Cardiovascular, respiratory, and urinary pathologies

From classic cardiovascular problems:

  • coronary artery stenosis
  • aortic coarctation
  • aortic and cerebral aneurysms
  • cardiac arrhythmia
  • heart valve replacement
  • peripheral stenting, arteriovenous fistula planning, etc.

with experts such as Prof Rod Hose, Prof Pat Lawford, Prof Richard Clayton, Dr Andrew Narracott, Dr Alberto Marzo, Prof Julian Gunn, Prof Chris Newman, Prof Robert Storey, we moved to cardiorespiratory pathologies (for example pulmonary hypertension, Dr David Kiely), and more and more toward respiratory pathologies (Prof Moira White).

We are also running exploratory research on certain urinary pathologies (Prof Albert Ong, Prof Chris Chapple).

Here are some examples of active research:

Risk of mechanical fracture in peripheral stents

As part of the RT3S project, we developed an pre-operative planning tool for peripheral stenting that, depending on patient-specific anatomy, site and lesion characteristics, stent characteristics, and location of the stent, predicts the risk of mechanical fracture, due to recurrent bending and stretch during daily activities (for example in the popliteal region).

Usability has been proven on small group of patients and this could be provided freely as a non-clinical research tool to explore its efficacy in a large multicentre trial.

Technical PI: Prof Pat Lawford, Cardiovascular Science; Clinical PI: Dr Jivendra Gosai, STH.

Non-invasive Fractional Flow Reserve in coronary stenosis

In the VirtuHeart project we are testing our vFFR technology on 200 patients. Fractional Flow Reserve (FFR) is an invasive measurement that was found effective in stratifying coronary stenosis patients for treatment; however, FFR requires special instrumentation, is expensive, and increases risk for the patient. As a result, it is rarely used despite its proven efficacy. The FDA has already approved a vFFR technology (HeartFlow) that estimates the FFR from cardioCT images; this requires imaging, but not the invasive procedure.

In Insigneo we developed an alternative version of the vFFR technology that uses angiography images – the standard procedure for coronary stenosis patients. If the accuracy of our vFFR is confirmed by the VirtuHeart trial, we could establish the Insigneo vFFR as an online service for all UK hospitals, which would submit digital angiography images and receive a model-based estimation of the FFR for that patient.

Technical PI: Prof Rod Hose, Cardiovascular Science; Clinical PI: Prof Julian Gunn, Cardiovascular Science.

Differential diagnosis of pulmonary hypertension

Pulmonary hypertension can be caused by cardiac, vascular, or pulmonary pathologies; a correct differential diagnosis is thus very important, but is also quite complex. By combining imaging and modelling indicators, we are developing a decision support system that on a small retrospective cohort has already showed excellent predictive accuracy.

Technical PI: Prof James Wild, Academic Radiology; Clinical PI: Dr Andrew Swift, Academic Radiology; Dr David Keily, Academic Unit of Respiratory Medicine, STH.

Hyperpolarised gas Proton MRI for lung imaging

The MRC Polaris grant will drive the expansion of the hyperpolarisation services and of the related medical imaging technologies to position Sheffield as the UK leader for this particular type of medical imaging, and as hub for other imaging departments in UK.

This new imaging technology makes it possible to visualise the respiratory apparatus with incredible detail and has immediate clinical applications in COPD, cystic fibrosis, asthma, etc.

Technical PI: Prof James Wild, Academic Radiology; clinical PI: Prof Paul Griffiths, Academic Radiology.