Every year, 7 million people in the UK undergo heart scans that cannot see the inflammation silently driving their disease. That inflammation—the root cause of artery plaques rupturing and causing heart attacks—remains invisible to every routine diagnostic scan currently in use. This blind spot forces doctors to make treatment decisions without knowing which patients are at imminent risk, wasting billions in healthcare spending on drugs that cannot be targeted to those who need them most. Researchers at the University of Oxford have discovered that inflamed arteries cause changes in the surrounding fat tissue, and that these changes can be detected by a new analysis technique applied to existing CT angiography scans—no new hardware required. The method has already been published in leading journals and shown to identify high-risk patients beyond what current tests can do. The team is now commercialising this technology through a spin-out company, Caristo Diagnostics, working with three NHS hospitals. They will refine the analysis for different CT scanners, build a regulated web-based service, and run a clinical trial to prove it can guide personalised drug treatments. If successful, this would transform cardiac risk management by turning a standard, widely used scan into a tool that sees the inflammation driving heart disease.
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"Cardiovascular diseases (CVD) are increasing world-wide, due in large part to the global epidemics of obesity and diabetes. CVD affects 7 million people in the UK alone, with healthcare costs of £9bn and an economic burden of £19bn. In CVD, formation of 'plaques' in the artery wall can either narrow progressively or can break open suddenly, causing an abrupt blockage that results in a heart attack or death. The formation of plaques and the sudden occurrence of heart attacks are both caused by inflammation in the wall of the artery, which is a critical factor in understanding, detecting and treating CVD. However, none of the enormous number of scans used for routine CVD diagnosis can currently identify inflammation in the artery wall. This major 'gap' in diagnostic technology gives inaccurate advice to patients, is inefficient and wasteful of tests and drug treatments, and fails to take full advantage of powerful new drugs, that cannot be 'targeted' to the patients who need them most. We have recently discovered that the fat tissue surrounding the artery 'senses' the presence of inflammation, and this can be detected by a new analysis technique that can be applied to existing cardiac computed tomography angiography (CTTA) scans that are already in routine clinical use. This method identifies people at high risk of heart attack and CVD death, above and beyond current diagnostic tests. The research work has already been published in leading scientific journals, and generated international media interest. We are now working to develop this powerful new technology into a carefully tested, commercial product, to improve the diagnosis and treatment of CVD, for patients, doctors and the pharmaceutical industry. We will achieve this through Caristo Diagnostics, our new spin-out company from the University of Oxford, working with 3 collaborating hospitals in London, Leicester and Oxford. First, we will refine the technical aspects of the new imaging technology to ensure that performance and consistency is excellent across different types of CT scanners used in hospitals. Next, we will develop an automated web-based service, with all of the necessary regulatory approvals, for rapid and reliable analysis of heart CT scans. Finally, we will conduct a clinical trial, involving patients with CVD undergoing CCTA scans, to demonstrate clinical effectiveness and to detect the effects of drug treatments. Caristo's new imaging technology will transform the current ways that we diagnose CVD, guiding the deployment of personalised therapeutic strategies."
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