Robots to spot and remove cancer tumours in £8 million Warwick Uni project

New technology that will marry probes that can detect cancer tumours through the skin with high-precision robotic surgery is to be developed for use in hospital settings for the first time in a project led by the University of Warwick.

The project, led by the University of Warwick, is among 20 innovative projects announced to revolutionise healthcare, improve treatments for millions of people with a wide range of conditions and save the NHS money (see other projects in our region also securing funding at the bottom of this story).

.The Terabotics project will use probes that use terahertz radiation, or T-rays, to scan for tumours under the skin while medical-grade surgical robots will be adapted to use these scans to guide them in removing tumours in skin and colorectal cancer patients more precisely.

If successful, the researchers hope it could lead to real-time diagnosis for cancer patients, shorter waiting periods for cancer surgery, and more comprehensive removal of tumours with reduced need for follow-up surgery.

The project, which has received funding of £8 million from the Engineering and Physical Sciences Research Council, part of UK Research and Innovation, is a collaboration between the University of Warwick, University Hospitals of Coventry and Warwickshire, University of Leeds and the University of Exeter. The five-year project starting in September aims to eventually trial the technology with patients attending cancer services at University Hospitals Coventry and Warwickshire and Leeds Teaching Hospitals NHS Trust.

Terabotics will use research from the University of Warwick into terahertz (THz) radiation, or T-rays, which sit in-between infrared and WiFi on the electromagnetic spectrum. Previous work from the University of Warwick’s Department of Physics has shown that these can be used to detect very subtle changes in the outermost layers of skin, and the technique has already been demonstrated on healthy volunteers. This will be the first time that it will be studied in patients within an active cancer process.

As well as assessing how effective T-ray technology is in diagnosing cancers compared to standard care, the project aims to incorporate the technology into surgical robots to guide them more accurately when detecting tumours during colonoscopy and removing them during surgery.

Principal Investigator Professor Emma Pickwell-MacPherson, from the University of Warwick Department of Physics, said: “What we will be testing is our hypothesis that we are able to detect a buried or hidden tumour. We think our terahertz probe will be able to detect those through looking at the transient response of the skin.

“Somebody might already be diagnosed with cancer but the actual extent of that cancer may not be known. For example, in skin cancer patients, the THz probe will image the visible tumour and the surrounding area to better determine the extent of the tumour that is beneath the surface. This will enable the whole tumour to be removed in one go, rather than incrementally. In turn, this enables better planning for reconstruction and speeds up the procedure.”

Initially, the researchers will focus on adapting the T-ray probes to work with the surgical robots, miniaturisation of the technology and refining the design to provide more diagnostic parameters.

Later stages of the project will involve trialling the technology with patients with a known or suspected cancer. Those attending cancer services at University Hospitals Coventry and Warwickshire will be offered the opportunity to participate alongside their routine care. Colorectal cancer patients will be seen at the University of Leeds, where an endoscopic probe is being developed specifically to examine the colon. Just like our skin, the colon is an epithelial lining and could potentially be scanned by T-rays in the same way.

At present, diagnosis of skin cancer relies upon a visual inspection by a clinician and a biopsy. There are more than 150,000 new cases of skin cancer in the UK each year and two to three million globally, numbers which are set to rise due to increased life expectancy. 1 in 15 UK males and 1 in 18 UK females will be diagnosed with bowel cancer in their lifetime and it is the second most common cause of cancer death in the UK.

Professor Joseph Hardwicke, Medical Lead for the project at University Hospitals of Coventry and Warwickshire, said: “This technique is a way to examine the skin at a deeper and more technical level than what we are able to at the moment. The main hope, especially for skin cancer, is to determine the extent of the spread locally and also to potentially diagnose these cancers without the need for a biopsy in future.

“This is a whole new area of diagnostics, like how MRI in the 1980s revolutionised medical imaging. I think this is a chance for terahertz combined with robotics to give us that greater accuracy. Even though we are still building evidence, there seems to be a lot of pieces of the jigsaw that make logical sense.”

Professor Pickwell-MacPherson added: "This area is up and coming and terahertz robotics is becoming a hot topic. It has long been suggested that THz technology could be used for cancer detection and this project will push the technology forward to make it a reality. We hope that by demonstrating its application to skin and colon cancers we will open up the door to applying the technology to benefit other cancers too and transform cancer treatment protocols.”

The other projects receiving funding include:

Beyond Antibiotics

Led by: Professor Eleanor Stride, University of Oxford

EPSRC support: £6.5 million

Antibiotic resistance has been identified by the World Health Organization as one of the greatest global threats, with the evolution of drug-resistant bacteria and lack of alternatives meaning we may not have viable treatments for even trivial infections within the next three decades.

The £6.5 million Beyond Antibiotics project led by Professor Eleanor Stride at the University of Oxford aims to develop alternatives to prevent this scenario from occurring.

They include developing ‘drug-free’ methods for treating infections and improving our immune function, as well as using antimicrobial therapeutics and targeted delivery techniques to improve the use of existing antibiotics and provide viable alternatives.

Healthcare Impact Partnerships

Led by: Professor Rainer Cramer, University of Reading

EPSRC support: £890,000

This project aims to substantially advance Matrix-Assisted Laser Desorption/Ionisation (MALDI) mass spectrometry (MS) profiling of organisms.

The researchers aim to achieve this by exploiting multiply-charged ions and their co-analysis with lipids and other biomolecules on an MS/MS instrument specifically optimised for large-scale, inexpensive clinical analyses.

This will lead to the next generation of superior MALDI MS biotyping for clinical use and mass testing.

The proposed new instrument and the associated technology will be high speed, cost-effective, and allow high specificity by MS/MS sequencing.

It would allow multiple diseases to be tested in one test run and will be highly adaptable to new diseases.

This will negate the need to develop test reagents that are disease or microbe-specific, difficult to source and therefore expensive - in particular for newly discovered diseases like COVID-19.

The aim is to reach a throughput level of 100,000 samples per day at high detection accuracy and low cost per sample.

Bionics+: User Centred Design and Usability of Bionic Devices

Led by: Professor C James, University of Warwick

EPSRC support: £900,000

The Bionics+ NetworkPlus will:

• represent the spectrum of research, clinical and industrial communities across bionic technologies within the EPSRC Grand Challenge theme of Frontiers of Physical Intervention
• invigorate and support a cohesive, open and active network with the mission of creating a mutually supportive environment
• lead to the co-creation of user-centred bionic solutions that are fit for purpose

These advances will have a global impact, consolidating the world-leading position of the UK.

The founding tranche will focus on:

• ambitious and transformative research
• new collaborative and translational activities
• the formulation of a longer-term strategy

As a community, the network will explore and identify areas of opportunity and value, driven by Bionics users' needs, complementary to existing activity and strengths.

The network will instigate and support early-stage research in these priority areas, alongside providing an outward-facing representation and engagement of the UK bionics community.

Further, it aims to contribute in an advisory capacity to public bodies, UK industry and government policy.

Future blood testing for inclusive monitoring and personalised analytics Network+

Led by: Dr Weizi Li, University of Reading

EPSRC support: £800,000

There is an extremely high demand for laboratory-based blood tests from community settings in the UK.

Analysis suggests an important role in the future for remote blood monitoring that would enable patients and health professionals to carry out their own tests remotely, greatly benefiting patients and speeding up decision making.

Current challenges include being able to obtain and process blood samples outside of clinical settings without training and laboratory facilities, and the added burden and risk associated with COVID-19 of patients needing to attend GP surgeries or hospitals.

Many blood analyses are done in batches that can take a long time to build up and process, with many tools labour-intensive or not suitable for use in monitoring at home.

The volume of tests carried out also means that inefficient and infrequent blood testing may lead to late diagnosis, incomplete knowledge of disease progression and potential complications.

The network will build an interdisciplinary community that will explore future blood testing solutions to achieve remote, inclusive, rapid, affordable and personalised blood monitoring, and address the above challenges in community health and care.

EMERGENCE: Tackling Frailty - Facilitating the Emergence of Healthcare Robots from Labs

Led by: Professor Praminda Caleb-Solly, The University of the West of England Bristol

EPSRC support: £700,000

Professor Caleb-Solly at UWE Bristol will lead a team of four other UK universities, Sheffield, Heriot Watt, Sheffield Hallam and Hertfordshire, who together will establish a new network, EMERGENCE.

The aim of the network is to create and catalyse a robotics for healthcare community, which connects researchers, health and social care professionals, service users, regulators and policy makers, to affect the wider use of healthcare robots to support people living with frailty in the community.

The EMERGENCE network will explore how robots can be used to support people to better self-manage the conditions that result from frailty and, by providing information and data to healthcare practitioners, enabling more timely interventions.

For the full list click on this link