A new hi-tech £1million-plus non-invasive disease detection facility, developed by the University of Leicester, has been unveiled today (Sept 1st 2011) for use in Leicester Royal Infirmary's A&E department.
It is designed to detect the "sight, smell and feel" of disease without the use of invasive probes, blood tests, or other time-consuming and uncomfortable procedures.
Scientists use three different types of cutting-edge technology in combination under a range of situations. All the methods are non-invasive, and could speed up diagnosis.
Scientists have surrounded a normal hospital bed with an unprecedented array of technology to examine patients:
- One group of instruments (developed in the University's Chemistry Department) analyses gases present in a patient's breath.
- A second uses imaging systems and technologies - developed to explore the universe - to hunt for signs of disease via the surface of the human body.
- The third uses a suite of monitors to look inside the body and measure blood-flow and oxygenation in real-time.
The technologies employed in the new Leicester Diagnostics Development Unit have never previously all been used in an integrated manner and with such a large pool of patients.
University of Leicester researchers from space research, emergency medicine and Chemistry, worked with colleagues in Cardiovascular Sciences, Infection, Immunity and Inflammation, Physics and Astronomy, Engineering, IT Services and the Leicester Royal Infirmary to create the Unit.
Some of the technology in the new Unit has been originally developed for use in planetary research: – in the year 2019, an international space probe is scheduled to arrive on Mars to look for life and will employ similar technologies. Some of the advanced technology and science behind the unit was developed at the University of Leicester.
Appropriately for something that comes from outer space, the technology might also be a first step towards ultimately developing devices akin to the 'tricorders' from Star Trek -- used by medics in the sci-fi series to diagnose illness simply by waving it near a patient, according to Professor Mark Sims, the University of Leicester space scientist who led the project alongside Tim Coats, Professor of Emergency Medicine at the University and head of accident and emergency at the Royal Infirmary.
Professor Sims said: "We are replacing doctors' eyes with state-of-the-art imaging systems, replacing the nose with breath analysis, and the "feel of the pulse" with monitoring of blood flow using ultra sound technology and measurement of blood oxygen levels.
"In the old days, it used to be said that a consultant could walk down a hospital ward and smell various diseases as well as telling a patient's health by looking at them and feeling their pulse. What we are doing is a high tech version of that in order to help doctors to diagnose disease."
Many diseases have visible effects that can be measured outside the body, whether it is a change in colour, temperature, or what organic compounds we breath out or a combination of them alongside changes in the cardio-vascular system e.g. pulse rate, blood oxygenation level. The equipment, it is hoped, can be used in diagnosis of a wide range of diseases from things like sepsis through to bacterial infections such as C. Difficile and some cancers. The Diagnostics Development Unit has identified over 40 possible applications to date.
Explaining how the project came about, Professor Sims said: "We are developing a device called the Life Marker Chip for the ExoMars space mission. It will look for organic molecules in samples from below the surface of Mars, helping to answer a question that has been fascinating mankind for many years, is there Life today or was there Life in the past on that planet? Developing it has involved both space technology and biology. The project therefore brought us into contact with health organisations and associated technology and helped lead to this initiative."
The researchers are using a £500,000 infrastructure grant from the Higher Education Funding Council along with a contribution from the University to equip the Unit.
Professor Sims explains that human breath contains a range of by-products (so-called volatile organic compounds) from bodily processes. Identified by an novel instrument called a real-time mass spectrometer, they can provide clues to a wide range of diseases. He says: "An obvious example is ketones, which we detect in the breath of diabetics during hypoglycaemia. But there are also chemicals that can or could be used to indicate conditions such as asthma, sepsis, liver disease, heart disease, and several types of cancer." While gases in the breath are the main focus, the same technology can be used to analyse urine and faeces.
Sepsis is especially interesting as a target because it is hard to detect at an early stage and is a considerable burden on the NHS and is expected to exhibit a number of different effects on the body that can be detected by the combined instrumentation.
Space technology is behind the imaging equipment used to gather information from patients, using visible light wavelengths as well as invisible infra-red light.
It includes a thermal imager to see patients' surface and core temperatures by imaging appropriate targets on the body. Comparing the two temperatures can reveal disease because one response to illness is to withdraw blood from peripheral parts of the body.
Other devices (multi-spectral and hyper-spectral imagers) can detect subtle changes in skin colour. Liver disease is associated with yellowing of the skin and it is possible that this equipment could detect it before it is readily visible to the human eye. Imaging technology can also see veins close to the surface of the skin inside the body and detect whether the blood contains enough oxygen is or oxygen-poor and whether circulation in the extremities is shutting down due to medical shock etc. Also early stage bruising and skin cancers should be detectable.
Some of the monitoring equipment, for example the cardio-vascular monitors surrounding the bed, are already in use but, Professor Sims says, they are rarely combined in such a comprehensive way - normally only one such type of monitor is used at a time. Even though nearly all the technologies employed in the Unit have been used in one way or another, they have never all been used in an integrated manner and with a large pool of patients.
"Ultimately in the longer term we would aim to work towards something like the "tricorder" device seen in futuristic science series like Star Trek. What we are developing so far is more like a first attempt at the medical bed in the sci-fi series," he said.
According to Professor Coats, early disease detection often leads to better outcomes. This technology could make for quicker and more patient-specific diagnoses.
He says: "I am a specialist in emergency medicine and we are starting the project in this area. But it could also be valuable elsewhere in hospitals and in GP surgeries and perhaps even in a future generation of ambulances. We are talking to industrial partners who might get involved in commercialising this work as the project matures."
Professor Sims added: "It is hard to predict how this work will develop. But ten years from now it could be routine for diagnostic technology to be combined in this way."
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