy (www.medicalimaging academy.co.uk) is your complimentary online resource library with live and on-demand expert training, face-toface courses and a hub of invaluable how-to guides for healthcare professionals.

Start your learning journey here The Medical Imaging Academy is your complimentary online resource library with both live and on-demand expert training for imaging healthcare professionals.

The Medical Imaging Academy is designed to help save imaging professionals time, to achieve optimal performance of imaging equipment and to develop deep user knowledge, which in turn, all help to provide the highest standard of care to patients. This is more important than ever as we strive to return to near normal in healthcare, create meaningful efficiencies to beat imaging backlogs and prepare for new intakes of patients needing procedures in the diagnostic imaging pathway.

Sign-up to the website today: www.medicalimagingacademy.co.uk

Key benefits Sign up for free! Become a member to gain access to a multitude of on-demand and live education delivered by experts Take control of your professional education by becoming a member of the Medical Imaging Academy A complimentary resource to support your development with CPD Accredited learning, in one easily accessible place

Personal development through CPD Accredited learning

Live webinars and on-demand expert training

Access to a full list of face-to-face and online education

Q&A sessions with guest speakers

VISIONS 05 // 25

How-To Guides Refresh, review, revisit. We have developed visual step-bystep how-to guides designed to be refresher training for imaging professionals when you need it most.

Accessible at any time and filtered by modalities, visitors can watch the guides in full or skip to a specific section.

On-demand Education Immediate and live, the on-demand education offered by the Medical Imaging Academy is designed to watch anytime, anywhere. This not only improves user confidence on a daily basis, but also ensures that the functionality of the systems is being maximised to ensure a sound return on diagnostic imaging investment. At the same time, it helps you collect CPD points throughout your learning journey.

Upcoming Education As we gently return to face-to-face training and workshops the Medical Imaging Academy is proud to offer both hands on education courses in the classroom as well as continuing live virtual webinars. The registration process is simple and all done online for your convenience so you can sign up to upcoming physical and virtual courses.

“The Medical Imaging Academy complements the support and advice delivered by our team of application and clinical specialists. It also offers the flexibility to refresh training knowledge, recap how to perform certain functions or introduce new skills at any time”. Mark Hitchman, Managing Director at Canon Medical Systems UK. Turn to page 59 for our educational calendar

Hear from our customers Jane Marling, Lead Sonographer, West Suffolk NHS Foundation Trust

26 // VISIONS 05

“Our sonographers are all really enjoying the sessions.

They find them easy to access, varied and really interesting — something for everyone.”

Empowerment Through Education and Resources

Register to expand knowledge and boost efficiency Registration and access to the Medical Imaging Academy is free 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.

Start your journey today. Logon to www.medicalimagingacademy.co.uk and register for 24/7 access.

VISIONS 04 05 // 27

“It is a very valuable resource in today’s world, and I look forward to it growing in depth and strength.”

David Sugden, CT Manager at Sheffield Teaching Hospitals NHS Foundation Trust

28 // VISIONS 05

Professional education at your fingertips, 24/7 Views and insights from Medical Imaging Academy users include high praise for easy-to-navigate hub of resources to help expand knowledge even when time is at a premium Early feedback from registered members of the Medical Imaging Academy has highlighted its value and relevance in today’s busy imaging world to provide instant and free live and on-demand education.

With radiology continuing to be under pressure from unfilled vacancies, backlogs and growing numbers of patients, the new online academy of how-to guides, live and on-demand videos plus a wide range of information, provides an instant panacea to keep education needs fulfilled.

Education on the go, or to help answer simple questions when in the scanning room

David Sugden, CT Manager at Sheffield Teaching Hospitals NHS Foundation Trust, reflects: “Having knowledge development and training resources at our fingertips – either on PCs in the scanning room or on our phones on the go – means we can get quick reminders on routine queries or immediate answers to advanced questions that we or our wider team may have. Sometimes you don’t want to ask another person a question that seems too obvious, but the Medical Imaging Academy is a free and instant go-to resource to hold our hand and guide the way. It also delivers high-end knowledge development that expands horizons without needing to physically attend events or training sessions.”

He continues, “The Medical Imaging Academy is also a great way of creating a professional network of Canon Medical users where we can share best practice and gain cutting-edge updates from industry specialists. It is a very valuable resource in today’s world, and I look forward to it growing in depth and strength.”

A secure and accredited training platform for hard working imaging teams

Gemma Walsh, Deputy Lead MRI Radiographer at Buckinghamshire Healthcare NHS Trust agrees: “We’re a busy

“Being able to attend sessions virtually means savings in time and cost to the NHS, at the same time as growing our skills.

I will recommend it to all my team.”

Gemma Walsh, Deputy Lead MRI Radiographer at Buckinghamshire Healthcare NHS Trust department with radiographers working rotationally around different sites. Any knowledge that is easily accessible in a safe and accredited format is such a positive, as we’re not all specialists in a given area. We also undertake out-of-hours scanning, so simple questions that can be answered using the Medical Imaging Academy could mean our team overcoming queries or challenges more quickly using it as a first-layer resource.”

“Additional benefits of the education hub are being able to attend live webinars and view videos. This will support us in being efficient in meeting CPD or training needs.

Being able to attend sessions virtually means savings in time and cost to the NHS, at the same time as growing our skills. I will recommend it to all my team.” //

VISIONS 05 // 29

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

30 // VISIONS 05

2

3

4

5

1

VISIONS VISIONS053 // 31

Five Easy Steps to a Greener Future that Clinical Departments can Take Now How to start making progressive steps towards the NHS Carbon Zero targets

32 // VISIONS 04

REPORT // CORPORATE SOCIAL RESPONSIBILITY (CSR) // Carbon Zero

A

s a leading supplier of diagnostic medical equipment to UK Radiology, it is Canon Medical’s duty to balance the health of patient populations and providing the imaging tools that clinicians need now, with the need to look ahead and predict the long-term future factors of health.

This guide is written to provide advice and guidance to our diagnostic imaging community of radiographers, sonographers, radiologists, cardiologists, radiology service managers, imaging managers, as well as the health managers in procurement or sustainability roles.

It is intended to provide practical steps that can be taken now to start working towards meeting the aims of the NHS’ net carbon zero targets, at the same time as being aligned to wider digital health innovation transformation initiatives.

Step 1. Embrace imaging equipment innovation Reduce departmental energy emissions at the same time as improving patient care 62% of carbon emission sources in the NHS are generated by ‘medicines, medical equipment and other supply chain’: medicines (20%), medical equipment (10%), non-medical equipment (8%) and other supply chain (24%) .

An easy hit for Radiology working towards decarbonising the NHS is a focus on the energy emissions from medical equipment that is used throughout the working day.

This could include CT, MRI, ultrasound, interventional imaging systems and X-ray.

Innovation in medical imaging is evolving at an astounding pace.

MRI and CT scanners are frontline tools for patient diagnosis and patient

triage and are well recognised for their versatility. The number of scans per year are set to rise.

• Evaluate models for energy consumption and carbon footprints at the same time as meeting clinical needs when the opportunity arises for new equipment selection.

• Official tender requests need to refresh, calling for imaging engine efficiency not requesting engine sizes in kw of CT scanners. Size does not matter. The larger the engine the greater the energy consumption.

This does not correlate to better imaging results. Perhaps the question and selection criteria should be ‘how efficient is your imaging engine’?

• Look for energy efficient innovation and features on medical equipment.

Sustainability reporting on carbon emissions will be far lower if systems go into standby between patients, for example an ‘EcoMode’, or innovative features that have been designed to generate a system’s own energy source such as CT gantry spin technologies.

62% of carbon emission sources in the NHS are generated by ‘medicines, medical equipment and other supply chain medicines'.

24%

20%

Medicines

Supply Chain

10%

8%

Medical Equipment

Non-Medical Equipment

The Aquilion ONE Genesis CT scanner is a Gold Winner of the Innovation category of the international Green Apple Awards, an annual accolade to recognise, reward and promote environmental best practice around the world.

Its small and light design needs less power compared to other models and can be installed in compact spaces avoiding costly renovations at hospitals.

• Embrace Artificial Intelligence (AI). Imaging AI is enabling greater image quality, faster and at a lower dose. This helps to deliver greater clinical confidence and better patient care with no additional energy draw.

For example, Canon Medical’s Advanced intelligent Clear-IQ Engine (AiCE) is a Deep Learning Reconstruction AI algorithm integrated into new CT scanners. It reduces overall energy emission per patient case and helps to remove the need for repeat scans.

• Select virtual equipment service whereby equipment engineers can make repair or diagnostic decisions remotely via IT infrastructure.

This saves physical travel that has a carbon footprint associated with it, and also saves time on diagnosing an equipment breakdown, ordering a part and getting it fitted.

Step 2. Carbon conscious supply partners An opportunity for green change via the NHS supply chain

By selecting supply partners with a carbon conscience helps reduce carbon footprint reporting and makes a positive difference to NHS sustainability reporting.

The ‘Greener NHS’ report highlighted two targets for the NHS to achieve net zero emissions: by 2040 (with interim 80% reduction by 2028-2032) for emissions under NHS direct control, and by

VISIONS 05 // 33

2045 (80% reduction by 2036-2039) including the wider NHS supply chain.

By highlighting the supply chain as one of the greatest areas of opportunity for the first time rather than the traditional thinking of buildings, heating/lighting and vehicle fleets, it expanded the scope of potential for driving down emissions covering products procured from approximately 80,000 suppliers.

With NHS purchasing having the power to influence green change, the supply chain has an obligation to respond.

Look for external environmental accreditations

Sustainability accolades of NHS supply chain should always be underpinned by robust external, independent verifications. This could include the British Standards PAS2060 requirements, environmental management ISO14001 certification, auditing via partner status from the United Nations’ Division for Sustainable Development Goals (DSDG), or ideally all of the above.

Canon Medical is one of the only UK medical equipment suppliers to be carbon neutral.

Every system it supplies comes with a ZERO carbon footprint for the lifetime of its use inside the NHS. This is because the entire carbon footprint of the system – from manufacture, shipping and logistics, through to the forecasted lifetime power consumption inside hospitals or clinics - has been taken into account and offset to a high impact project such as providing clean water bore holes or modern cooking stoves in developing countries.

Canon Medical’s latest carbon offset report , externally audited and verified to UN Gold Standard criteria, highlights the cumulative numbers since it became a ‘net zero carbon’ medical equipment supplier. It shows not just how carbon has been offset to advantage

34 // VISIONS 05

Canon Medical is one of the only UK medical equipment suppliers to be carbon neutral the health of the planet, but also how the wellbeing of less fortunate people in developing nations is benefited every time there is a new installation of medical imaging technology to assist UK NHS healthcare provision. This includes: • 24 million litres of clean water provided from deep water bore hole projects; • 13,600 tonnes of wood saved, and not deforested, from the clean stove project; and cleaner, healthier air for families to breath inside their homes via modern stoves that emit less smoke;

• 24 million litres of clean water provided from deep water bore hole projects; • 13,600 tonnes of wood saved, and not deforested, from the clean stove project; and cleaner, healthier air for families to breath inside their homes via modern stoves that emit less smoke; • Children are able to go to school as no longer required to help their families to walk miles to clean water wells far from their villages, or help collect firewood for old inefficient style stoves • Females have been empowered in remote villages as they are no longer have to risk long walks in search of water or firewood.

• Overall, 11,000 people have benefitted from the carbon offset project providing them clean water and modern stoves to avoid illness.

• Children are able to go to school as no longer required to help their families to walk miles to clean water wells far from their villages, or help collect firewood for old inefficient style stoves

Step 3. Take imaging closer to the community

• Females have been empowered in remote villages as they are no longer have to risk long walks in search of water or firewood.

Moving patient care out of the acute setting and into the community is on the horizon as part of the revaluation of UK health systems magnified by the arrival of Coronavirus. This will provide

• Overall, 11,000 people have benefitted from the carbon offset project providing them clean water and modern stoves to avoid illness.

Canon Medical’s latest carbon offset report , externally audited and verified to UN Gold Standard criteria, highlights the cumulative numbers since it became a ‘net zero carbon’ medical equipment supplier. It shows not just how carbon has been offset to advantage the health of the planet, but also how the wellbeing of less fortunate people in developing nations is benefited every time there is a new installation of medical imaging technology to assist UK NHS healthcare provision. This includes:

Fewer patient journeys to hospitals means lower carbon emissions

better infection control in the new Covid-era, give greater convenience for people to have appointments closer to home and therefore drive down carbon emissions due to less travel.

With the speculated introduction of Community Diagnostic Hubs, the conversion or introduction of new building facilities or mobile / relocatable buildings will also need to have environmental infrastructure considerations as part of the wider NHS infrastructure.

Whilst all new hospitals will have a new Net Zero Carbon Hospital Standard from Spring 2021 as part of the Government’s Health Infrastructure Plan, will this include guidelines towards mobile units or community hubs?

Initial considerations to think about when redesigning patient imaging in the community includes: • The use of low carbon building materials in remodelling facilities for use as Community Diagnostic Hubs or selecting sustainably built mobile / relocatable imaging units. This could include FSC certified wood and other building materials that have low environmental impact;

Fifteen relocatable Canon Medical CT scanners, deployed by NHS England’s COVID-19 recovery plan to help with patient imaging backlog and winter COVID-19 preparations, had zero carbon tonnes of emission for the NHS to incorporate into its environmental reporting totals. The 1,161.75 tonnes had already been offset by Canon Medical’s robust carbon offset scheme which includes the CO2 emissions during manufacturer and the lifetime electrical running of the system once inside the hospital estate.

• Placement of mobile imaging units near to high density communities and where public transport links are good such as supermarkets or shopping centres.

This removes the need for single use cars, taxis and promotes shared transportation or walking that emits lower overall emissions.

exchange of diagnostic images to patient records, and for pre-emptive equipment maintenance / service.

• Selection of specially designed and compact imaging equipment to minimise space and keep construction costs and needs low. For example, the Vantage Elan MRI requires an overall installation area 29% smaller than previous 1.5T MRI systems and does not require a separate computer room.

Broadening knowledge within NHS departments and creating a self-propelling cycle of cultural change towards environmental consciousness should become part of the norms of radiology.

• Maximise the use of digital health infrastructure and innovative imaging applications to power remote radiology reporting, support the efficient

Step 4. Encourage and reward green behaviours Cultural change within imaging departments is easy to achieve

Encouraging wider green behaviours through extended training and education and rewards through internal award schemes or CPD will have a self-propelling positive effect on UK Radiology.

VISIONS 05 // 35

• Make use of imaging equipment providers’ online training and education programmes. Learn new imaging techniques and protocols than can reduce repeat diagnostic scans and drive down power consumption.

Plus reduce carbon footprints from travel to ‘traditional’ study days or industry events and widens the reach of training benefits within a hospital department.

• Ensure that the creators of tenders and procurement professionals understand the energy efficiency of modern imaging equipment.

For example, requesting efficiency metrics to evaluate competitor systems.

• Move towards new generation innovations and embrace AI. Modern technologies have been designed to be more energy and workflow efficient. Fewer repeat scans and lower dose are better for patients and better for the environment.

• Keep an eye on waste. Review if necessary, recycle and reuse strategies to eliminate waste in the department.

This includes single use consumables,

packaging on supplies and even the disposal strategies for old imaging equipment. Do you know how much gets recycled versus put into landfill?

To use a car analogy, you wait longer and pay more when selecting bespoke features. The same is true of imaging equipment.

Step 5. The benefits of standardised medical imaging equipment

“It is estimated that carbon footprints of medical equipment can be reduced by a third when produced to a standard criterion. It can also greatly speed up the manufacturing process giving hospitals and clinics much quicker access to much needed modern diagnostic imaging equipment.

Sometimes there can be too many variables of bespoke imaging equipment available to the NHS. Meetings and steering groups to decide upon specifications and evaluate features can slow down the procurement process and then add time onto manufacture and set-up. Lean decision making often translates into lower cost, scale and lower carbon footprints.” //

Uniformity equals scale, speed and less waste

Speed of access to modern imaging equipment is needed to catch up on Covid19 related imaging backlogs and decrease patient waiting times that existed even before the pandemic. Reducing choice of all the variable elements of imaging equipment and standardising the systems for routine patient diagnostic needs would give wider and quicker access to UK patient populations.

To find out how to start saving your department and hospital CO2 emissions:

Please contact Crawley CMSUK Headquarters, on 01293 653 700, email marketing.UK@eu.medical.canon or use the QR code.

References Recent clinical evidence is included for reference within this article.

1 Delivering a Net Zero National Health Service, October 2020 2 Diagnostics: Recovery & Renewal – Report of the Independent Review of Diagnostic Services for NHS England, October 2020 3 Delivering a Net Zero National Health Service, October 2020 4 Canon Medical UK Carbon Offset Reports produced

by CO2Balance.

5 Canon Medical – https://global.medical. canon/products/magnetic-resonance/ Vantage_Elan-Compact

A community of children just outside of their local school. These are just some of the children who can live healthier lives, with the C02balance collaboration projects.

36 // VISIONS 05

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

INTERVIEW // ULTRASOUND // Research

Collaboration in Precision Biopsy Research Aims to Improve Cancer Care Patient Pathways How academia and industry are working together to improve personalised medicine by fusing real-time ultrasound with CT information to enable fewer, more targeted biopsies

T

he one-size-fits-all approach to cancer, where everyone with the same type gets the same treatment, is no longer the state of the art. Personalised medicine has enabled a more targeted approach to oncology where the genetic characteristics of a tumour are understood earlier to enable a more targeted and specifically tailored course of treatment. In order to determine the genetic character of lesions, it is necessary to biopsy them. But where

38 // VISIONS 05

there is heterogeneity, knowing that the potentially different genomic elements have been sampled is of course a challenge. Furthermore, because of the invasive nature of these procedures and the potential for patient discomfort, minimising the number of biopsies is always preferred.

New research, pioneered by Professor Evis Sala from the Department of Radiology at the University of Cambridge and co-lead of the Cancer

VISIONS 05 // 39

Image of the ovary using CT Ultrasound Fusion

Research UK (CRUK) Cambridge Centre’s Advanced Cancer Imaging Programme, was published in European Radiology earlier this year. It offers exciting insights to help push the current boundaries of precision tissue sampling or, indeed, establishes the feasibility of virtual biopsies in the future.

The study focused on a small cohort of ovarian cancer patients due to have ultrasound-guided biopsies prior to starting neoadjuvant chemotherapy. Firstly, a CT scan was performed, from which it was possible to define different habitats within an ovarian lesion. A habitat is a region of tumour that has well defined image characteristics that are different to other zones. Maps visualising these habitats were then superimposed on the CT images, which could be used in conjunction with real time ultrasound Fusion, to guide biopsy procedures. This enabled a more informed and detailed approach to taking biopsy samples to capture a diversity of cells.

40 // VISIONS 05

Dr Stephan Ursprung, Clinical Researcher in Professor Sala’s team at the School of Clinical Medicine at the University of Cambridge explains, “Our work is attempting to solve unmet clinical needs in cancer care. Cancer-care pathways for today’s patients depend on the balance between several factors including, the ability to detect cancer and its treatment response using imaging; to detect molecular treatment targets; and to develop drugs that act upon these targets. A development in one of these areas enables progress in the others.”

“Cancer-care pathways for today’s patients depend on the balance between several factors” Dr Stephan Ursprung, Clinical Researcher in Professor Sala’s team at the School of Clinical Medicine

He continues, “Clinical practice has moved on from a single approach to cancer treatments, and today individual treatments are tailored to patients, even for the most aggressive cancers.

But the big challenge for radiology is how can we sample such a diverse tumour environment and how do we facilitate multi-regional sequencing?”

“Our study looked at ovarian cancer.

To tackle the lesion, targeted chemotherapy is usually prescribed to shrink the tumour before the surgery stage.

The challenge is to obtain high-quality targeted samples of the cancer to sequence and tailor treatments. To exhaustively biopsy the many regions of the cancer can be cost prohibitive, or is simply not acceptable to the patient. Imaging therefore holds the key to understanding more about the intratumor heterogeneity. “ “Our collaboration with Canon Medical Systems UK and Canon Medical Research Europe has resulted in the successful live fusion of CT and

“Clinical practice has moved on from a single approach to cancer treatments, and today individual treatments are tailored to patients, even for the most aggressive cancers.”

Dr Stephan Ursprung, Clinical Researcher in Professor Sala’s team at the School of Clinical Medicine

“Academia, clinical practice and industry, working together to explore new procedures and techniques, can help improve the outcomes of cancer care and the quality of life of patients” states Sally Davey, Ultrasound Product Manager at Canon Medical Systems UK. “Our Aplio I Series ultrasound platform, with ‘Smart Fusion’ capability, is being used in the University of Cambridge ovarian cancer study.

It enables clinicians to view, simultaneously, images from a previously performed CT scan, alongside real-time Image of segmentation prior to the Fusion procedure ultrasound imaging. The CT scan has a coloured overlay, ultrasound images; enabled improveindicating the different tissue habitats ments in biopsy technique; helped to within a lesion. By synchronising these overcome the challenge of respiratory two modes, it is possible to navigate motion; and, thanks to a dedicated complex anatomy confidently, taking research ultrasound system, it has laid biopsies from different habitats, while the basis for the success of this and keeping the number of tissue samples future ultrasound projects. Our next required, to a minimum. This will help steps will be the implementation of MR provide the most detailed informaultrasound fusion, translation to other tion possible to make confident cancer organs and molecular analysis of tissue treatment decisions.” samples; and comparison to surgical tissue samples. This is evidence of a sucThe study involved researchers cessful collaboration across disciplines from the Department of Radiology, and across departments,” he concludes.

Cambridge University Hospitals NHS

Foundation Trust, CRUK Cambridge Centre, and collaborators at Canon Medical. It was facilitated through the CRUK Cambridge Centre Integrated Cancer Medicine programme and funded by Cancer Research UK and The Mark Foundation for Cancer Research.

Sally Davey at Canon Medical concludes, “Smart Fusion has been used in many studies and in clinical practice where CT or MRI images are fused with real time ultrasound, to give the most accurate picture for biopsies. Other exciting projects beyond the ovarian cancer study include renal and liver disease studies, or the use of omniTRAXTM positioning aids. These are single use tracking devices that are attached to the patient during their CT or MRI scan. The omniTRAXTM is then kept in-situ if the biopsy is to take place immediately, or its position marked on the skin for later repositioning. The use of this device aids rapid synchronisation during the Fusion procedure, which is particularly helpful if the patient has to be re-positioned or needs additional CT scans during an interventional procedure. By continuing to work together with many different innovators, clinicians and researchers, we will help answer many of the big questions of research, to make a difference to people’s lives through advanced clinical care.”//

VISIONS 05 // 41

INTERVIEW // SPORTS MEDICINE // Cardiology

Cardiac Collaborations in the Sporting Spotlight The close collaborations between industry, sport and academia are heralding many advances in imaging research techniques to improve cardiac health for all

T

he world watched in horror as Inter Milan player Christian Eriksen suffered a sudden cardiac arrest during the Denmark vs Finland UEFA Euro 2020 football match played in summer 2021. This rare but shocking incident brought into sharp focus the fragility of cardiac health, even for elite sports people.

Each year 100,000 people die from sudden cardiac arrest and although rare in sports, the recent football event shows that it can still happen to elite sports people despite the numerous screening tests by European sporting institutions including FIFA and the Football Association (FA). But the incident also brought into sharp focus the concerns about young and fit people who have unknown and undetected heart conditions.

It is estimated that every week in the UK, 12 under 35-year-olds die from undiagnosed cardiac conditions .

These are young people at play, at school, working or undertaking grass roots sports that have not had any screening checks yet live at risk of a cardiac anomaly. Undertaking exercise

increases the risk of triggering the anomaly as the heart is put under stress.

Ensuring exercise remains a healthy activity for all

Whilst there are valid calls for greater awareness of sudden cardiac arrest, to increase the availability of defibrillators at sporting grounds and schools, and expand knowledge of CPR, it is also important to continue research into how the heart functions during exercise.

Dispelling the issue of ‘over-care’ of children and adults with already diagnosed congenital heart disease is also pertinent. Each day 13 babies are born with heart defects , with 1 in 500 young people and 185,000 of current adults living with a congenital heart issue . Hesitation to engage in physical exercise has always been a concern in these patient cohorts, but this could now be exacerbated by the worry of high-profile cardiac collapses on the football pitch. As their physical inactivity rises, so too do the negative side-effects of increasing obesity and other connected diseases such as high blood pressure or diabetes.

VISIONS 05 // 43

“Collaborations between industry and academia are certainly a key way to keep research progress continuing.”

Professor Guido Pieles, Consultant Cardiologist at the Institute of Sports Exercise and Health London

How elite sports research can help adult and paediatric patients

Partnerships between the medical imaging industry, sporting organisations and academic institutions are an important way to help understand the warning signs, identify cardiac issues in the undiagnosed and understand the impacts and safe levels of exercise in those already identified.

These collaborations also play a key part in designing medical imaging systems for the future.

Professor Guido Pieles, a Consultant Cardiologist at the Institute of Sports Exercise and Health London and an expert in inherited cardiac conditions, advanced imaging and sports and exercise cardiology, is the author of numerous studies about the effects of exercise on the heart. For many years he has worked with Dr Steve McNally, Head of Football Medicine & Science at Manchester United Football Club to not only screen and safeguard players and youth academy members who train regularly, but also to expand knowledge about heart health and contribute to the development of advanced diagnostic imaging systems.

44 // VISIONS 05

This includes echo ultrasound, CT, MRI and mobile scanning units that aim to help unlock greater anatomical detail of the heart.

This will help to provide athletes and their families with peace of mind and offer valuable time and cost efficiencies for sporting organisations.”

In a bid to expand the knowledge of sports medicine for the good of all, a new ‘Mobile Cardiac Laboratory’ has been launched by Professor Pieles in conjunction with the Institute of Sport, Exercise & Health, HCA Healthcare Ltd and Canon Medical UK.

“Besides our cardiology work in elite sports, the mobile cardiac laboratory would be very useful to consider for school-based screening in the future based on the experiences of football Premier League youth academies that have been undertaking heart screening for young players from the age of 12 over the last decade,” adds Professor Pieles. “Ultimately, the fitter you are, the better your mortality rate and this applies to all people, even those with heart conditions. If we can expand the knowledge and identification of cardiac conditions, we will help a greater number of people to live fuller lives without fear.

The launch of sports medicine mobile cardiac lab

“This is an exciting stage in our groups work into sport and cardiac health,” states Professor Pieles. “The Mobile Cardiac Laboratory will be available to attend any sporting event in the UK and Europe, providing specialised cardiac performance evaluations using ECG techniques, plus resting and exercise stress 4D echocardiography diagnostic ultrasound imaging. It will provide in-depth assessment of cardiac anatomy and function to identify pre-existing cardiac abnormalities and ensure optimal management and follow up, thereby reducing the potential for adverse events and loss of life.

Collaborations between industry and academia are certainly a key way to keep research progress continuing.

This is particularly true for the field of cardiology, where we clinicians depend on state-of-the-art imaging technology.

The continuing support by Canon Medical Systems is a great example of such collaborations.”//

References Heart Rhythm Alliance, heartrhythmalliance. org/aa/uk/what-you-need-to-knowabout-sudden-cardiac-arrest ii Cardiac Risk in the Young (CRY), c-r-y.org.uk/ why-the-young-and-healthy-drop-dead/ iii British Heart Foundation Factsheet, July 2021, bhf. org.uk/what-we-do/our-research/heart-statistics iv Prof. Guido Pieles, Cardiac Risk in the Young Conference, 2019, .c-r-y.org.uk/ conference-videos-2019/ v Canon Medical Systems Aplio i900 diagnostic ultrasound system i

PRODUCT // SERVICE // Support and Service

Keeping You ...Running Always Our people and our personality set us apart, but we don’t just want you to enjoy working with us, we also want you to have unwavering faith in our partnership and, well, trust us

W

e understand that your patients are relying on you, and equally, we want you to rely on us too.

In fact, thanks to Canon’s InnerVision remote monitoring, we’re often beavering away in the background without you even being aware. The system runs 24 hours a day, seven days a week and can mean that we detect and resolve any issues before you even know about it.

It goes without saying that when it comes to healthcare, time is of the essence. You don’t want to be kept waiting nor do your patients. We therefore aim for spare parts to be with you on the same day and, in the unlikely event of downtime, replacement equipment is available for loan or hire while your machine is being repaired.

“The engineering support is excellent.

Lifetime apps is a plus.”

Our service promise to you • Seven-day support • Applications for Life • Remote diagnostics/predictive maintenance • Option to loan equipment • Out of hours planned maintenance • Cyber security management and compliance • Vitrea Intelligence – Asset and Workflow Management Our opening hours continue to be: Monday – Friday: 8am – 8pm Saturday and Sunday: 9am – 5pm You can reach us on: 01293 653710

User & Purchaser, CT & Ultrasound

VISIONS 05 // 47

48 // VISIONS 37

INTERVIEW // MAGNETIC RESONANCE // Vantage Orian 1.5T, AiCE, Compressed SPEEDER, Pianissimo

VISIONS spoke with Matthieu Butavant (Radiographer at IRM 39 Nord, Dole, France) about his experiences with the Vantage Orian 1.5T.

A Seamless Transition that Boosts Productivity Matthieu Butavant is a Radiographer with IRM 39 Nord, a radiology center based in the town of Dole, in France. Last Summer, the center installed a next-generation 1.5T MRI, Vantage Orian, which comes equipped with Canon Medical’s Advanced intelligent Clear-IQ Engine (AiCE). We spoke to Butavant about his experience with this new MRI and his relationship with Canon Medical.

C

an you tell us a little about the center and the work you do?

I am the referring radiographer at IRM 39 Nord, which is a public/private radiology center located in Dole, France.

It is shared between the Dole Hospital and the private group, IM2P, which is based in the East of France.

We carry out a broad spectrum of medical imaging for Neurology, MSK, Cardiology, Oncology and so on. We work with both outpatients and inpatients at Dole Hospital. We opened the center in 2007.

Could you describe the Vantage Orian?

We work with the Vantage Orian. It comes equipped with AiCE, an artificial intelligence reconstruction algorithm, as well as all the productivity boosting technology, including Compressed SPEEDER as well as k-t SPEEDER for cardiology.

We have all the standard coils (neurovascular, body, breast and spine), and we chose 16ch Flex SPEEDER coils for MSK scans.

What initiated the recent change in supplier?

Since opening the center, we worked with the same image equipment manufacturer for the 14 years. We had a close partnership with them, and we were even a visitor center for other specialists to see their systems. However, we needed a breath of fresh air. We felt that we had to shake things up. All manufacturers responded to the call for tenders that we put out. Canon Medical’s response was very impressive, and we were immediately interested, especially technically, from an operator’s perspective. Most impressive was the reduced acoustic noise and the availability of Deep learning reconstruction with AiCE which no one could offer.

How would you rate the support that you have received?

We received pre-training during the installation works, which involved an application specialist giving us on-site training using a simulator. They also provided us with a lot of training materials ahead of time, which meant that we were familiar with the system even before it was delivered.

VISIONS 05 // 49

After that, the first patient was scheduled and we had two weeks of training during our clinical routine at a reduced activity to give us more time to learn. We then had a third week, following which we were back to our normal throughput of 40-45 patients a day. We are in touch with our Canon Medical Application Specialist all the time, and we regularly talk to her about how we can improve sequences and protocols.

How do you rate the image quality of your system compared to the old one?

Honestly, it’s on a completely different level!

What’s impressive is how it brings together image quality and scan time. It can produce very fast images but with better image quality compared to what we had before.

We already realized this when we performed a site visit, and this was the reason why Canon Medical was at the top of our list. But everyone knows that what you’re shown during a demo doesn’t always reflect how it will perform in practice. However, this time, we were very satisfied. It’s a real improvement across the board, particularly in MSK scans, where the technology is excellent. We have increased through-plane resolution by 30% to enhance radiologists confidence. We’re now going even thinner, with higher resolution, which makes the operator’s job easier.

On top of that, we’ve integrated a lot of 3D imaging, specially for brain and spine studies. We were using 3D imaging before, but not with this image quality, and we’ve extended it to a range of other sequences.

Have you noticed an improvement in your workflow?

After two weeks with the system, we were able to get back up to our previous throughput of 40 patients per day. Now, we have accelerated up to 45-50 patients a day, even taking into account the new workflows opened up by this leap forward in examination quality. We’re doing more of our most complex, time-consuming examinations, such as cardiology and abdomen, which we used to have some difficulty taking on. And all this despite the fact that we’ve had to get to grips with a whole new system.

50 // VISIONS 05

“The Flex coils are super coils. It was the right call to get them, and I would recommend them to others.”

Matthieu Butavant, Radiographer at IRM 39 Nord, Dole, France.

What is your opinion on AiCE? It was one of the main things that intrigued us with Canon Medical; we think it is very innovative. There really is a huge benefit to using AiCE. We set up sequences with and without AiCE, and there really is no comparison.

AiCE gave us the possibility to substantially increase the overall image quality.

This is a major advantage, and Canon Medical is the only one to offer it.

It’s makes a big difference and is not just a gimmick. It is also a flexible tool that that can be adapted to your taste.

No doubt, the best thing about it is knowing that we’ve still not seen everything possible with this technology. We’ll be rolling it out for cardiac imaging soon. As an operator, it’s really exciting to refine the use this technology.

What is your opinion on Compressed SPEEDER? We started to use Compressed SPEEDER for different anatomies and different imaging types. It allows us to perform a scan that normally take three minutes in just a minute and a half.

I’m now using it to get the most out of the system, with improvements in both examination time and image quality.

What is your opinion on 16ch Flex SPEEDER coils?

We thought long and hard about them, because we had exclusively used rigid coils up until that point. We considered it to be a bit of a gamble, especially in terms of workflow. We decided to go with these coils because we had been given guarantees about image quality, which results from the 16-element array. We felt they would be at least as good as the rigid coils.

With six months’ hindsight, we have no regrets at all. It was definitely the right choice. It took the technologist a bit of getting used to, but it turns out that flex coils are very practical, very lightweight and the image quality is excellent. They’re even faster to position than the rigid coils: Where I used to change the coils as per body part.

Now, I don’t have to change them at all, I just use the same flex coil for different body regions. They’re superb coils. It was the right call to get, and I would recommend them to others.

Has patient experience improved?

I think it’s a very good set up. Obviously, the opening is wider than before, but it’s the whole experience. The system is really bright, the bore is very short.

It also makes less acoustic noise, which is not only a plus for the patients, but for us as well. We don’t get any complaints from our patients about it being too loud.

Canon Medical's Vantage Orian 1.5T at the IRM 39 Nord, France.

Another thing we can do is lower the table between patients, so they don’t have to leap up onto the step.

What do you think are the other strengths of the system?

In general, it is obviously the short scan time combined with fantastic image quality, as well as the way it makes it easy to set up sequences.

On top of that, picking up how to use the console was fairly straightforward. It’s absolutely intuitive, especially for those of us who still do filming and printing.

What three words would you use to describe Canon Medical?

Firstly, I’d say Family. It might seem ‘over the top’, but I sometimes feel like Canon Medical application specialist is my colleague at work.

I speak to her on the phone most days, I text her to ask for advice, and she always gets back to me very quickly.

“What’s impressive is how it brings together image quality and acquisition time.”

Matthieu Butavant, Radiographer at IRM 39 Nord, Dole, France.

Next would be Responsiveness, because, as I’ve said, it was a big adjustment. Not only did we have the new system, but also a new manufacturer, and there were significant installation works to contend with. It all went well, right from the start, and I feel like you can really count on Canon Medical, even for the tiniest problem.

People may say: “It can’t be that perfect”, but the main thing is the ability to manage a range of concerns and resolve them

very quickly. This is something that makes Canon Medical who they are today.

Lastly, I would pick Novelty or Inventiveness, because, as I see it, Canon Medical offers something that other suppliers just don’t have right now. Whether it's AiCE or the very quiet MRI, thanks to Pianissimo, these are exclusive features that aren’t just gimmicks and things that we actually use on a daily basis. //

VISIONS 05 // 51

52 // VISIONS 05

PRODUCT // COMPUTED TOMOGRAPHY // Aquilion ONE / PRISM Edition, Aquilion Prime SP

Future-Proofing Imaging Capacity Crawley Hospital doubles imaging capacity & expands range of patient procedures

S

urrey and Sussex Healthcare NHS Trust has installed two new CT scanners from Canon Medical Systems UK. An Aquilion ONE / PRISM Edition CT scanner has replaced an ageing system at East Surrey Hospital and an Aquilion Prime SP has been introduced for additional scanning capacity at Crawley Hospital. Together they will enable 1000 patient CT scans each month increasing outpatient imaging capacity.

“Daily work numbers have doubled at Crawley Hospital with the arrival of the Aquilion Prime SP from Canon

Medical,” states Janis Duff, Crosssite CT Superintendent at Surrey and Sussex Healthcare NHS Trust.

“The extra imaging capacity has not only helped us catch up on backlog numbers since COVID-restrictions were eased, but also broadened the range of examinations we can offer to patients, meaning more flexibility and closer-to-home appointments.

This includes aortic arch-angiograms, peripheral angiograms and some neck procedures.“ Dr Tony Newman-Sanders, Consultant Radiologist and Chief of Cancer

VISIONS 05 // 53

Surrey and Sussex Healthcare NHS Trust has installed two new CT scanners from Canon Medical Systems UK. Pictured (L to R): Matt Shepherd, Account Manager at Canon Medical UK; Lindsay Brooks, Diagnostic Imaging Assistant; Sandra Brown, Diagnostic Imaging Assistant; Janis Duff, Superintendent Radiographer; Angela Eiffert, Operations Manager Diagnostic Imaging – Non acute sites; Jamile Siddiqui, Commercial Solutions Business Development Manager at Canon Medical UK.

“The extra imaging capacity has not only helped us catch up on backlog numbers since COVID-restrictions were eased, but also broadened the range of examinations we can offer to patients” Janis Duff, Cross-site CT Superintendent at Surrey and Sussex Healthcare NHS Trust and Diagnostics, states, “We are pleased to be able to transform and improve patient care using the latest technology to perform specialised examinations. We have made significant investment within the radiology department to ensure that our

54 // VISIONS 05

services offer more flexibility to our patients and reduce wait times.”

Both CT systems from Canon Medical will be used to increase capacity for outpatient diagnostic appointments for the local community in East

Surrey, Crawley and Horsham. This includes many of the Canon Medical UK team living close to the UK headquarters in Crawley.

Matt Shepherd, Account Manager at Canon Medical states, “We’re very pleased to provide the new CT systems to Surrey and Sussex Healthcare NHS Trust, supporting the local NHS hospitals closest to our UK headquarters. By future-proofing imaging capacity for local patients and choosing a provider that strives for 100% uptime targets, we are confident that the Trust will meet its care commitment to patients now and into the future. //

VISIONS 05 // 55

CAMPAIGN // MULTI-MODALITY // Altivity, AI, DLR

Introducing our New Approach to AI in Healthcare Canon Medical has announced the launch of Altivity, a new AI innovation brand, that consolidates machine learning and deep learning technologies to deliver uncompromised quality and value across the entire care pathway

C

anon Medical has announced the launch of Altivity, a new AI innovation brand, that consolidates machine learning and deep learning technologies to deliver uncompromised quality and value across the entire care pathway.

Canon Medical has been steadily redefining the role of AI in healthcare, starting with its Advanced intelligent Clear-IQ Engine (AiCE). Initially developed for CT, this denoising deep

Under the promise of Intelligent healthcare made easy, Altivity enables: Informed healthcare Altivity is here to help enhance clinical confidence with high-quality images and applications that help make informed decisions in real-time.

Fast, tailored care Altivity has been created with patients in mind, to deliver the fast and accurate results they need for a more personalized treatment approach.

Efficient workflows Altivity helps create simple, streamlined AI-driven workflows that optimize resource deployment and ensure your teams have the insights they need to work smarter every day.

56 // VISIONS 05

learning technology was soon deployed across MRI and molecular imaging to help speed up scan times and improve image quality. Next came the launch of Automation Platform and AUTOStroke solution, both of which were designed to enhance clinical confidence and streamline workflows with the power of deep learning technology.

More recently, Canon Medical has transformed the ultrasound space with AI innovations*, that revolutionize clinical workflows. One of the most time-consuming aspects of an ultrasound exam is the care that must be taken to ensure serial measurements are done in a standardized and highly reproducible way.

By leveraging the power of AI, Canon Medical has been able to automate these routine tasks to increase clinical productivity and reporting accuracy.

Toshio Takiguchi, President and CEO of Canon Medical, says of the launch, “We are passionate about the development of intelligent imaging solutions that reflect the changing medical landscape. With Altivity, we are strengthening our focus to help clinicians leverage their data and transform it into essential insight that improves outcomes for everyone.”

Naoki Sasaki, Head of Research and Development echoed these sentiments by saying that “Canon Medical’s commitment to continued research and development has resulted in products that are establishing new standards in the area of AI in medicine and healthcare.”//

Intelligent healthcare made easy

REPORT // IMAGING SOLUTIONS // Commercial Solutions, Diagnostic Hubs

A Vision for the Future Inspired by Challenges of Today At Canon Medical UK we work in tandem with our customers and partners to ensure we meet the diagnostic community’s changing requirements. We share their ambition to improve patient outcomes and continually seek new, innovative ways in which we can support their valuable work

I

n recent years, there has been 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.

At Canon Medical we are proud of our varied and flexible solutions that range from our mobile, transportable units, to our more permanent bespoke solutions designed to meet the specific needs of each community.

We continue to adapt to this changing landscape of diagnostic services and we’re confident of the vital role we can play in assisting healthcare professionals to deliver efficient, patient-centred care and diagnostic pathways.

For more information on our Commercial Solutions offerings, scan here:

Mobiles

Our mobile units can be deployed to wherever they are needed in the country, often with very little notice. With expandable sides, a patient staircase and a lift for access, they offer space and flexibility and can be delivered with ease.

Relocatables

Our relocatable units are designed to feel like a distinct building. The units sit at ground level, so no need for staircases. Installation is eased with the use of hydraulic legs so they do not require crane lifts. The units offer spacious settings and are built with the healthcare professional and patient experience in mind.

We offer

• Flexible financial options • Spacious units • Rapid solutions and access • Applications support

Bespoke Modular Solutions

Our bespoke, modular facilities are based on your individual requirements and can be instantly deployed as a combination of multiple relocatables, or as a modular, fast-build imaging hub designed to fit your specific needs.

These bespoke centres are available for rental or purchase and are tailored to be as simple or as complex as your needs require.

We offer

• Cutting edge imaging facilities • Innovative solutions • Rapid deployment • Cost effective • Scalable, adaptable size footprint • Financed services

58 // VISIONS 05

Upcoming Education Calendar 2021-2022 Keep up-to-date with all of our latest events and where you can register online at: medicalimagingacademy.co.uk

Canon Medical UK are sponsoring events or running them – there is something for everyone all-year-round.

Canon Medical Systems offer an excellent variety of events, education roadshows and study days, both virtually and face-to-face. Whether

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

December 2021

May 2022

29th Nov - 10th Dec BMUS 2021 Location: Virtual Online Conference Duration: 12 day event with CPD credits available Register here: bmus.org/ultrasound-2021

2nd - 4th MRI Safety Matters - Dr Emanuel Kanal’s 2nd European MRSO/MRMD course Location: Leonardo Royal Hotel London City, London, UK Duration: 2-day course Register here: uk.medical.canon/courses

All content from BMUS will be available online until March 2022

March 2022 2nd - 6th ECR 2022 Location: Vienna, Austria Duration: 5-day event Register here: myesr.org/congress

April 2022 5th - 6th Wessex Diagnostic: Vascular Ultrasound Location: To be announced Duration: 2-day course with CPD credits available Register here: uk.medical.canon/education/events

June 2022 18th Wessex Diagnostic: Carotid Ultrasound Location: To be announced Duration: 2-day course with CPD credits available Register here: uk.medical.canon/education/events/

July 2022 4th - 6th UKIO Congress 2022 Location: ACC Liverpool, UK Duration: 3-day event with CPD credits available Event link: ukio.org.uk/

For the updated information on all our active events, please scan here.

Please be advised all dates are subject to change.

VISIONS 05 // 59

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 t­ reatment 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