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Simplicity is all

Simplicity is all

In this issue of BioScience Today, Ellen Rossiter speaks to Professor Kawal Rhode about his work in the realm of biomedical engineering, his inspiration, motivation and why simplicity is all.

“Way back in school, we were taught science in a very thorough way, spending at least a day a week in the lab, which sparked my interest. I initially studied medicine at Guy’s and St Thomas’ NHS Foundation Trust and during the course, I had the opportunity to study medical imaging for a year – this was really when my research career started.

“I was fortunate that the hospitals had a pioneering course in imaging sciences and I got to work with some of the greatest in that field including Professor Raymond Gosling, who actually took the famous image known as ‘Photograph 51’.

“Under the tutelage of his research team, I built software that enabled measurements to be made of the stiffness of the aorta in patients with diabetes – enabling the progression of vascular diseases to be monitored, so from an early stage, I was involved in projects that were highly translational. This project proved to be a turning point – it was then that I realised that I wanted to be a research scientist rather than a clinical doctor.

“Later, I studied for my PhD in the Department of Radiological Sciences at King’s College London and at the Department of Surgery at University College London, looking at x-ray images of the coronary arteries and trying to work out how to quantify the passage of contrast material when it had been injected into patients – which consolidated my career in biomedical engineering.

“The most surprising thing that I’ve found in my career is that despite the sophistication of the tools and systems at our disposal, in the real world, simplicity is all powerful. Some of the simplest things have a huge impact on care pathways for patients.

“A recent example is an undergraduate student of mine who noticed the problems encountered by patients undergoing surgery to remove lung cancer, whose ribs were often irreparably damaged during the process.

“She came up with a simple solution which involved taking 3D images of their ribs before surgery, then building a 3D model of the ribs, before reconstructing them using bone cement. It is a simple modelling procedure from a cast which we are performing on a patient for the first time in the next few weeks.

“At the other end of the spectrum, we have a team of ten people working on a robot that can take multiple ultrasound scans, which will takes about 3-4 years to build. But very often simplicity results in the most purposeful thing.

“Bringing people together and getting the best out of them is the most impactful part of the job. Mine is a people-centred role; it is as much about the way you work with others than your own capabilities.

“A little bit of freedom can be extremely valuable in a research setting, we respect everyone’s capabilities, giving them the freedom to be creative, so they can extend their skills and we can grow together as a team.

“The focus of the School of Biomedical Engineering and Imaging Sciences is to develop things that can be translated so that they solve real-world problems. Once, when visiting Dallas Children’s Hospital, I saw a navigation system being used to repair a child’s heart which had been built by my team in partnership with Philips Healthcare – it was quite emotional. It is moments like this which make it all worthwhile and you know that your work is making a difference.

“Having an engineering department in a hospital is extremely advantageous, clinicians can visit us and discuss the problems they are encountering so that we can work on a solution. Once a clinical colleague walked into the department and discussed the challenges of passing tubes into patients’ stomachs, within a short time we anticipate having a solution that will make the process more comfortable and successful.

“It is essential that the engineering department is multidisciplinary, as it affects the scale of things we can achieve and the scale of the problems we can take on. The end game is to see the equipment we’ve developed being used on patients.

“We’ve got lots of projects going on at the moment, but one of the largescale projects, which is funded by the Wellcome Trust, is aimed at improving the diagnosis of foetal abnormalities at the 20- week scan.

“When we looked at the national statistics we realised that these scans had a detection rate of only 50%, meaning that one in two failed to detect serious abnormalities. However, this average figure hides a huge variability around the country with some scans having an accuracy rate of 95%, whilst others were as low as 30%.

“We are building a robot with the hope of making these scan results more consistent, it won’t perform the scan as well as the best person, but it will do them better than average. Overall, the robot will help raise the accuracy rate, enabling parents to make more informed decisions and in some cases enable in utero treatments to be performed, so the impact of this project is potentially huge.

“As long as we know they can do what we say they can do, using robots in the healthcare environment is an effective way to put resources where they are most needed, meaning doctors can spend more time with patients seeing how their treatment is progressing and utilising the people skills that can’t ever be replaced by a robot.

“We are living in difficult times, we’ve got a lot of problems in the western world, including dealing with an ageing population – which is increasing the burden of disease. Biomedical engineering has a large part to play in solving this crisis, so it is a very worthwhile branch of engineering in which to be working and one of the major motivators in my life is to build the engineers of the future.

“Here at King’s College London, we are at the forefront of tackling these long term issues. Our vision is to make the world a better place and our next steps are to get a lot of good projects translated into the clinical environment.

“Connectivity has opened up research possibilities, our work is global rather than local, with partners all around the world, it is now much easier to know what research is going on and progress is being made at a much faster pace.

“The materials we need are more easily available now and at a lower cost too, so that when I need a piece of equipment I can get it almost immediately, all of which means the research cycle has become much quicker and we can get things out into practice sooner.

“Research in the UK is booming and being a research scientist here is a wonderful career – it is a very satisfying job as you are developing yourself whilst also having an impact on society, plus the research world is much more diverse and inclusive than was once the case.

“The UK is a world leader in research, with some of the top-ranked research universities based here and as a research scientist you are addressing real problems and you can make a difference.”

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