Powerful imaging technology aids research to transform clinical pathways


Patient care is set for a radical overhaul as research is helping to discover how imaging technology can be used more pro-actively and effectively

The Transforming Outcomes and Health Economics Through Imaging (TOHETI) programme is looking to change the way medical imaging works by undertaking pioneering research.

The research aims to streamline diagnostic pathways in order to enhance patient care while contributing to a more cost-effective health service. A recently-installed SOMATOM Force CT system will aid the research, in addition to two further CT and two 3T-MRI scanners from Siemens Healthineers, which are set to go live later this year across Guy's and St Thomas' hospitals.

The £13.3m TOHETI programme has been funded by Guy’s and St Thomas‘ Charity and Guy’s and St Thomas‘ NHS Foundation Trust.

The programme of work will take place across King’s Health Partners Academic Health Sciences Centre (AHSC), a collaboration between King’s College London, and Guy’s and St Thomas’, King’s College Hospital, and South London and Maudsley NHS Foundation Trusts. The research will look to challenge current practice within common clinical pathways and, through the use of Siemens Healthineers technology, demonstrate how imaging can be used more proactively and effectively. It will combine academic research and service improvements and it is hoped this will enable change that is focused on patient care and experience while providing solutions that contribute to cost savings.

One of the pathways being explored is colorectal cancer. Nyree Griffin, consultant gastrointestinal radiologist at Guy’s and St Thomas’ NHS Foundation Trust, said: “Colorectal cancer is one of the most-common cancers in the UK, accounting for 12% of all new cases.

“Optical colonoscopy is the traditional first-line investigation for patients presenting with large bowel symptoms, with CT colonography usually reserved in our trust for elderly patients with co-morbidities, where optical colonoscopy is contraindicated. However, a significant number of patients referred to NHS clinics with large bowel symptoms will have a negative colonoscopy.”

She added: “Through this TOHETI programme we are carrying out a one-year study where CT colonography will be offered as a first-line, non-invasive alternative investigation for patients who are at low to medium risk of colorectal cancer.

“A health economic analysis will be performed, comparing the outcomes of this new CT colonography pathway with the traditional optical colonoscopy pathway. It is hoped that the results of this study will facilitate discussions on a revised colon cancer pathway in our trust, which should be more cost effective, resulting in reduced waiting times in endoscopy, increased access to CT colonography, and improved patient experience.”

Other studies that will utilise the new CT and MRI technology include management within primary care of patients with chronic headache. In the oncology setting, helping to speed up diagnosis of prostate cancer and increasing early detection of lung cancer in high-risk patients will also be explored. Other studies include the use of MRI on presentation to achieve an earlier and more definitive diagnosis of scaphoid fractures and expedited use of imaging system capacity and capability for patients presenting with acute chest pain.

The CT technology encompasses a Dual Source Dual Energy feature where two X-ray sources run simultaneously at different energies, allowing for easy classification of the scanned tissue at the right dose. The SOMATOM Force utilises power reserves from two 120 kW generators, and direct anode cooling from the Vectron X-ray tubes. The system also offers the industry's-highest native temporal resolution of 66 ms at 0.25 s rotation, which will allow images to be taken even when the patient is moving and provides excellent image quality.

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Russell Lodge, CT business manager at Siemens Healthineers, said: “TOHETI is a large, interesting research project that looks to challenge current practice and lead the way in innovation within radiology. Constant evaluation of medical practice is important to ensure hospitals continue to evolve and keep pace with a changing healthcare landscape. In years to come we could have patient pathways that are unrecognisable when compared to those of today.”