The Royal Marsden has always led the way in diagnostic imaging, and by installing two new state-of-the-art MRI scanners in Chelsea, the Trust has ensured that the hospital will remain at the forefront of cancer diagnostics and continue to pioneer new methods.
The Reuben Imaging Centre has been equipped with the 1.5T and 3T MRI scanners thanks to £6.9 million raised by The Royal Marsden Cancer Charity. Two CT scanners will also be part of the centre, which is due to be completed this year.
MRI scans enable us to look at a tumour in fine detail. They are particularly important for soft-tissue cancers, such as brain, spinal cord, bowel, gynaecological and prostate cancers, as the magnetic resonance uses the properties of the soft tissue to create the detail in the image. The 1.5T MRI scanner has a large field of view and will enable the future development of whole-body imaging.
In contrast, the 3T MRI scanner provides incredible detail over a smaller field of view, allowing us to undertake – and patients to participate in – clinical research trials that require this level of fine detail. CT scanners use X-rays to produce cross-sectional images of the body. When the images are reassembled by computer, the result is a detailed 3D view of the body’s interior. CT scans can be used to help make a cancer diagnosis or assess the effects of cancer treatment.
The benefit of MRI scanners is that they produce exceptionally clear and detailed images. However, the combination of the two types of scanner is also useful, helping us to meet increased demand and to offer our patients the highest level of MRI diagnostic imaging – a standard that surpasses those set by the NHS.
“With the new MRI 1.5T and 3T scanners in Chelsea, we can now scan more patients more efficiently using state-of-the-art technology,” says Bernadette Cronin, Deputy Director for Clinical Services. “We can now offer our patients and our research teams the best standard of care.”
The new scanners will also improve our patients’ experience by increasing their comfort. In addition, by allowing the maximum flexibility in clinical practice, the new scanners will help our staff produce personalised treatment plans.
Cheryl Richardson, Superintendent Radiographer for MRI at the Reuben Imaging Centre, believes the new scanners are already making a difference to patients’ experiences.
“We are delighted with these new scanners, and the feedback we have had from our patients has been very positive,” she says. “They really are at the leading edge of imaging technology.”
Building for the future
The new Reuben Imaging Centre is the final part of the rebuilding and remodelling work at the Chelsea site following the fire there in 2008. As the centre is on the fourth floor, its construction was not without challenge and involved extensive structural work. Owing to the weight of the machines and the fact they were to be installed in a Victorian Grade II listed building, the floors had to be bolstered by 320 tonnes of steel.
The scanner rooms were fitted with special windows so that the space would feel less confined. Image panels displaying pleasant scenes were added and audio-visual equipment installed to help patients relax during longer scans. To enhance the patient experience, the rooms were decorated with light colours, and a rooflight was installed to provide natural light.
A new extension in the courtyard at the back of the hospital provides support spaces, where clinicians can interpret the high-resolution images and monitor a patient’s progress in a comfortable environment. This is supported by columns that rise from foundations in the basement by the theatre changing areas and recovery area. There are also numerous temperature and humidity-controlled technical rooms that keep specialist equipment in optimum condition.
With the new MRI 1.5T and 3T scanners in Chelsea, we are now able to scan more patients more efficiently using state-of-the-art technology
Dr Angela Riddell, Consultant Radiologist, and Dr Liam Welsh, Clinical Research Fellow, explain how the new 3T MRI scanner will benefit the Trust’s research programme.
Which clinical trials are making use of the 3T MRI scanner at the Chelsea hospital?
The superior-quality images produced by the 3T scanner’s high field strength allow us to conduct studies that would be less effective at the 1.5T field strength. The Head and Neck Unit has three clinical trials that use the new 3T MRI scanner. These are among the first MRI research trials conducted at the Chelsea site and will facilitate the recruitment of patients to imaging studies, with the aim of accelerating the pace of new imaging discoveries.
The first study investigates the effects of radiotherapy for head and neck cancer on the brain, using diffusion tensor imaging (DTI) to better understand the imaging changes associated with radiotherapy. The second study examines the effect of blood transfusion during radiotherapy on the oxygen status of head and neck cancers. The third trial makes use of the superior technology of the 3T scanner to show oxygen fluctuation within tumours. This has implications for future radiotherapy treatment. Together with our other 1.5T scanners at Chelsea and Sutton, the new 3T scanner at Chelsea will form part of the imaging infrastructure to support state-of-the-art cross-site research studies.
How will this benefit The Royal Marsden and its patients?
Our research aims to benefit patients by providing critical information that can be used for better patient management, thereby improving treatment outcomes. By applying and developing new imaging techniques, we hope to discover which treatment is effective and whether patients are likely to benefit from a particular treatment. Imaging can also identify treatment-related complications and inform clinicians when they occur. There is also a direct benefit to patients. Before the new scanners were installed in the Reuben Imaging Centre, Chelsea patients had to travel to Sutton for scanning if they wished to participate in a study. Now they will be able to undergo scans on the same site as their treatment.
What are the future plans for these clinical trials at Chelsea?
Having both 3T and 1.5T MRI scanners at Chelsea enables us to grow the research portfolio on this site. The head and neck DTI study is nearing completion. Future studies being planned include whole-body diffusion MRI scanning to assess the spread of disease to the bones, as well as new studies across a range of cancers treated at The Royal Marsden.