Canterbury father and son’s invention will revolutionise medical treatment – Stuff.co.nz

A typical father and son project might mean restoring a classic car or completing a home renovation, but this Christchurch pair have set their sights a little higher. LEE KENNY reports.

Phil and Anthony Butlerhave utilised cutting-edge technologyused in the hunt for the Higgs Boson to invent the world's first 3-D colour X-ray.

Phil is a professor at University of Canterbury and a Fellow of New Zealand Institute of Physics, while Anthony is a clinical radiologist and a professor at University of Otago.

Together they have created the MARS scanner, which will one day replace many of the functions of the X-ray, positron emission tomography (PET) scans and magnetic resonance imaging (MRI).

ALDEN WILLIAMS/STUFF

Phil and Anthony Butler work on an arm scanner at MARS' Christchurch laboratory.

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The non-invasive technique will enable doctors to see colour images from inside the body, allowing them to make a more accurate diagnosis when treating everything from a broken bone to heart disease.

Phil, 72, first thought about the concept while he was atCERN (European Organization for Nuclear Research) in 2002.

Scientists working on the Large Hadron Collider used high-tech Medipix detectors to track particles and it was theorisedthey could also be used to detect X-ray photons.

Anthony joined CERN in 2005 and it was while the Butlerswere on a family holiday in Croatia that they decided to put the theory to the test.

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A 3-D image of Phil Butler's wrist taken by the MARS scanner in 2018.

They founded MARS Bioimaging in 2007 and today their 50-strong team consists of physicists, radiologists, mathematicians, biologists, engineers and computer scientists.

The company is part owned by University of Canterbury where it is based and has close ties to Otago Medical School.

Anthony, 44, explains the machine works by shining X-rays through the body and measuring the tissue composition before a computer reconstructs the information into a high-resolution 3-D colour image.

"The underlying process is often called spectral photon counting we measure the X-ray beam one photon at a time, which means we need to have very fast electronics to do this."

He says they have been looking at several medical applications for the scanners, across a range of clinical disciplines.

ALDEN WILLIAMS/STUFF

Professor Phil Butler is the chief executive of MARS Bioimaging but still takes a hands-on role.

"We've been working with orthopedic surgeons looking at fracture healing, cardiologists looking at the causes of heart disease and stroke, cancer specialists looking whether we can look at cell lines and the way they progress and we've looked at infectious diseases.

"That covers a large chunk of medicine and I expect we'll see [the scanners]hit the clinics at different times.

"It's going to be routine within a few years for a lot of point-of-care stuff."

The primary difference between the MARS scanner and other techniques is the level of detailed information it can record.

Anthony says the work is so cutting edge that components had to be built from scratch.

Dean Mouhtaropoulos

The MARS scanner was inspired by technology used at CERN, the World's Largest Particle Physics Laboratory.

"We did computer simulations to work out what we should be doing, then we had to come up with the designs, then manufacture it."

Dipanjan Pan, professor in chemical and biological engineering and radiology at University of Maryland Baltimore County, is an expert in nanomedicine and molecular imaging.

He collaborated with the MARS team for several years and says the3-D scanner has the potential to "dramatically change the ambiguity often found in black and white conventional CT imaging".

"Looking through MARS's proprietary photon counting CT 'magic lenses', you are visualising in colour the future of various biological processes as it merges with the present," he says.

"Their powerful reconstruction technique is astounding."

The technology has a range of uses from security and engineeringto physics and astronomy.

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The traditional 2-D X-ray is good at showing solid objects like bones.

But the Butlers are focused on clinical applications and in July 2018 Phil became the first person to be scanned, with images generated of his wrist and ankle.

The next stage will be clinical trials next year when orthopaedic and rheumatology patients from Christchurch will bescanned.

Phil saysthe breakthrough is comparable to the first X-ray images in 1895 and the first low-resolution Computed Tomography (CT) in 1972.

"It's a major step. We went from 2-D to 3-D, now we're going from black and white to colour.

"The other thing that makes ours different from pretty much any other clinical system is we've got very high-resolution, basically 10 times the resolution of any other comparable technology."

Dr Diana Siew, associate director at MedTech Centre of Research Excellence at Auckland Bioengineering Institute, said the MARS X-ray scanner is a "game changer in medical diagnostics" because "it visualises what is happening in the body in a way that has not been achieved before".

"Different components of the body like fat, calcium, water and disease biomarkers show-up on the X-ray images in different colours, thus allowing a fuller and more accurate picture of a patient's condition," she says.

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The new MRI scanner at Palmerston North Hospital had to be slotted through a hole in the wall when it was installed in April 2019.

"From a research perspective, this is exciting as it could underpin new understanding of disease onset and progression and be used to determine the efficacy of treatments.

"The MARS technology is a world's first and it is so exciting that it is happening in NZ."

As well as heralding a quantum leap in imaging capability, Anthony says the MARS technology will improve health treatment for Kiwis, as not everywhere has access to PET or MRI scanners.

"About half the people in rural New Zealand don't get appropriate cancer treatment, not because the country can't afford it but because the cancer centres are in large hospitals, the same is true for imaging," he says.

"If you are on the West Coast you cannot get a PET scan, you have to come over to Christchurch.

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MRI scanners can record incredible detail but they are large and not widely available.

"So those access issues, we beat most of them because we use X-rays and they are very easy to have in a local practice, every dentist has got one."

Phil added: "One of the design goals for this system is to make it as easy to operate as a dentist's X-ray".

As well as the high cost of PET and MRI scanners, Anthony says there are other practicalities that make them less accessible.

"MRI requires rooms with big machines, you have to have liquid helium cooling it down, you can't put someone in with a pacemaker, certain vascular clips can't go in there [or] hip replacements," he says.

"With PET you have similar things, you have radioisotopes. In New Zealand we have one cyclotron in Wellington producing radioisotopes and they have to be flown around the country, so if it's a windy day in Wellington, no PET imaging can happen in the country."

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A 3-D image of Phil Butler's ankle, scanned in 2018.

MARS is operated from a secure area of University of Canterbury and as well as full-time staff, research is carried out by 15 PhD candidates.

Phil is in no doubt that a key component of the project's success is that it's based in Canterbury.

"If you look at the electronics or mechanical engineering skills of Christchurch, we can build anything," he says.

"We've got the skills to do it but the people also know each other, whereas if you go to a big city of several million, they can do it but they can't talk to their allied disciplines.

"That goes back to the farming industries, where people had to build their own machines and those skills of being able to build anything are all part of that."

Anthony agrees.

"If you go to really large research institutes they can be really skilled but they tend to have big silos. In New Zealand we tend not to operate that way.

Don Scott/Stuff

The Butlers, pictured here in 2010, examine coloured Iodine and Barium infused tissue.

"I think we're the sweet-spot in terms of size, where there's enough skill around that there's experts but we're not so big that we can't talk to each other."

Almost 15 years since the father and son team decided to embark on the research, they have made huge advances but there is still work to be done.

"If you look at where we were in 2006 or 2007 we were able to measure four colours but we had to do them one after the other, not simultaneously," Anthony says.

"We scanned the abdomen of a mouse, a pretty small object, and it [took] a day to image it and a month to do all the data reconstruction to get a picture to look at."

Day-to-day, Anthony is the company's chief medical officer and scientific lead.

Phil is the chief executive but, but according to Anthony, he still "does a lot of the technical work".

Working with family members can bring its challenges but Anthony says one of the advantages of partnering with his dad is the "innate trust" they have.

"It's actually a real pleasure," he says.

"I'm quite lucky, I didn't start working with him until I was in my early 30s, which meant I'd done all of my qualifications, established my own life.

"He had done many things himself and been pro-vice chancellor of the university and wanted to get more into practical applications so we founded this project together and that's been really nice.

"You're always going to have problems in any relationship but the fact that it's a family member gives you structure where you can actually work through problems and solve them and know that you're on the same team."

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Canterbury father and son's invention will revolutionise medical treatment - Stuff.co.nz

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