Grants awarded: Innovative Engineering for Health

Image-guided intrauterine minimally invasive fetal diagnosis and therapy

Researchers at University College London (UCL), were awarded funding for up to 7 years to develop better tools and imaging techniques that will improve the success of surgery and other therapies on unborn babies in collaboration with KU Leuven, Great Ormond Street Hospital and University College London Hospital.

The project, led by Professor Sebastien Ourselin, will aim to develop low-risk techniques for diagnosis, treatment and therapy of a range of debilitating abnormalities of the baby during pregnancy. Although interventional therapy for the unborn child is already a reality, the procedures have high risk and poor outcomes due to inadequate instrumentation and imaging. By extending state-of-the-art imaging technologies, instrumentation and guidance, the team will build instruments and imaging techniques that provide clearer visualisation of critical structures and their relationship to the surrounding anatomy of the fetus at both microscopic and macroscopic scales while providing the surgeon with the means to safely treat the fetus. This will greatly reduce the risks associated with procedures and will extend the range of possible interventions. An additional shorter term impact is expected in minimally invasive neonatal surgical interventions where instrumentation for early interventional surgery is less developed than that of adult laparoscopic approaches. The proposed platform with miniaturized instruments and imaging probes will facilitate significant impact in this field.

Computer-guided imaging systems for prenatal screening and comprehensive diagnosis of fetal abnormalities

Ultrasound, which passes sound waves into the body to create pictures from their reflections, is commonly used to check that babies in the womb are healthy. Although every pregnant mother in the country has a scan at around 20 weeks, many of the babies who have problems are not picked up on these ultrasound scans.

This is because scanning requires significant expertise which is difficult to have present in every hospital. We are proposing new technologies that allow scanning to be carried out not just with one probe (the device which takes the ultrasound picture) but with up to four probes that can be used at the same time and move automatically to the right place to get the best pictures. This will mean we get a detailed picture of the whole baby which can then be analysed in an automatic way using advanced computer technologies to ensure we do not miss babies with potential problems. This should mean a high quality scanning service across the country which is not dependent on local expertise.

Controlling Abnormal Network Dynamics with Optogenetics (CANDO)

Within the brain nerve cells connect together to generate rhythmic activity visible as brain waves on an EEG. In many neurological diseases this network is disrupted, producing abnormal patterns of activity. In epilepsy, abnormal activity can be localised to a small ‘focus’, but this can spread across the whole brain as a seizure.

Epilepsy affects 600,000 people in the UK alone and uncontrolled seizures have a devastating effect on patients’ quality of life. Most cases respond to drugs, but if these are ineffective it may be necessary to surgically remove the ‘focus’. However, surgery is not suitable in all patients and can damage cognitive function. This project, led by Dr Andrew Jackson and Professor Anthony O’Neill from Newcastle University, proposes an alternative based on a small implant that continuously records the abnormal activity and provides precisely timed stimulation to prevent it ever developing into a seizure. This requires that some cells within the focus are genetically altered using a safe virus to become sensitive to light. The implant will monitor their activity and provide pulses of light from tiny LEDs to prevent the build of abnormal activity.