Advanced MRI of Nerve and Muscle

At the Advanced Imaging Centre, University of Leeds, my team and I are developing non-invasive biomarkers of nerve and muscle health, using advanced MRI techniques.

MRI is brilliant because it's biologically safe (no radiation) even for babies, no needles or drugs are needed and we can use it to see anatomy as well as measure function/physiology. This makes MRI an ideal tool for assessing major nerve injuries.

Some seminal publications from our group are shown below

Diffusion tensor MRI can diagnose acute major nerve injury, specifically traumatic root avulsion of the brachial plexus
Diffusion MRI can diagnose carpal tunnel syndrome
Conventional MRI is unreliable for diagnosing brachial plexus root avulsion.
Cubital tunnel syndrome can be diagnosed using non-invasive diffusion tensor MRI.

Surgery for major nerve injury

Our group has published several important works on the best way to treat major nerve injuries:

The nerve transfer used to restore elbow flexion and delay to surgery are important factors in the final outcome
Children with a median nerve injury from a supracondylar fracture benefit from open reduction
Brachial plexus injuries from shoulder dislocation cause long-term disability which may be preventable.

Measuring the impact of nerve injury

With my collaborators, I am developing new and better ways to measure the impact of nerve disorders on people's work and quality of life

Using a smartphone application, we can measure patients' symptoms in real-time from their own home, negating the need for check-up appointments and providing reassurance to both doctors and patients, but also identifying those who need help
Using the UK Hand Registry, we show that surgery for cubital tunnel syndrome rapidly improves hand function

Evidence Synthesis

I have delivered several important systematic reviews with pairwise, network and diagnostic test accuracy meta-analyses. Many of these have changed medical practice around the world, such as:

Does this Infant Have A Dislocated Hip? This is revolutionising neonatal hip dysplasia screening programmes
Network meta-analysis of skin antiseptic. This informed global guidelines on skin antisepsis before surgery
A global COVID-19 Symptom Review: this article formed the cornerstone of the WHO pandemic guidelines

Qualified Statastician

I am a registered statistician, chartered with the Royal Statistical Society with the GradStat qualification. I provide independent statistical services to medical researchers.

Reducing Bias in Quantiative MRI

Our research into simultaneous multicel imaging (SMS, aka multiband) accelerated MRI, using the NIST/QIBI diffusion phantom made by CaliberMRI, made the following important discoveries:

SMS x2 gives similar results to SMS off
SMS x3/4 introduces clinically important bias in diffusion parameters
The observed bias in ADC with SMS x3/4 was independent of TR

Researchers and academics can safely apply SMS x2 and shorten the TR in humans without introducing bias in estimates of diffusivity

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