Soundeffects news | Dr Steven Rogers (UK)

Dr Steven Rogers (UK)

The College and Society for Clinical Vascular Science of Great Britain & IrelandVASCULAR & PROFESSIONAL TOPICS

Dr Steven Rogers, the UK’s first NIHR clinical lecturer in vascular science at The University of Manchester, holds an honorary senior clinical vascular scientist status at Manchester University NHS FT. With a focus on advanced vascular ultrasound, his research explores 3D and contrast-enhanced ultrasound for prevention and surgical planning. As president-elect and founding member of the SVT Research Committee, he contributes to leadership positions in medical ultrasound societies. Dr Rogers, an award-winning researcher, also teaches and examines academic programs, supervises students, and provides expertise to organisations like NICE and the UK Biobank. We chat with Dr Rogers about AI, the benefits of interdisciplinary collaboration and the MAVRIC initiative.

Do you think AI techniques for carotid artery disease are better suited to measuring carotid artery stenosis or to better identify features of plaque vulnerability?

AI is everywhere. It’s certainly a hot topic and it’s not surprising that some, if not all, ultrasound scanners already have a degree of AI capability. When it comes to vascular disease, I don’t think the question should be whether AI is better suited to stenosis or identifying vulnerable plaque. The important question is, should we? We already know that the stenosis value itself isn’t predictive of who will have a future stroke. What atherosclerosis is made of and how much of it is far more interesting in terms of determining risk and probably represents the future of personalised medicine for carotid assessment. The power of AI in that decision-making process will be invaluable.

Can you explain what MAVRIC stands for and why the project was initiated?

Manchester Academic Vascular Research and Innovation Centre (MAVRIC) was an initiative set up and launched in 2023 and is a joint venture between the University of Manchester and Manchester University NHS FT (the UK’s largest hospital group). We have clinical and non-clinical staff including engineers, data scientists and operational support. We aimed to develop research opportunities for both staff and patients with the ambition of improving outcomes across the region. We are fortunate in Manchester that health and social care decisions are devolved from central government and we have a very successful Greater Manchester and East Cheshire network that spans primary and secondary care. In the secondary care setting, we have close to 30 consultant vascular surgeons and over 60 clinical vascular scientists serving a specialised population of close to four million. It has certainly been an interesting experience and I look forward to presenting the lessons we learned from creating MAVRIC in such a large centre.

How does interdisciplinary collaboration between sonographers and vascular surgeons enhance diagnostic accuracy, patient outcomes, and innovation in vascular medicine?

Collaboration not competition is key to team success. No surgeon can work without a sonographer and vice versa. Equally, nursing and allied health/therapy staff groups are just as important. In the 2021 Provision of Vascular Services (POVS) document, the UK vascular societies (surgeons and scientists) for the first time stipulated that there had to be a minimum number of scientists/sonographers in each unit as well as a whole host of other wellbeing-based recommendations such as mixed scan lists. This set a standard that aimed at improving capacity and workforce numbers and reducing RSI risk. That in itself improves diagnostic accuracy and patient outcomes. However, the close bond between surgeon and sonographer/ scientist is critical to ensuring the scan report addresses the specific need the surgeon wants to understand and produce the best surgical plan. When it comes to innovation, the benefit of a one-team approach is paramount. One individual might think of a research question but another might have the solution to answer it. Research takes a multidisciplinary team to succeed.

How has tomographic ultrasound revolutionised the way we visualise vascular structures? Is there one clinical application you feel highlights its advantages the best?

This comes back to the surgeon-sonographer/scientist trust that needs to exist. We build 3D mental images when we scan them and then write them down. As a result, most surgeons need a CT or MR angiogram to help visualise the 3D problem they are repairing. If we can present our mental 3D image from the ultrasound scanner itself, we immediately address that unique situation. Importantly, having 3D images means we can measure and monitor disease in completely different ways, which opens up the possibility of personalised care. As an example, combining 3D ultrasound and contrast agents to produce angiogram-like images might prevent the need for catheter angiography, which is often needed as CT and MRI angiograms of the foot are diagnostically poor. It also means those patients with allergies to radiological contrast can receive the same standard of care as those who don’t.