Published in the Staff E-bulletin on Thursday 2 February 2012. Please note, staff will need to log in to read the bulletin.

Advances in Imaging and Biomedical Engineering have dramatically changed the practice of medicine and have transformed patient diagnosis and treatment. Professor Reza Razavi leads the Imaging and Biomedical Engineering Clinical Academic Group (CAG), which provides comprehensive imaging facilities across one of the largest set ups of its kind in Europe. He explains more about this vital medical discipline:

What is imaging and biomedical engineering?
Imaging is the medical discipline of taking pictures of the body to see its different organs and how they function. It enables us to make diagnoses, look at a patient’s response to treatment and guide treatments in real-time, for example in the keyhole surgery technique.

Biomedical engineering is the physics, maths, engineering and chemistry that underpin the technology used in imaging. In Guy’s and St Thomas and King’s College Hospital, biomedical engineers look after and develop medical equipment and software. In the College, we have a large department conducting research in this area covering everything from the programming of new devices to software which simulates how the body works.

What are the CAG’s key aims and ambitions?
Our first aim is to integrate excellence in clinical services, research and education by bringing everyone together to work as an integrated team, which will enable us to be more effective in delivering clinical services and research innovations. Education is also vital. Through our teaching programmes, we need to ensure our radiographers, nurses, doctors and scientists are stars of the future.

Another ambition is to work more closely with GPs and the frontline of primary healthcare by using imaging to work out whether a patient really needs secondary care treatment. Currently, following a referral from a GP patients are often sent to specialists before they are referred to imaging. When appropriate, it would be more efficient for patients to come directly for imaging so that we can let the GP know results quickly and start treatment if needed. 

Finally we want to expand our work in interventional radiology. This is where operations are carried out using keyhole techniques by inserting devices and treatments down small holes instead of cutting people open. We also want to expand our radionuclide therapy work - treatment which uses antibodies or other agents to deliver radioactivity to diseased parts of the body and kill off faulty cells, including cancers.

What do you see as the most exciting aspect of work in your CAG at the moment?
We’re developing new tracers to put into patients that help us better diagnose diseases and provide more effective treatments, which will be a world-first. How the two hospitals are coming to work together is also exciting. In radionuclide therapy for example, King’s College Hospital and Guy’s and St Thomas’ have the same protocols, management and sharing best practice to come up with the best way of treating patients.

How do you collaborate with other CAGs?
We have a lot of interaction with other CAGs, particularly Cancer and Cardiovascular. Indeed, we have academic departments in our CAG called Cardiovascular and Cancer Imaging, which focus on those areas of medicine. Lots of the researchers in cardiovascular imaging are cardiologists who also work in the Cardiovascular CAG. Collaboration allows us to share best practice about how to manage patients.

Tell us about your research in cardiovascular disease.
The three main patient groups I am involved in are patients with congenital heart disease – so children and adults who are born with heart problems; patients with cardiac arrhythmias; and patients with heart failure that need specialised pace makers. My research involves using imaging to make diagnoses and as a tool to guide therapy. Most imaging procedures use x-ray or ultrasound, but we’re the first people in the world to use MRI to do cardio-catheter procedures and cardiovascular therapy inside the MR scanner. By bringing MRI, ultrasound and x-ray together, we get a fuller picture for interventional procedures.

What is PET (positron emission tomography) imaging and how does it differ to MRI scans?
PET scanning is a technique where a tracer is put in the body and then detected by a scanner. By locating where the tracer is and how much of it there is, we can ascertain information about diseases.

MRI works in a very different way. It uses a large magnet and radio transmitters to make hydrogen atoms in the body emit radio waves, which are picked up with a big antenna. We then use maths to locate where particular hydrogen atoms are. As hydrogen is in every water molecule, and different tissues have different amounts of water, they produce different amounts of signal enabling us to differentiate between tissues and see structures inside the body and how they move.

Does the CAG have an education programme?
Yes, we have many - from training radiologists and nuclear physicians to our new undergraduate biomedical engineering course which will start in September 2012. We also run a new Masters programme in clinical engineering and medical physics which is both a postgraduate qualification and part of the training programme provided for scientists working in the NHS.

How has imaging transformed the treatment of patients with mental healthcare needs?
For the last 15 to 20 years, there has been a fantastic team at the Institute of Psychiatry led by Professor Steve Williams pioneering neuroimaging nationally and internationally. They have found that by scanning the brains of patients with mental health disorders, you see a physical difference. We’re developing new technology at the King’s Medical Engineering Centre (MEC) for patients with depression, schizophrenia and autism enabling us to scan brains and make diagnoses much quicker than with traditional methods. Brain scans can also reveal very quickly whether patients are responding to treatment.

What practical difference would you like the CAG to make for service users?
For us the bottom line is to improve patient care. That’s why I’m a doctor and that’s why I get up in the mornings and do what I do. We can do this by providing a patient friendly and convenient service. Our users should come here to see the most highly skilled imaging specialists using the best equipment and the latest cutting edge medicine. It’s also really important that our users know they are helping to push the frontiers of medicine forward as partners in our research and teaching. 

What is the one piece of advice you would give staff working in your CAG?
To start thinking about the different way of working King’s Heath Partners offers. We want our staff to engage with the mission of providing excellence in clinical care, research and education. This means working in partnership with other colleagues in different hospitals and areas so that together we can achieve better health care.