Monthly Archives: November 2023

How CT Colon analysis tools and expanded radiology training programs
can alleviate shortages.

Imagine a future where hospital waiting lists, backlogs, and healthcare workforce shortages are a thing of the past. This doesn’t have to be a medical technology dream; it can become a reality. The key to achieving this lies in the innovative use of diagnostic imaging technology and comprehensive people development
programs.

Dr. Burling, a Consultant Gastrointestinal Radiologist and Co-Director of the National CT Colonography Training and Accreditation Programme (NCTCTAP), sheds light on the magnitude of the issue: “Bowel cancer is the second leading cause of cancer death in the UK, affecting both men and women from all communities. It is also the most common cause of cancer death among non-smokers. Early diagnosis and prevention are crucial, and we are just scratching the surface in this regard.”

“The gap is starting to close through increased understanding of how to access investigation and expedite early diagnosis. Efforts in the NHS and the independent sector focus on early cancer detection through diagnostic and screening programs. Increasing awareness among individuals, GPs, and colleagues outside the colorectal cancer specialty has led to more people being involved in early diagnosis techniques, such as referrals for colonoscopy or CT colonography.”

CT colonography, also known as virtual colonoscopy, offers numerous advantages over traditional endoscopic colonoscopy. It is more cost-effective, accessible, and provides a wealth of information. For example, it can detect cancers outside the colon, highlighting concerns in the abdomen and pelvis. Moreover, CT colonography is less invasive, more comfortable, and safer for patients.

Improving Detection and Diagnosis
Radiologists, and in some cases specially trained radiographers, utilise analysis packages for the interpretation and reporting of CT colonography. These packages provide optimised layouts for 2D and 3D examination of the colon, along with tools for quantitative analysis of suspected polyps.

Advanced Visulisation “The Vitrea® Advanced Visualisation CT Colon Analysis package is my colon software of choice,” explains Dr Burling. “It is a smooth scrolling visualisation software, enabling controllability as an extension of my interpretation and perception skills to identify an abnormality. It allows me to focus on important areas on the screen display without any distractions.”

“It also helps with characterisation. This relies on the flagging of polyp or cancer candidates and the yellow arrow system on the Vitrea® CT Colon analysis tool is efficient and easy to master.

Secondly, the steps required to characterise a polyp candidate as to whether it is a true abnormality or one that can be dismissed and rejected as faeces or a normal anatomical structure. These steps require manipulation of 2D and 3D images to look at differences in shape, density and polyp matching. The ease of achieving this is the hallmark of CT colonography software and I have found this very intuitive over the years. I use Vitrea myself and to teach others,” he adds.

Empowering Radiographers in Clinical Reporting
The shortages of radiographers and radiologists have been long documented. Even before the Covid pandemic amplified waiting times for diagnostics, the challenge of succession planning for retiring radiologists, and reducing radiographer burnout was making headlines. The opportunity for alleviating growing reporting workload could be to bring specially trained radiographers into the role supported by specialist visualisation and reporting software.

“Evolving the role of radiographers in CT colonography reporting to support radiologists and the cancer care continuum is vital,” states Dr Burling.

“The National CT Colonography Training and Accreditation Programme (NCTCTAP) is at the forefront of progress in this area. By bringing together CTC experts from across the UK, the program aims to narrow the gap in CT colonography performance variations and improve quality. The associated PERFECTS2 study examines the performance effects of empowering radiographers through training. Similar to the extension of nurses’ roles, empowering radiographers in CT colonography reporting could bring significant
efficiency benefits to the NHS. Radiographers are cost-effective, dedicated to specific specialties, and capable of providing interpretation services multiple days a week.”

“The potential extension of the role of radiographers could have huge efficiency benefits to the NHS in the short to medium term. Radiographers are more cost-effective compared to radiologists and they are dedicated to specific specialities. For example, if you can successfully train a radiographer on CT colonography reporting, you could be getting 2-3 days of interpretation a week from that person compared to 0.5 days a week from a radiologist. This has enormous potential for speeding up healthcare,” he explains.

Harnessing Healthcare IT Innovations
Healthcare IT innovations, like the Vitrea® suite of Advanced Visualization tools, facilitate quick and easy diagnostic reporting and visualization.

When combined with comprehensive people development programs, this partnership between Canon Medical UK and NCTCTAP has the potential to expedite referral-to-treatment rates and address radiology resource gaps.

“The colonoscopy conundrum can be solved through the use of CT colon analysis tools and expanded radiology training programs. By embracing innovative technology and empowering radiographers, the healthcare system can enhance efficiency,” concludes Dr Burling.

Photo Captions: All scans taken by Dr David Burling, Gastrointestinal Radiologist, using the Vitrea®Advanced Visualisation CT Colon Analysis package.

Mark Hitchman, Managing Director of Canon Medical Systems UK, discusses the creation of the UK’s first carbon-neutral built community sports and event arena with an integrated Medical Diagnostic Centre. He explains why this unique fusion of sport and wellbeing will be a catalyst for positive regional health plus highlights how its creation will advance medical technology innovation, build trust in health data and accelerate disease prevention.

Where we live shouldn’t determine how long we live. Yet across the UK there are areas of inequality where wellness can still be determined by socio-economic groupings or postcodes. This is a huge challenge for modern healthcare.

Progress is being made with the government’s Levelling-Up strategy funding projects up and down the country to close the gap between the wealthier and poorer parts of the nation. This includes many health related initiatives that aim to improve ‘wellbeing’ and narrow gaps in healthy life expectancy between the areas where it is lowest and highest.

At the same time, the NHS England roll out of Community Diagnostic Centres (CDCs) has gathered pace. This is increasing the numbers of diagnostic imaging tests and MRI, CT or Ultrasound scans accessible to patients to help address some of the challenges and delays associated with the Covid-era while also looking to the future by increasing frontline diagnostic capacity. A total of 160 new CDCs has been promised by March 2025 and latest figures suggest that the initiative has delivered an additional three million checks since the programme started in mid-20211.

Creating health equality through wellness
With the above in mind, a decision was made to develop a unique community sports and event arena with an integrated Medical Diagnostic Centre. The project’s construction is now complete on Sheffield Olympic Legacy Park, a regenerated life sciences and recreation area alongside other key organisations focused on health, wellbeing, sport, education and research. It is located next to a residential area housing some of the UK’s poorest and ethnically diverse communities.

First of a kind initiative
This blueprint initiative is built on a belief that the way to improve people’s overall wellbeing is through proactive health, sport, social engagement and education; creating a cycle of future health prosperity that boosts a longer quality of life. With Canon’s long links to charitable causes, academic partnerships, health research and development organisations in South Yorkshire, the city of Sheffield is an obvious choice to build this first-of-a kind catalyst for societal change.

When it comes to health inequality, Sheffield continues to lag behind the England average on most outcomes including life expectancy, healthy life expectancy, educational attainment, unemployment and housing. Bleakest of all is the inequality in healthy life expectancy in Sheffield – 20 years between the most and least deprived men; 25 years for women2. It is further estimated that 20% of deaths per annum in Sheffield could be prevented by removing the direct cause factors of obesity, physical inactivity and environmental pollution.

So, in a bid to encourage greater accessibility to affordable sporting facilities, the Arena will aim to help people partake in exercise to reduce weight and create healthier lifestyles, at the same time as providing a one-stop-shop for symptomatic healthcare.

It encompasses a flexible multi-sporting facility, featuring three full-size basketball courts, and is designed to hold 2500 spectators. It is the new home for the Sheffield Sharks and the Sheffield Hatters (women) professional basketball
teams, and is also available to wider sporting, education and community organisations. Run by PCA Ltd, it also features a café and function/meeting rooms including a Study Support Centre that will work with disadvantaged children from the area.

A medical diagnostic centre in the heart of the community
To the north end of the Arena we have opened a state-of-the-art Medical Diagnostic Centre featuring Canon Medical’s advanced imaging systems including AI-assisted CT and MRI, diagnostic ultrasound, and digital X-ray. Also available is fluoroscopy, consulting rooms and a minor surgery operating theatre. The centre is operated and staffed by The LivingCare Group is available to the community in conjunction with local Integrated Care Systems, NHS providers and health insurance companies.

Canon Medical Arena also provides the South Yorkshire region with its first specialist sports diagnostic imaging facility that will translate elite-level health, injury and rehabilitation learnings to routine clinical practice. This enables early detection, prevention and faster rehabilitation for sports injury and illness, as well as provide
pre-season medicals and sports injury services to professional, elite, semi-professional and committed athletes.

Alleviating health workforce pressures by introducing hybrid staffing models
Pressure on healthcare resourcing has long been predicted due to the retirement rates in specialities such as radiology coupled with the replacement delays from long training timeframes for new recruits. Covid has added to this workforce crisis with well- documented burnouts of NHS staff who had to just keep going through the darkest days. Despite the introduction of new systems and strategies to catch up on the growing waiting lists, new community-based diagnostic centres cannot operate without people power.

Canon Medical recognise this and that the evolution of modern healthcare goes further than just increasing capacity and volume of imaging systems. It also requires strategic consideration of how to innovate the deployment of human resources in healthcare facilities. This has been factored into the development of the Canon Medical Arena. By working in collaboration with specialist partners, new ideas on staffing models – to work alongside the arrival of new CT and MRI scanners – are happening. This approach is about working to support the NHS to improve productivity by creating a rich and shared talent pool, and building back resilience in existing people by creating flexible roles and training new people for the future.

Winning workflows that help to see more patients each day Installation of the very latest medical imaging systems into the Medical Diagnostic Centre will also help drive operational productivity benefits to see more patients during the working day and battle through waiting lists.

This will include the introduction of the latest generation of imaging systems with built-in AI and automation features. These help radiographers or sonographers with patient positioning, procedural consideration and accurate image acquisition first time to improve workflow efficiency.

For example, a new MRI scanning planning tool, Auto Scan Assist, will form part of the new imaging innovations. This utilises Deep Learning and Machine Learning to enhance diagnostic imaging of a wide range of anatomical examinations from Musculoskeletal (MSK), breast, cardiac, knee, liver, prostate, to whole spine to achieve greater efficiencies. Early data3 indicates that this can not only reduce the workload burden by up to 80% on MRI radiographers, but also improve overall workflow and the potential number of MR examinations and procedures to be carried out throughout the working day. A 75% reduction in operating time and workflow also reduces the overall examination times for patients, improving their comfort and experience.

Advancing preventative health & screening programmes
The advent of Community Diagnostic Centres (CDCs) can be applauded for the success of increasing the number of diagnostic imaging tests and scans accessible to patients. Yet one of the downsides widely reported is that the conceptional aim of preventative health closer to the community still has some way to go.

Early diagnosis is far better for the longterm health economy. Identifying some conditions or disease early can enable the prescription of lifestyle shifts, such as diet and exercise, before invasive, complicated and costly hospital interventions are required. So, imagine the potential if healthcare professionals could detect health population problems even earlier before symptoms present.

Early diagnosis
Screening programmes are hugely beneficial – 10,000 lives a year are saved through prevention and early diagnosis4. The potential quality of life that could be saved if more people were seen and targeted by understanding disease prevalence in more detail following data analysis by postcode or patient profile is certainly worth pursuing.

This is another bold and ambitious aim with the Canon Medical Arena and works in synergy with the government’s Medical Technology Strategy5 and its priority actions of early diagnosis and industry engagement. The Canon Medical Arena has been designated to undertake research and development of health screening and disease prevention and as a regional location for a health diversity project to accelerate AI for early disease detection.

Keeping carbon zero as a health objective
Another important element of the Canon Medical Arena is its close observation of sustainability agendas such as ‘Delivering a Net Zero NHS’, ‘Greener NHS’ and Sheffield’s own ambitions to be a net-zero carbon city by 2030.

The Canon Medical Arena is a carbon-neutral build plus providing closer-to-home diagnostic imaging. This reduces the need for lengthy travel and promotes the use of shared public transport that is already in place on Sheffield Olympic Legacy Park. This contributes to reducing carbon emissions associated with healthcare appointments.

Furthermore, the lifetime carbon footprint of the imaging equipment inside the Medical Diagnostic Centre will be offset through Canon Medical’s unique and decade-long carbon offsetting scheme. This calculates the total carbon emissions from the manufacture, packaging, shipping and average energy usage for the whole lifetime of the diagnostic imaging system, and then offsets it to a highimpact project that reduces CO2 from damaging the natural environment
and contributing to climate change.

Healthcare beyond the walls of the traditional health estate
Strengthening the spirit of community and encouraging healthy, active lives is an essential philosophy for long-term modern healthcare. The walls of the traditional hospital environment as we know it have expanded, and serving patient communities means developing ideas and new processes of how we build, adapt, service and maintain new community-based healthcare facilities. It’s exciting and it’s most certainly essential.

References
1 One-stop-shops for testing deliver over 3 million potentially lifesaving checks, tests and scans, 13/02/23, https://www.gov.uk/government/news/one-stop-shops-for-testing-deliver-over-3-millionpotentially-lifesaving-checks-tests-and-scans
2 NHS Sheffield Annual Report 20/21, https://www.sheffieldccg.nhs.uk/Downloads/About%20US/Documents%20Policies%20and%20Publications/2020%2021%20Annual
%20Report%20including%20Annual%20Accounts%20without%20front%20page.pdf
3 Canon Medical Systems internal data results of image selection, plan setting and time savings, https://eu.medical.canon/products/magnetic-resonance/auto-scan-assist
4 Review of national cancer screening programmes in England, 2019, https://www.england.nhs.uk/publication/terms-of-reference-review-national-cancer-screening-programmes-england/
5 Department of Health & Social Care, Medical Technology Strategy, Feb 2023,
https://www.gov.uk/government/publications/medical-technology-strategy/medical-technology-strategy

Picture Caption 1: Canon Medical Arena, Sheffield.

Picture Caption 2: Sheffield Sharks Basketball Team using the basketball court inside Canon Medical Arena.

Picture Caption 3: LivingCare using an MRI Vantage Galan 3T inside Canon Medical Arena’s Medical Diagnostic Centre.

Picture Caption 4: LivingCare using an ultrasound Aplio i-series inside Canon Medical Arena’s Medical Diagnostic Centre.