The Centre has a long history of developing new techniques for medical imaging (particularly in magnetic resonance imaging), transforming them from a primarily diagnostic modality into an interventional and therapeutic platform. This is facilitated by the Centre's strong engineering background in practical imaging and image analysis platform development, as well as advances in minimal access and robotic assisted surgery. Hamlyn has a strong tradition in pursuing basic sciences and theoretical research, with a clear focus on clinical translation.

In response to the current paradigm shift and clinical demand in bringing cellular and molecular imaging modalities to an in vivo – in situ setting during surgical intervention, our recent research has also been focussed on novel biophotonics platforms that can be used for real-time tissue characterisation, functional assessment, and intraoperative guidance during minimally invasive surgery. This includes, for example, SMART confocal laser endomicroscopy, time-resolved fluorescence spectroscopy and flexible FLIM catheters.

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  • Journal article
    Chabloz N, Wenzel M, Perry H, Yoon I, Molisso S, Stasiuk G, Elson D, Cass A, Wilton-Ely Jet al., 2019,

    Polyfunctionalised nanoparticles bearing robust gadolinium surface units for high relaxivity performance in MRI

    , Chemistry - A European Journal, Vol: 25, Pages: 10895-10906, ISSN: 0947-6539

    The first example of an octadentate gadolinium unit based on DO3A (hydration number q = 1) with a dithiocarbamate tether has been designed and attached to the surface of gold nanoparticles (around 4.4 nm in diameter). In addition to the superior robustness of this attachment, the restricted rotation of the Gd complex on the nanoparticle surface leads to a dramatic increase in relaxivity (r1) from 4.0 mM‐1 s‐1 in unbound form to 34.3 mM‐1 s‐1 (at 10 MHz, 37 °C) and 22 ± 2 mM‐1s‐1 (at 63.87 MHz, 25 °C) when immobilised on the surface. The ‘one‐pot’ synthetic route provides a straightforward and versatile way of preparing a range of multifunctional gold nanoparticles. The incorporation of additional surface units improving biocompatibility (PEG and thioglucose units) and targeting (folic acid) lead to little detrimental effect on the high relaxivity observed for these non‐toxic multifunctional materials. In addition to the passive targeting attributed to gold nanoparticles, the inclusion of a unit capable of targeting the folate receptors overexpressed by cancer cells, such as HeLa cells, illustrates the potential of these assemblies.

  • Journal article
    Modi HN, Singh H, Fiorentino F, Orihuela-Espina F, Athanasiou T, Yang G-Z, Darzi A, Leff DRet al., 2019,

    Association of residents' neural signatures with stress resilience during surgery

    , JAMA Surgery, Vol: 154, ISSN: 2168-6254

    Importance: Intraoperative stressors may compound cognitive load, prompting performance decline and threatening patient safety. However, not all surgeons cope equally well with stress, and the disparity between performance stability and decline under high cognitive demand may be characterized by differences in activation within brain areas associated with attention and concentration such as the prefrontal cortex (PFC). Objective: To compare PFC activation between surgeons demonstrating stable performance under temporal stress with those exhibiting stress-related performance decline. Design, Setting, and Participants: Cohort study conducted from July 2015 to September 2016 at the Imperial College Healthcare National Health Service Trust, England. One hundred two surgical residents (postgraduate year 1 and greater) were invited to participate, of which 33 agreed to partake. Exposures: Participants performed a laparoscopic suturing task under 2 conditions: self-paced (SP; without time-per-knot restrictions), and time pressure (TP; 2-minute per knot time restriction). Main Outcomes and Measures: A composite deterioration score was computed based on between-condition differences in task performance metrics (task progression score [arbitrary units], error score [millimeters], leak volume [milliliters], and knot tensile strength [newtons]). Based on the composite score, quartiles were computed reflecting performance stability (quartile 1 [Q1]) and decline (quartile 4 [Q4]). Changes in PFC oxygenated hemoglobin concentration (HbO2) measured at 24 different locations using functional near-infrared spectroscopy were compared between Q1 and Q4. Secondary outcomes included subjective workload (Surgical Task Load Index) and heart rate. Results: Of the 33 participants, the median age was 33 years, the range was 29 to 56 years, and 27 were men (82%). The Q1 residents demonstrated task-induced increases in HbO2 across the bilateral ventrolateral PFC (VLPFC) and right dorsolateral P

  • Journal article
    Li Q, Lin J, Clancy NT, Elson DSet al., 2019,

    Estimation of tissue oxygen saturation from RGB images and sparse hyperspectral signals based on conditional generative adversarial network

    , International Journal of Computer Assisted Radiology and Surgery, Vol: 14, Pages: 987-995, ISSN: 1861-6410

    Purpose: Intra-operative measurement of tissue oxygen saturation (StO 2 ) is important in detection of ischaemia, monitoring perfusion and identifying disease. Hyperspectral imaging (HSI) measures the optical reflectance spectrum of the tissue and uses this information to quantify its composition, including StO 2 . However, real-time monitoring is difficult due to capture rate and data processing time. Methods: An endoscopic system based on a multi-fibre probe was previously developed to sparsely capture HSI data (sHSI). These were combined with RGB images, via a deep neural network, to generate high-resolution hypercubes and calculate StO 2 . To improve accuracy and processing speed, we propose a dual-input conditional generative adversarial network, Dual2StO2, to directly estimate StO 2 by fusing features from both RGB and sHSI. Results: Validation experiments were carried out on in vivo porcine bowel data, where the ground truth StO 2 was generated from the HSI camera. Performance was also compared to our previous super-spectral-resolution network, SSRNet in terms of mean StO 2 prediction accuracy and structural similarity metrics. Dual2StO2 was also tested using simulated probe data with varying fibre number. Conclusions: StO 2 estimation by Dual2StO2 is visually closer to ground truth in general structure and achieves higher prediction accuracy and faster processing speed than SSRNet. Simulations showed that results improved when a greater number of fibres are used in the probe. Future work will include refinement of the network architecture, hardware optimization based on simulation results, and evaluation of the technique in clinical applications beyond StO 2 estimation.

  • Journal article
    Marques MJ, Hughes MR, Vyas K, Thrapp A, Zhang H, Bradu A, Gelikonov G, Giataganas P, Payne CJ, Yang G-Z, Podoleanu Aet al., 2019,

    En-face optical coherence tomography/fluorescence endomicroscopy for minimally invasive imaging using a robotic scanner.

    , Journal of Biomedical Optics, Vol: 24, Pages: 1-15, ISSN: 1083-3668

    We report a compact rigid instrument capable of delivering en-face optical coherence tomography (OCT) images alongside (epi)-fluorescence endomicroscopy (FEM) images by means of a robotic scanning device. Two working imaging channels are included: one for a one-dimensional scanning, forward-viewing OCT probe and another for a fiber bundle used for the FEM system. The robotic scanning system provides the second axis of scanning for the OCT channel while allowing the field of view (FoV) of the FEM channel to be increased by mosaicking. The OCT channel has resolutions of 25  /  60  μm (axial/lateral) and can provide en-face images with an FoV of 1.6  ×  2.7  mm2. The FEM channel has a lateral resolution of better than 8  μm and can generate an FoV of 0.53  ×  3.25  mm2 through mosaicking. The reproducibility of the scanning was determined using phantoms to be better than the lateral resolution of the OCT channel. Combined OCT and FEM imaging were validated with ex-vivo ovine and porcine tissues, with the instrument mounted on an arm to ensure constant contact of the probe with the tissue. The OCT imaging system alone was validated for in-vivo human dermal imaging with the handheld instrument. In both cases, the instrument was capable of resolving fine features such as the sweat glands in human dermal tissue and the alveoli in porcine lung tissue.

  • Conference paper
    Adshead J, Oldfield F, Hadaschik B, Everaerts W, Mestre-Fusco A, Newbery M, Elson D, Grootendorst M, Vyas K, Fumado L, Harke Net al., 2019,

    A pelvic phantom and porcine model study to evaluate the usability and technical feasibility of a tethered laparoscopic gamma probe for radioguided surgery in prostate cancer

    , Annual Meeting of the Society-of-Nuclear-Medicine-and-Molecular-Imaging (SNMMI), Publisher: SOC NUCLEAR MEDICINE INC, ISSN: 0161-5505

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