Thanks to the generosity of our donors and supporters, we are able to launch what is probably the most significant transformation in the centre’s history, bringing three new scanners to Mount Vernon.
Major upgrade to centre brings AI to Mount Vernon
Thanks to the generosity of our donors and supporters, we are able to launch what is probably the most significant transformation in the centre’s history, bringing three new scanners to Mount Vernon that capitalise on the artificial intelligence (AI) revolution in modern cancer imaging.
A major upgrade to Paul Strickland Scanner Centre’s MRI and PET-CT scanning capabilities will allow patients to benefit from the artificial intelligence revolution sweeping modern medicine.
The upgrade involves the installation of two new MRI scanners and a new PET-CT scanner, as well as a revolution in our IT capabilities, vital to diagnosis and treatment planning in modern cancer care. In addition, a far-reaching refurbishment of the centre, including waiting area, will be undertaken. Donations and legacies from our supporters have played a significant role in making the £6million upgrade, possibly the biggest in the centre’s history, a reality.
All three scanners, manufactured by medical imaging industry market leader Siemens Healthineers, come with very advanced software which will make scans faster and provide better images to our radiologists, which in turn could lead to a more accurate diagnosis and better informed treatment plans used by medical teams in patient care.
One of the MRI scanners was not originally scheduled for replacement and the charity has now launched a fundraising drive to secure the additional expenditure.
Mr Will McGuire, the long-standing Deputy Superintendent for MRI at Paul Strickland Scanner Centre, is leading on the MRI side of the upgrade project. He said: “We are replacing our existing 3T and 1.5T MRI scanners with two new very advanced 1.5T MRI scanners, a decision taken specifically with the needs of cancer patients in mind. Not only will the new scanners have a much wider opening, which is better for bigger patients and those who are claustrophobic, but they will be able to scan patients faster and produce better images. In addition, they will allow us to scan more people who have had implants, such as metal hips, than currently and therefore increase patient access.”
Perfect for whole-body MRI
The new MRI machines, which will form part of our fleet of three MRI scanners, are also an excellent choice for whole-body MRI scans, an area where Paul Strickland Scanner Centre is the undisputed global leader.
In addition to providing more cancer patients access to MRI scans, the new scanners are more comfortable for patients, feature next-generation safety features, are more reliable and more environmentally sustainable. Will said: “MRI scanners need helium to operate and our current scanners need to be refuelled every few months, which typically means they are out of action for a day. Helium is a finite and rare resource on Earth and the world is running out of it. The new scanners feature ‘zero boil-off’, which means they should not need to have their helium stores replenished.”
“Our scanners are already really fast and very high quality compared to many other centres and it’s the software the new scanner uses that will take things to the next level.” Scanning times could be reduced by as much as 60%, which means we could potentially scan twice as many patients on any given day as currently, significantly increasing access to our high-quality imaging service for cancer patients.
“It’s the first time we have used deep learning, often referred to as artificial intelligence, as part of the image acquisition. The scanner software has been trained on thousands of scans. When the radiographer runs the scan, the scanner takes less data from the patient and the ‘Deep Resolve’ software then basically fills in the gaps based on its knowledge. The software packages we will get will both reduce ‘noise’ on scan images and provide radiologists with a better definition image.
“When you put together the better hardware and new software, you are looking at insane levels of time reduction, with better image quality at the same time.”
While the new scanner will be easier to use for staff, one remarkable feature is that it will be able to run a prostate MRI completely by itself for the first time. “It’s a bit of a threat to the radiographer profession, however the benefit for the patient is that you eliminate variability between scans caused by the operator, as every scan will be done in exactly the same way.
“If your objective is the improvement of healthcare, then it’s got to be this way, in particular given the long-standing staffing pressures in the industry. You can produce thousands of MRI scanners, but who is going to run them? We’re embracing the future.” Another exciting part of the project is Relax and View panels, which are due to be installed on the ceiling of the new scanner room and create a pleasant and uplifting distraction for patients being scanned.”
The project is due to start in March, with the old machines being removed consecutively in the first instance and an upgrade of the control room from where radiographers operate the scanner – as well as installation of the two new scanners. Mobile MRI scanner units will be used to continue the service while the work takes place.
“The new scanners should be in and ready to use in June and August,” says Will. “The project is super exciting because it’s a whole new generation of machine, leading to better patient access to scans and shorter scan times for patients and a better experience altogether.”
A new PET-CT scanner
In addition to MRI, the centre is making a substantial investment in its PET-CT capability, completely revamping our PET-CT suite and replacing our two existing PET-CT scanners with a very advanced new machine (Siemens Biograph Vision600) that will eventually be able to scan as many, if not more patients, on any given day as we currently scan with two scanners.
This part of the project is run by Mr Bruno Ferreira, our Superintendent for PET-CT. He said: “It’s very exciting project – you don’t often see such significant upgrades.” Just as with the MRI upgrade, the improvements will translate into more patient comfort and much faster scan times.
Faster scans for patients, with fewer re-scans
PET-CT scans can take between 25 to 30 minutes, but with the new scanner we can complete the process potentially in less than half that time, with the scan itself taking as little as 7 minutes. The new scanner will also provide better scan images, due to a reduction in “motion artefacts” (scan image distortions due to movement by the patient during the scan). Bruno said: “It can be very difficult for someone to remain completely motionless for over 20 minutes. As a result it will be less likely that a patient will have to come back for additional scans, saving them time and exposure to additional radiation.
In addition, it also saves our team time which can then be put into scanning more patients and our radiologists reporting their scans.
‘A game-changer for patients’
“One innovative feature of the new scanner is ‘tailored acquisition modes’, which means it can focus on a particular part of the patient’s body during the scan. Additionally, thanks to artificial intelligence software, the scanner is able to learn the breathing patterns of a particular patient and adapt how it scans accordingly. For example, if the patient has a lesion in the chest that is subject of the scan, the scanner will be able to adjust for the individual up and down movement as the patient breathes, which will make images much clearer for our radiologists who report the scans for the referring clinician, clearly indicating whether a cancer is in the liver or the lung for example. This could be a game-changer for patients.”
Having just one PET-CT scanner instead of two will free up a significant amount of space, which will be used to construct new cannulation and uptake bays, where patients are injected with radiopharmaceutical agent before their scan and wait for it to be dispersed through their body, until they can be scanned in the PET-CT scanner.
The new uptake bays will significantly improve privacy and comfort for our patients and provide improved shielding from radiation to our staff.
The changes are being made with the centre’s recently acquired Posijet (an automatic dispensing and injection device, which can be wheeled from patient to patient) in mind. As a result, there is less need for patients to move around, which can be particularly beneficial for those with mobility problems, and also resulting in a big reduction of radiation dose to the staff Additionally, a new patient waiting area will be created in an annexe on the East side of Paul Strickland Scanner Centre, with views over landscaped gardens, using the innovative modular construction techniques already pioneered elsewhere at Paul Strickland Scanner Centre by Mr Damion Melsome, the centre’s Operations Manager, and which are the envy of others operating on the Mount Vernon site.
Bruno is ambitious about the service and plans to evaluate whether it may be possible for the team to serve even more patients during a given day than currently.
“We could potentially reduce scan times even further in the future, which we will determine with the help of clinical audits.” Bruno and the team will also investigate whether it may also be possible to apply a lower radiation dose to scans, reducing radiation exposure to patients and the staff. “There are no drawbacks for patients, only positives.”
The much-discussed possible move of Mount Vernon Cancer Centre to Watford in the long-term should not create a major problem for Paul Strickland Scanner Centre, as we would move together with the cancer centre (see December 2021 issue of Inside View for more information). If the move happens significantly sooner than 10 years from now, the scanners would be moved to Watford.
If not (which is possible since a decision about a possible move has not yet been made by the Government and Bruno believes the building of a new cancer centre in Watford is likely to only start after the Watford General Hospital rebuild has been completed), both the new PET-CT and MRI scanners would be reaching the end of their lives at that stage. By then, the option to move the existing scanners or change them for new ones, would have to be re-evaluated.
Minimising disruption to patients
“We’re trying to keep the amount of time the project takes to a minimum and have broken it down into phases, minimising any impact on patients. The first phase is due to start at the end of April or beginning of May,” according to Bruno.
The two projects will run at the same time, with the PET-CT project aimed for completion in July, however there may be delays due to Covid-19, if construction workers become ill or need to isolate for example. Difficulties in the sourcing of materials is also something that could delay the project. As with the old MRI scanners, the old PETCT scanner will be sold off to mitigate the cost of the project. “It’s going to be a challenge for the team to run the service at the same time as the building work is going on.”
It is planned to always have at least one PET-CT scanner running at Mount Vernon at any one time, with our satellite site at the Lister Hospital in Stevenage providing additional PET-CT capacity. “This is a huge project but it will be so rewarding when it is done.