For the last half-century doctors have routinely used radioactive drugs - radiopharmaceuticals - to detect and diagnose disease in patients and to treat cancer. This speciality is known as nuclear medicine. Modern imaging with radiopharmaceuticals is known as molecular imaging, and treating cancer with them is known as radionuclide therapy. Currently there are economic and geographical barriers, both in the UK and overseas, for patients accessing these scans and treatments. Our programme will develop technologies to perform both molecular imaging and radionuclide therapy more cost-effectively, benefitting more patients and greatly enhancing quality of information, depth of understanding of the disease, and therapeutic benefit. We will use new chemistry to make synthesis of the radiopharmaceuticals faster, more cost-effective and usable in more locations, and hence more accessible for patients. It will improve healthcare by producing and clinically translating new radioactive probes for positron emission tomography (PET), single photon emission computed tomography (SPECT) and radionuclide therapy, to harness the potential of emerging new scanners and therapeutic radionuclides, and provide a diagnostic foundation for emerging advanced therapies. Advanced medicines such as cell-based and immune therapies, targeted drug delivery and radionuclide therapy pose new imaging challenges such as personalised profiling to optimise benefit to patients and minimise risk, and tracking the fate of drug/radionuclide carriers and therapeutic cells in the body. New alpha-emitting radionuclides for cancer therapy are impressing in early trials. New understanding of cancer heterogeneity shows that imaging a single molecular process in a tumour cannot predict treatment outcome. New generation scanners such as combined PET-MR are finding clinical utility, creating niche applications for combined modality tracers; new gamma camera designs and world-wide investment in production of technetium-99m, the staple raw material for gamma camera imaging, demand a new generation of technetium-99m tracers; and "total body PET" will emerge soon, enhancing the potential of long-lived radionuclides for cell and nanomedicine tracking. Demand for new tracers is thus greater than ever, but their short half-life (minutes/hours) means that many of them must be synthesised at the time and place of use. Except for outdated technetium-99m probes, current on-site syntheses are complex and costly, limiting availability, patient access and market size, particularly for modern biomolecule-based probes. Therefore, to grasp opportunities to improve healthcare afforded by the aforementioned advances in therapies and scanners, they must be matched by new chemistry for tracer synthesis. This Programme will dramatically enhance patient access to molecular imaging and radionuclide therapy in both developed and low/middle-income countries, by developing and biologically evaluating faster, simpler, more efficient, kit-based biomolecule labelling with radioactive isotopes for imaging and therapy, streamlining production and reducing need for costly and complex automated synthesisers. In addition, it will maximise future impacts of total body PET, SPECT, PET-MR by evaluating and developing the potential of multiplexed PET to harness the full potential of total body PET: combined imaging of multiple molecular targets, not just one, using fast chemistry for several very short half-live tracers in tandem in a single session to offer a new level of personalised medicine. The programme will also enable the tracking of nanomedicines and cells within the body using long half-life radionuclides - an area where total body PET and PET-MR will be transformative). Finally, we will secure additional funding of selected probes into clinical use in heart disease, cancer, inflammation and neurodegenerative disease.

This application brings together two world-renowned research- and educational-focused Universities in a unique collaboration to create an interdisciplinary training approach to meet challenges in healthcare. With complementary strengths in basic physical sciences, engineering and clinical translation, close strategic and geographical links and a CDT embedded within a top-rated teaching hospital, the KCL/ICL alliance is superbly placed to train the next generation of imaging scientists and research leaders. The CDT will provide a unique interdisciplinary training program to develop the skills for creating innovative technical solutions through integration of the physical sciences, engineering and biological and clinical disciplines. The Centre will be integrated into a large research portfolio in medical imaging funded through EPSRC/Wellcome Trust Medical Engineering Centres, MRC centres, the CRUK/EPSRC Cancer Imaging Centres, and the BHF Centres of Excellence. In order to foster clinical translation of research, the CDT will be linked into two Academic Health Science Centres and NIHR-Biomedical Research Centres. The CDT will create a critical mass of teachers and researchers to establish an interdisciplinary training program by bringing together students from different disciplines to work on research topics in medical imaging. The CDT will feature a 1 + 3 years MRes+PhD structure and will manage the students as a single cohort. We have developed the different phases of the PhD programme, i.e. Recruitment, MRes, PhD and Alumni, to achieve the highest quality in training, research and career development for the individual student. We place a strong emphasis on clinical translation, therefore the CDT will continue with a formal training programme in clinical applications in parallel to the PhD projects. In addition, the teaching location of the Centre in a dedicated, newly-refurbished CDT teaching hub within a world-class teaching hospital engenders strong links with the NHS and provides further enhanced opportunities for clinical translation. The first and foremost goal of this CDT will be to provide the highest quality supervision for individual students. To achieve this, we will combine the experience of senior supervisors with the energy and development of more junior academics. At the start of the CDT, we will be defining PhD projects from 60 supervisors with world-leading research expertise in the underpinning of the multidisciplinary themes in medical imaging. All of those scientists have a track record in PhD supervision and delivering research funded by research councils. We have also identified clinical champions in three major disease areas (Cardiology, Oncology, Neuro) who will organize training in clinical application. This training is designed to forge interactions between scientists and clinicians. It will provide students with valuable contacts with whom they can discuss clinical implications of their PhD research. The CDT will provide training of a new generation of scientists with skills in interdisciplinary research, clinical translation and entrepreneurship. The focus of both graduate training and the individual student research projects will be to innovate medical imaging technologies in the care cycle of patients across a range of diseases. Another central theme within the program will be training to translate innovations into commercial products. For this, we will leverage our strong industrial links and have obtained financial commitment for more than 25 co-funded industrial CDT studentships from various industrial partners. The partners, including new UK-based SMEs and start-up companies, will also provide internships to enable career paths into industry.

Medical imaging has transformed clinical medicine in the last 40 years. Diagnostic imaging provides the means to probe the structure and function of the human body without having to cut open the body to see disease or injury. Imaging is sensitive to changes associated with the early stages of cancer allowing detection of disease at a sufficient early stage to have a major impact on long-term survival. Combining imaging with therapy delivery and surgery enables 3D imaging to be used for guidance, i.e. minimising harm to surrounding tissue and increasing the likelihood of a successful outcome. The UK has consistently been at the forefront of many of these developments. Despite these advances we still do not know the most basic mechanisms and aetiology of many of the most disabling and dangerous diseases. Cancer survival remains stubbornly low for many of the most common cancers such as lung, head and neck, liver, pancreas. Some of the most distressing neurological disorders such as the dementias, multiple sclerosis, epilepsy and some of the more common brain cancers, still have woefully poor long term cure rates. Imaging is the primary means of diagnosis and for studying disease progression and response to treatment. To fully achieve its potential imaging needs to be coupled with computational modelling of biological function and its relationship to tissue structure at multiple scales. The advent of powerful computing has opened up exciting opportunities to better understand disease initiation and progression and to guide and assess the effectiveness of therapies. Meanwhile novel imaging methods, such as photoacoustics, and combinations of technologies such as simultaneous PET and MRI, have created entirely new ways of looking at healthy function and disturbances to normal function associated with early and late disease progression. It is becoming increasingly clear that a multi-parameter, multi-scale and multi-sensor approach combining advanced sensor design with advanced computational methods in image formation and biological systems modelling is the way forward. The EPSRC Centre for Doctoral Training in Medical Imaging will provide comprehensive and integrative doctoral training in imaging sciences and methods. The programme has a strong focus on new image acquisition technologies, novel data analysis methods and integration with computational modelling. This will be a 4-year PhD programme designed to prepare students for successful careers in academia, industry and the healthcare sector. It comprises an MRes year in which the student will gain core competencies in this rapidly developing field, plus the skills to innovate both with imaging devices and with computational methods. During the PhD (years 2 to 4) the student will undertake an in-depth study of an aspect of medical imaging and its application to healthcare and will seek innovative solutions to challenging problems. Most projects will be strongly multi-disciplinary with a principle supervisor being a computer scientist, physicist, mathematician or engineer, a second supervisor from a clinical or life science background, and an industrial supervisor when required. Each project will lie in the EPSRC's remit. The Centre will comprise 72 students at its peak after 4 years and will be obtaining dedicated space and facilities. The participating departments are strongly supportive of this initiative and will encourage new academic appointees to actively participate in its delivery. The Centre will fill a significant skills gap that has been identified and our graduates will have a major impact in academic research in his area, industrial developments including attracting inward investment and driving forward start-ups, and in advocacy of this important and expanding area of medical engineering.