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We talk to Professor Robin Choudhury, Clinical Director of the Acute Vascular Imaging Centre (AVIC). The Centre, part of the Radcliffe Department of Medicine, opened in early 2011 and is based in the John Radcliffe Hospital.

Three professionals doing some checks in an MRI machine

Extracted from Issue 18, February 2015 OxfordMedSci News.

Tell us a little about the Acute Vascular Imaging Centre (AVIC)?

AVIC 1The AVIC is a unique facility dedicated to clinical research in acute coronary syndromes (heart attack and unstable angina), stroke and transient ischaemic attack (TIA). AVIC houses two imaging modalities: a 3 T MRI scanner and an interventional angiography. These are joined using the Siemens MIYABI function (MIYABI is Japanese for elegance), where the unique transfer shell system enables a fast and smooth transfer of the patient between the two modalities without the need to transfer the patient off either examination table (watch MIYABI in action (video)). This is achieved by specially designed, floor-embedded motorised rails enabling the angio table to be AVIC 2moved towards and ‘meet’ the MR tabletop. The Centre is embedded in the NHS-hospital environment and contains ‘high-dependency’ bays with facilities for full medical support including anaesthesia. AVIC is positioned adjacent to the Emergency Department and the Heart Centre.

How many staff use the AVIC? And where are they from?

AVIC 3Around 100 people are involved in AVIC in some capacity. This includes core staff who reside in AVIC, a number of staff from a rotating pool of NHS staff, and researchers from other departments. At any one time we will have around three or four projects (and expanding) running within AVIC and within those projects are many sub-studies. In total there are about 20 Principal Investigators who use AVIC, each with their own research teams, many of which are multi-disciplinary and include clinical research fellows, DPhil students and post-docs (clinical and physicists), and allied health professionals.

The users come from a number of the University clinical departments and units: Division of Cardiovascular Medicine, Nuffield Department of Clinical Neurosciences, and Investigative Medicine Division.

What’s a typical day like in AVIC?

As with any clinical research, some days are very busy and fitting in the various studies can be quite a logistical challenge. The work covers both cardiac and neuro MRI scanning and there are weekly staff meetings to keep everyone up-to-date with new and existing projects, equipment and staff. There is always the paperwork and the need for record-keeping for audit and ultimately the billing! These roles are covered by a small team of core AVIC staff.

Can other university members use the Centre?

Yes. Other University and OUH Trust members can use the centre if they have a research project which fits into AVIC’s remit i.e. acute and vascular. If you have an idea for a project to run in AVIC then you should contact Professor Robin Choudhury for initial discussions. There is a formal approval process and a project review where you can meet with the AVIC staff and discuss in detail the logistics of your study.

How do you see AVIC developing in the next ten years? What are the obstacles (technical or otherwise) to getting there?

AVIC 4We will need a new MRI scanner at some point, and also we’ll need to replace much of the peripheral equipment to ensure we remain are up-to-date with current OUH-NHS practices. Hopefully, some of the research scanning will become part of routine clinical care as the diagnostic benefit of the scans is demonstrated.

 



Images:

  • Top left: cardiac MR image: short axis slice of left and right ventricle acquired acutely in a patient following a myocardial infarction, using T1 mapping which was developed in Oxford and allows for quantitative characterisation on a pixel by pixel basis
  • Top right: Brain MR image: vessel-encoded perfusion image showing the vascular territories of the four main brain-feeding arteries, this quantitative technique was developed in Oxford and provides information such as cerebral blood flow
  • Middle left: AVIC angio suite and MRI
  • Bottom: AVIC participating in Oxford Open Doors, September 2014

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