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Medical imaging is playing an increasingly important role in finding new drugs for intractable diseases. By bringing together researchers in the Department of Radiology and GSK, an EPSRC IAA Partnership Development Award is yielding new MRI techniques that could make it quicker and cheaper to test new treatments for osteoarthritis.

Since entering service in hospitals during the 1980s, Magnetic Resonance Imaging (MRI) has become a mainstay of healthcare systems around the world. But as well as being used to diagnose disease and injury, MRI is finding an increasingly important role in clinical trials.

For the pharmaceutical industry, using MRI is an ideal way to test the safety and efficacy of new drug treatments. Instead of relying on survival rates or symptom reduction, which are time consuming and require large numbers of patients, being able to measure small changes in disease progression via MRI can make drug trials significantly faster and more cost-effective.

Osteoarthritis is a case in point. This painful, often debilitating condition affects more than eight million people in the UK alone, yet current treatments remain limited to symptomatic relief. Now, thanks to an EPSRC IAA Partnership Development Award, leading pharmaceutical company GSK has teamed up with researchers in the Department of Radiology to find new ways of using MRI for clinical trials in osteoarthritis.

According to Fiona Gilbert, Professor of Radiology at the Clinical School of Medicine: “Osteoarthritis is a big problem that affects a lot of the population, but we don’t have good treatments or disease-modifying drugs. We want smarter, more accurate imaging techniques so that we can look at patients while they are getting new treatments, otherwise it takes a long time to evaluate whether or not you’ve halted the progression of the disease.”

The partnership with GSK began in 2014 when the pharmaceutical firm approached Gilbert to ask if she’d be interested in applying for EPSRC funding. The Partnership Development Award allowed Dr Joshua Kaggie, an experienced MRI physicist, to join the Department of Radiology to work on new ways of making MRI more sensitive for osteoarthritis.

“GSK wanted a biomarker, a measurement tool they can apply safely and repeatedly to patients to say this novel drug is working and that one is not. It speeds up the clinical trials, reduces the number of patients you need in the trial, so that reduces the cost of the trials themselves,” explains Gilbert. “We’re investigating different ways of using MRI to better visualise the soft tissues around the knee, the cartilage and synovium, which become boggy and inflamed in the initial stages of osteoarthritis.”

By bringing GSK and the University together, the EPSRC funding has brought benefits to both. “GSK want access to the best resources and collaborating with Cambridge is a great way to achieve this,” says Kaggie. “The Partnership Development Award gave GSK direct access to cutting-edge medical imaging research, and it gave the University access to GSK staff and resources.”

Following the success of the Partnership Development Award, GSK has continued to fund Kaggie for a further three and half years, and he has since gone on to secure a Royal Society International Exchanges grant to collaborate with a team in Pisa on a method called Magnetic Resonance fingerprinting as well as getting EU Horizon 2020 funding for a stem-cell tracking project.

The results of the partnership have been encouraging. “One of the methods we’ve developed is called ultra-short echo time imaging. It’s my favourite for detecting osteoarthritis and the most promising of all the methods we’ve been working on,” says Kaggie. “With it you can begin to see some of the degeneration in bony structures very early as well different layers within the cartilage. This is a major advance and we hope we can make it even more sensitive.”

There have been challenges as well as rewards along the way, not least because of the degree of flexibility Kaggie was afforded in his research. “It allowed me to get involved in many projects, but the flip side of that freedom is maintaining focus. At the beginning there was a lot to learn about the different expectations of industry and academia and what the relationship between the two should be.”

But with promising results, further funding and additional investment by GSK in five more PhD students in the Department of Radiology, the EPSRC award laid firm foundations for a very productive working relationship, Gilbert concludes. “Working with GSK has been hugely helpful. Working in partnership with GSK has allowed Josh to do more and develop more techniques. And as a Department, it’s allowed us to extend and develop new collaborations with both GSK and GE Healthcare, our MRI equipment manufacturer.”