Could medical imaging innovation be the catalyst for precision medicine?

We all have a unique face, fingerprint, voice and signature, so why wouldn’t we have a unique response to the medicine and treatments we receive?

Personalised precision medicine is the use of an individual’s health profile, including their genetic makeup, alongside environmental and lifestyle factors to guide diagnosis, prevention and treatment of disease. With a record 3.7 million workers in England projected to be living with major illness by 2040[i], driven up by factors such as age, obesity and addiction, such a concept has been heralded as a crucial component in the migration towards a smarter and more effective approach to healthcare.

Cancer is one condition where precision medicine promises to deliver a huge impact, with doctors already using it to treat several types of cancer, including chronic myeloid leukaemia (CML) and some cases of lung, bowel and breast cancers[ii]. In the past, everyone with the same type of cancer used to get the same treatment. But the one-size-fits-all approach isn’t always the most effective. Every person’s cancer has its own genetic makeup, and increased focus is being put on developing treatments to target those differences and producing treatment pathways tailored towards the individual.

Whilst precision medicine for cancer treatment is an area that researchers are still working on, exciting developments such as the Stratified Medicine Paediatrics 2 (SMPaeds2) research programme (launched in November 2023)[iii] will see £5.5 million of funding put into advancing precision medicine for children and young people with returning cancer – another step closer to a tailored treatment future.

In addition to enabling better treatment outcomes, experts believe precision medicine will help lower healthcare costs by guiding doctors in choosing treatments that are likely to work best and helping to prevent disease in the future. This means a patient might avoid certain treatments, along with unnecessary side effects (and the possible costs that might go along with them). With the NHS continuing to grapple with alarming levels of debt[iv] – driving treatment efficiency and cost savings has never been more important to future stability.

Although there is still some way to go to unlock the full potential of personalised precision medicine within the UK health system and across the globe, exciting advancements in diagnostic technology are already moving in this direction – facilitating enhanced precision and accuracy for better treatment outcomes.

Rising demand for precision procedures

One area where greater precision is already driving a huge impact in healthcare is within complex procedures such as Prostate Artery Embolization (PAE), a non-surgical procedure using Interventional Radiology (IR) systems to shrink an enlarged prostate or Benign Prostatic Hyperplasia (BPH). These procedures offer reduced risk and see patients discharged the very same day, allowing them to get back to their normal daily lives quicker, whilst freeing up hospital beds.

IR refers to a range of techniques which rely on the use of radiological image guidance to precisely target therapy. This can include X-ray fluoroscopy, ultrasound, CT or MRI. The continued tide of innovation in IR is helping to evolve traditional surgical options by providing alternatives that are less invasive whilst speeding up procedural and recovery times for patients.

Advances in the technology behind these systems mean that clinicians can now benefit from superior ergonomic access to patient anatomy, via features such as floor and ceiling-mounted C-arms which offer full-body coverage from head-to-toe and fingertip-to-fingertip – increasing precision and aiding workflow efficiency. Superior image quality, that can be achieved at a low radiation dose, is also vital for navigation accuracy and decision certainty whilst safeguarding the patient and operator throughout the procedure.

Forth Valley Royal Hospital has been carrying out PAE procedures since early 2024 and has introduced new services treating liver cancer using its IR system. An example of this includes the Chemosaturation procedure which is a complex treatment involving cardiac bypass and administering high-dose chemotherapy directly into the hepatic artery with systemic circulation isolation[v].

A fusion of modalities 

The combination of images from multiple medical imaging modalities is another key factor to consider when driving increased precision for both diagnostics and treatment. Advanced fusion imaging innovation of this kind enables the accurate targeting of biopsies by merging real-time ultrasound with previously acquired CT, MRI or ultrasound data to highlight concern areas. This allows clinicians to identify and compare lesions indicative of disease with ease whilst navigating complex anatomy securely.

Improved accuracy negates the need for a patient to return for a repeat procedure while speeding up the timeframe to receive pathology results to treat the patient accordingly. This can help save lives by delivering better outcomes sooner.

AI-enhanced image quality

Whilst the fusion of modalities and use of advanced IR systems are certainly driving momentum, high image quality remains a fundamental necessity on the road to a precision medicine future.

Technologies such as AI are advancing the capabilities of medical imaging machines, with advancements in innovative deep-learning reconstructive technology enabling users to reduce noise and boost signal to deliver sharp, clear and distinct images at speed. 3D imaging in modalities such as CT and MRI allows clinical practitioners to see images from different perspectives, but it also generates more noise due to the additional data acquisition required. By filtering out noise and motion artefact, users can focus on the information they need for precise and effective diagnosis and treatment.

Are we there yet?

The movement towards precision medicine is certainly underway with the development of medical imaging systems and technologies geared towards facilitating such a future. Research is also in motion to support a preventative approach to healthcare by looking closely at the environmental and lifestyle factors that can impact the population’s health and risk of disease in the future. In October 2023, Sheffield and Sheffield Hallam University joined forces with other key stakeholders to launch an ambitious new digital healthcare hub in South Yorkshire, to develop innovative digital technologies to improve the way diseases are diagnosed and treated[vi]. Following recent investment from Google[vii], a series of research opportunities have been set in motion, including the PUMAS study which aims to understand whether pixel smartphone sensors that detect light, radar and electrical signals from the heart could aid the detection of common conditions such as hypertension, high cholesterol and chronic kidney disease. Early detection of such conditions is set to change the way people interact with their health by making informed life choices that can slow down or even prevent progression. This has the potential to save lives, improve health outcomes and free up valuable NHS resources.

Today, the healthcare industry has more data about people, their habits and their overall health than ever before. To maximise the true value of the information available, we need to bring together genomic, clinical and diagnostic medicines, and lifestyle data. It is the integration and analysis of this information that forms the powerhouse for personalised precision medicine and, in turn, better patient outcomes with the added benefit of this coming in at a lower unit cost per patient.

[i] Health inequalities in 2040 (April 2024). https://www.health.org.uk/publications/health-inequalities-in-2040.

[ii] What is personalised medicine? (no date). https://www.cancerresearchuk.org/about-cancer/treatment/personalised-medicine.

[iii] The Institute of Cancer Research, London (no date) Major collaborative childhood cancer research programme launched with. https://www.icr.ac.uk/news-archive/major-collaborative-childhood-cancer-research-programme-launched-with-5.5-million-children-with-cancer-uk-and-cancer-research-uk-funding.

[iv] Helm, T. and Campbell, D. (2023) 'NHS sinks into £7bn cash crisis as inflation and strikes bite,' The Guardian, 17 September. https://www.theguardian.com/society/2023/sep/17/nhs-sinks-into-7bn-cash-crisis-as-inflation-and-strikes-bite.

[v] Canon Medical Systems UK (2023) How ceiling-mounted IR helped protocolise same-day Prostate Artery Embolization - Canon Medical Systems Ltd. https://uk.medical.canon/how-ceiling-mounted-ir-helped-protocolise-same-day-prostate-artery-embolization/.

[vi] Sheffield Olympic Legacy Park (2023) South Yorkshire leads the UK’s digital healthcare revolution - Sheffield Olympic Legacy Park. https://sheffieldolympiclegacypark.co.uk/south-yorkshire-leads-the-uks-digital-healthcare-revolution/.

[vii] Sheffield Olympic Legacy Park (2024) South Yorkshire Digital Health Hub unveils Google investment - Sheffield Olympic Legacy Park. https://sheffieldolympiclegacypark.co.uk/south-yorkshire-digital-health-hub-unveils-google-investment-to-tackle-health-inequalities-and-drive-economic-growth/.