The aim is to develop MR sequences and computer algorithms that will remove distortions in images. The primary application is to improve prostate cancer diagnosis but the methods could potentially be applied to other organs with or without tumours.
The following publications have arisen so far from the grant:
- Kakkar, L., Usman, M., Kirkham, A., Arridge, S., Atkinson, D. Towards the clinical application of model‐based reconstruction framework for distortion correction in prostate diffusion weighted MRI. ISMRM 2020, Poster 4363.
- Usman, M., Kakkar, L., Matakos, A., KIRKHAM, A., Arridge, S., & Atkinson, D. (2020). Joint B0 and image estimation integrated with model based reconstruction for field map update and distortion correction in prostate diffusion MRI. Magnetic Resonance Imaging, 65, 90-99. doi:10.1016/j.mri.2019.09.008
- Usman, M., Matakos, A., Kakkar, L., Arridge, S., & Atkinson, D. (2019). Model based joint B0 and image estimation framework for dynamic field mapping and signal pile-up correction in prostate diffusion MRI. ISMRM 2019
- Atkinson, D., Usman, M., Kakkar, L. S., & Arridge, S. R. (2018). 5652 Geometry in MR Reconstruction. Presented at: Joint Annual Meeting ISMRM-ESMRMB 2018.
- Usman, M., Kakkar, L., Shmueli, K., Arridge, S., & Atkinson, D. (2018). An integrated model-based framework for the correction of signal pile-up and translational offsets in prostate diffusion MRI. ISMRM 2018
- Usman, M., Kakkar, L. S., KIRKHAM, A. P. S., Arridge, S. R., & Atkinson, D. (2018). Model based reconstruction framework for correction of signal pile-up and geometric distortions in prostate diffusion MRI. Magnetic Resonance in Medicine. doi:10.1002/mrm.27547
Ethical approval for the project is in place: UNDISTORT
Background to the grant
Current guidelines (NICE CG175) advocate multi-parametric MRI (T2 and diffusion weighted imaging) for detection of tumour within the prostate and for active surveillance of low risk confirmed disease. However, approximately 40% of diffusion images suffer from distortions and this is most marked in the prostate peripheral zone where 75% of prostate cancers occur. The distortions can make diagnosis harder and may increase the requirement for a biopsy.
The cause of the distortions is magnetic field variations near the interface of tissue and air in the rectum. There is an additional cohort of prostate cancer patients with metallic hip prostheses for whom images are often badly affected over the whole prostate region.
Our approach will be to measure and model the field variations on a person-specific basis. This field map will be one of the inputs to an inverse-problem reconstruction algorithm, together with diffusion data acquired with positive and negative phase encoding gradients. Both signs of this gradient are required to give images where distortions lead to signal contractions and expansions. Without at least two images, it would not be possible to assign the correct intensity value to each pixel in the final image.
The grant has funded two PostDoctoral Research Associate positions. One based in the Division of Medicine, focusing on the MR acquisition, pulse sequences and MR physics, and the other in the Computer Science Department with an emphasis on the field modelling and solution to the inverse problem. The grant is due to finish in March 2021 and there is still a few months of funding for a PostDoctoral researcher. We are currently open to Epxressions of Interest from potential PotDocs who might be able to use this effectively.
The Centre for Medical Imaging has a strong track record of clinical prostate research, working closely with the Urology, Histology, Surgical and Interventional teams at University College London Hospital (UCLH). For the adoption of new imaging methods, there are close links with the Centre for Medical Image Computing and the Centre for Inverse Problems. These links include joint supervision of PhD students, PostDoc RAs and research publications.
Within UCLH, there are 5 MR scanners and 1 PET-MR scanner that perform prostate imaging. A research agreement with Phillips provides access to the code that controls the operation of a 3T Achieva and a 3T Ingenia scanner. Research MR imaging at UCLH re-started in July 2020 following the covid-19 outbreak, subject to safety procedures. We have access to a substantial amount of development time on a scanner located within a part of the hospital not used for covid patients.
Study Participants: Informaton and Recruitment
A lot of testing and development can be undertaken on participants who do not have cancer (or even a prostate!) and many participants will fall into this category.
GDPR Statements to Participants
The Information Sheet provided to participants contains the following description regarding what happens to the data collected in the study:
"The original MR images will be stored securely on a special electronic system at UCL called the UCL Data Safe Haven that is designed to handle confidential medical data. The images may also be stored on the standard UCLH NHS hospital systems. Each participant will be assigned a study ID and the link between study ID and your identity will be stored on the UCL Data Safe Haven. Only members of the research study will have access to this list. Copies of your images will be anonymised, have your study ID assigned, and be used by researchers at UCL who are part of this study. In cases where we wish to understand the connection between improved images and clinical data, for example biopsy results, your medical records may be viewed by trial personnel. This will be the minimal information needed and linked to your identity onlyusing the study ID.
We would like to be able to use your anonymised images for future studies at UCL. We expect to keep the data for 15 years.
Fully anonymised images, with the study ID removed, may be used for teaching and educational purposes and shared with companies and researchers at other institutions (possibly outside the European Union) with whom we collaborate.
Parts of the anonymised data may be published in scientific journals and related media."
The following statements use wording adapted from the Health Research Agency regarding data transparency:
As a university we use personally-identifiable information to conduct research to improve health, care and services. As a publicly-funded organisation, we have to ensure that it is in the public interest when we use personally-identifiable information from people who have agreed to take part in research. This means that when you agree to take part in a research study, we will use your data in the ways needed to conduct and analyse the research study. Your rights to access, change or move your information are limited, as we need to manage your information in specific ways in order for the research to be reliable and accurate. If you withdraw from the study, we will keep the information about you that we have already obtained. To safeguard your rights, we will use the minimum personally-identifiable information possible.
Health and care research should serve the public interest, which means that we have to demonstrate that our research serves the interests of society as a whole. We do this by following the UK Policy Framework for Health and Social Care Research.
If you wish to raise a complaint on how we have handled your personal data, you can contact our Data Protection Officer who will investigate the matter. If you are not satisfied with our response or believe we are processing your personal data in a way that is not lawful you can complain to the Information Commissioner’s Office (ICO).
Our Data Protection Officer is [name] and you can contact them at [email].
UCLH will collect information from you and/or your medical records for this research study in accordance with our instructions.
UCLH will use your name, UCLH Hospital number and contact details to contact you about the research study, and make sure that relevant information about the study is recorded for your care, and to oversee the quality of the study. Individuals from UCL and regulatory organisations may look at your medical and research records to check the accuracy of the research study. UCLH will pass these details to UCL along with the information collected from you and/or your medical records. The only people in UCL who will have access to information that identifies you will be people who need to securely store the collected data or audit the data collection process. The people who analyse the information will not be able to identify you and will not be able to find out your name, UCLH Hospital number or contact details.
UCLH will keep identifiable information about you from this study for the same duration as clinical records. UCL will safely store the collected images for 15 years.
When you agree to take part in a research study, the information about your health and care may be provided to researchers running other research studies in this organisation and in other organisations. These organisations may be universities, NHS organisations or companies involved in health and care research in this country or abroad. Your information will only be used by organisations and researchers to conduct research in accordance with the UK Policy Framework for Health and Social Care Research.
This information will not identify you and will not be combined with other information in a way that could identify you. The information will only be used for the purpose of health and care research, and cannot be used to contact you or to affect your care. It will not be used to make decisions about future services available to you, such as insurance.