Patients suspected of having rheumatoid arthritis in Exeter will be the first in the country to trial a new type of 3D imaging technology that could help avoid permanent damage to joints by detecting rheumatoid arthritis at the earliest stages.
With funding from Innovate UK, the University of Exeter is undertaking the first live trials of the AdaptixOrtho350 – a new, portable imaging technology that offers 3D imaging at a similar cost and radiation dose to traditional 2D X-rays. supporting clinicians to obtain more detailed images that aid earlier diagnosis and improve ongoing management of the condition.
Rheumatoid arthritis affects an estimated 18 million people worldwide. It is an autoimmune condition in which the body's immune system mistakenly attacks its own tissues, causing pain, swelling, stiffness and permanent joint damage over time. Early diagnosis is key to minimising this effect, yes traditional X-rays miss many cases.
The first adult through the new study was Emma Carnell, 45, who was on a family holiday in Corfu in July, when she woke up one morning with an unfamiliar pain in her hand. "It was really odd - it was all cramped and claw-like. I thought I'd slept on it and blamed the hotel bed. I stretched out in the pool but the next morning, it was back again. I thought I just need to get back to my own bed, but when I got home, things got worse."
Soon, the pain was also affecting her hands and ankles, accompanied by swelling. "I had to stop driving - I could no longer turn the key in the ignition. I'm decorating my house, but I couldn't pick up a paintbrush. I was so tired, and I had intense brain fog. I've been lucky, though, because my GP acted quickly to get me onto the right treatment. If there's a delay, it can lead to irreversible damage to your joints and organs."
Initially, hospital X-rays and blood tests showed negative results for rheumatoid arthritis, but Emma's consultant also ordered an ultrasound, which confirmed the diagnosis.
Emma said: "That early diagnosis is really key and I'm now hopeful that the medications I'm on can control my condition. It's crazy to think that I went on holiday and came back with rheumatoid arthritis, but I know I have been quite lucky in way."
Emma, a company secretary, said: "This research is so important. If this new 3D imaging technology can detect people earlier, it'll make a huge difference and could avoid more people experiencing irreparable damage to their joints, which can hinder their everyday function."
The new trial will evaluate the performance of Adaptix' 3D imaging technology when compared to traditional 2D X-rays. It will look at three main areas: Improved diagnostic potential; effective measurement of joint spaces; and evaluation of bone density – all in patients with inflammatory arthritis.
Professor Karen Knapp, Professor of Musculoskeletal Imaging at the University of Exeter, who is leading the trial, said: "Up to 50 per cent of people with early joint changes due to rheumatoid arthritis are missed when diagnosed using 2D X-rays, but more-detailed 3D imaging options – such as MRI and CT scans - are expensive and waiting lists can be long.
"We're really excited to be the first to trial the new Adaptix Ortho350, which promises much better visualisation of bone and joints than traditional 2D images, meaning the signs of inflammation and subtle changes – such as joint erosion – could be picked up and managed at an earlier stage. This trial is an excellent example of a partnership between our university and industry directly benefiting patients."
Dr Siân Phillips, Chief Medical Officer at Adaptix, said: "Our mobile imaging technology uses Digital Tomosynthesis to enable clearer visualisation of bones and joints than 2D X-rays. It creates 3D images from a stack of image 'slices', much like CT and MRI imaging, but with a lower radiation dose compared to CT, faster image acquisition, lower power requirements and compact size that allows for imaging at the point of patient care.
"Our technology is already in use across both the veterinary and non-destructive testing sectors and has delivered positive results in cadaver trials. The Exeter trial marks the next stage in our journey with the first live human trials, and also proves our range of use cases, from purely diagnostic applications to assessing disease progression."
The trial will focus on adults with rheumatoid or other inflammatory arthritis of the hand, with participants being scanned with both the Adaptix Ortho350 and traditional 2D X-rays to assess and compare each imaging modality's performance.
