Rowland Illing

Rowland Illing
University College London | UCL · Academic Department of Surgery

About

80
Publications
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Introduction
Dr Rowland Illing is the Chief Medical Officer and Director of International Public Sector Health for Amazon Web Services (AWS). He has responsibility for public sector healthcare strategy and operations for AWS internationally. This encompasses healthcare service delivery, research and genomics. He is passionate about transforming and developing networks to improve access to care and using the power of healthcare data to improve lives.

Publications

Publications (80)
Article
Objectives: Radiation dose index monitoring (RDIM) systems may help identify CT dose reduction opportunities, but variability and complexity of imaging procedures make consistent dose optimization and standardization a challenge. This study aimed to investigate the feasibility to standardize and optimize CT protocols through the implementation of...
Article
Full-text available
Background To determine whether artificial intelligence (AI) processed PET/CT images of reduced by one-third of 18-F-FDG activity compared to the standard injected dose, were non-inferior to native scans and if so to assess the potential impact of commercialization. Materials and methods SubtlePET™ AI was introduced in a PET/CT center in Italy. El...
Preprint
Full-text available
Background To determine whether artificial intelligence (AI) processed PET/CT images of reduced by 33% administered 18-F FDG activity acquired in a single center, were non-inferior to native scans and if so to assess the potential impact of commercialization. Methods SubtlePET™ AI was introduced in a PET/CT center in Italy. Eligible patients referr...
Preprint
Full-text available
Background To determine whether artificial intelligence (AI) processed PET/CT images of reduced by 33% administered 18-F FDG activity acquired in a single center, were non-inferior to native scans and if so to assess the potential impact of commercialization. Methods SubtlePET™ AI was introduced in a PET/CT center in Italy. Eligible patients referr...
Article
Purpose Radiation Protection Apparel (RPA) is used during diagnostic imaging and interventional procedures to minimise incidental radiation expo. The majority of RPA in use are lead-containing, which has until now been considered safe. A recent single-centre study has demonstrated that the external surface of 63% of RPA was contaminated with lead d...
Article
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Purpose: The purpose is to investigate cardiac magnetic resonance and laboratory findings in patients with clinically suspected acute myocarditis and re-assess the evolution of findings in relation to clinical parameters and smoking habits. Methods: We prospectively analyzed 68 consecutive patients (4 females, 64 males, median age 25 years) at base...
Article
Purpose Working in a dynamic, complex and high workload environment can lead to unintended radiation exposures. Unintended does not mean unable to prevent. Establishing a unified incident management system in an international healthcare services organisation facilitates better identification of safety critical steps. A bigger ‘pool of events’ can i...
Article
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Microwave ablation (MWA) has been proposed to suffer less from the heat sink effect compared to radiofrequency ablation but has been reported to cause extension of the ablation zone along intrahepatic vessels in clinical practice. To study this effect in detail, eight fresh porcine livers were perfused in an ex-vivo organ perfusion system. Livers w...
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We present a case of a patient who following chemotherapy developed semi-invasive pulmonary aspergillosis and an aspergilloma in a lung cavity previously formed by microwave ablation (MWA). A 55-year-old woman presented with cough and shortness of breath after finishing three cycles of chemotherapy for a metastatic nerve sheath tumour. She had been...
Article
Purpose: To compare the size of ablation zones derived from nonperfused ex vivo livers with ablation zones created using an ex vivo perfused porcine liver model. Materials and methods: Six fresh porcine livers were used to evaluate microwave ablation (MWA). Perfused (n = 3) and nonperfused (n = 3) livers were warmed to 37°C by oxygenated, O-posi...
Article
A 69-year-old man who presented with abdominal discomfort was, on examination, found to have a palpable abdominal mass. Contrast-enhanced CT showed a mass arising from the inferior vena cava, which biopsy confirmed to be a leiomyosarcoma. One month after chemoradiotherapy, CT demonstrated a new 15 mm solitary central right liver metastasis. Microwa...
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Purpose: To evaluate the safety and efficacy of percutaneous high-energy microwave ablation (MWA) for the treatment for pulmonary tumors. Materials and methods: A retrospective review was undertaken of 44 patients (21 men, 23 women; median age, 66 y; range, 17-89 y) who underwent 62 sessions of high-energy MWA for 87 pulmonary tumors at a single...
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To determine the evolution of prostatic multi-parametric magnetic resonance imaging (mp-MRI) signal following transrectal ultrasound (TRUS)-guided biopsy. Local ethical permission and informed written consent was obtained from all the participants (n=14, aged 43-69, mean 64 years). Patients with a clinical suspicion of prostate cancer (PSA range 2....
Article
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One-third of men may experience biochemical failure by 8years following radical radiotherapy for localised prostate cancer. Over 90% of men are started on androgen deprivation therapy (ADT) which is non-curative and confers systemic side-effects. Focal salvage therapy (FST) limits collateral tissue damage and may improve therapeutic ratios. In orde...
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Background: Patients with pancreatic cancer have a poor prognosis apart from the few suitable for surgery. Photodynamic therapy (PDT) produces localised tissue necrosis but previous studies using the photosensitiser meso-tetrahydroxyphenylchlorin (mTHPC) caused prolonged skin photosensitivity. This study assessed a shorter acting photosensitiser, v...
Article
Objectives: To assess the safety and feasibility of high-intensity focused ultrasound (HIFU) ablation of liver tumours and to determine whether post-operative MRI correlates with intra-operative imaging. Methods: 31 patients were recruited into two ethically approved clinical trials (median age 64; mean BMI 26 kg m(-2)). Patients with liver tumo...
Article
IntroductionRenal cancerProstate cancerFuture directionsConclusions References
Article
Minimally invasive, image-guided thermal ablation is gaining acceptance for the treatment of solid tumour deposits and its use is increasing. This overview discusses one method of thermal ablation in one palliative setting; the local control of breast cancer liver metastases (BCLM) using radiofrequency ablation. Breast cancer is common and over hal...
Article
To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services....
Article
To determine whether primary extracorporeal high-intensity focused ultrasound (HIFU) is safe, feasible and effective for managing small renal tumours. Although surgery currently remains the standard treatment for localized renal cell carcinoma (RCC), the increasing incidence of small renal cancers has led to a shift towards nephron-sparing surgery,...
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The use of minimally invasive ablative therapies in localised prostate cancer offer potential for a middle ground between active surveillance and radical therapy. An analysis of men with organ-confined prostate cancer treated with transrectal whole-gland HIFU (Sonablate 500) between 1 February 2005 and 15 May 2007 was carried out in two centres. Ou...
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The use of MRI in prostate cancer management is controversial and current guidelines underplay its role. Technological advances over the past 5 years, however, demand a re-evaluation of this position. In this article, we propose an increased use of MRI, not only in those with a diagnosis of prostate cancer but also for men before a prostate biopsy....
Article
To report on the high rectal fistula rate associated with salvage high-intensity focused ultrasound (HIFU) after the failure of combined brachytherapy and external beam radiotherapy (EBRT) for prostate cancer; salvage ablative therapy for prostate cancer is indicated when there is local recurrence after RT, brachytherapy or their combination. We re...
Article
Cancer therapies usually depend on cross-sectional imaging for the assessment of treatment response. This study was designed to evaluate the ability of MRI to predict zones of necrosis following the use of high-intensity focused ultrasound (HIFU) to treat liver metastases. Patients with liver metastases, who had been scheduled for elective surgical...
Article
To investigate the use of minimally invasive high-intensity focused ultrasound (HIFU) as a salvage therapy in men with localized prostate cancer recurrence following external beam radiotherapy (EBRT). A review of 31 cases treated using the Sonablate 500 HIFU device, between 1 February 2005 and 15 May 2007, was carried out. All men had presumed orga...
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Full-text available
Magnetic resonance (MR) imaging is potentially useful in the assessment of many benign penile diseases. When T1- and T2-weighted sequences are used, MR imaging can clearly delineate the tunica albuginea and can be used to diagnose penile fracture and Peyronie disease; in both conditions, MR imaging may help refine the surgical approach. It is also...
Article
To assess the role of magnetic resonance imaging (MRI) for evaluating changes in the prostate after transrectal high-intensity focused ultrasound (HIFU) for treating prostate cancer, correlating the findings with histology to assess its possible role in predicting the outcome, evaluating residual cancer or local recurrence of disease. Ten patients...
Article
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To prospectively evaluate magnetic resonance (MR) imaging findings after high-intensity focused ultrasound (HIFU) treatment of the prostate and to correlate them with clinical and histologic findings. Local ethics committee approval and informed consent were obtained. Fifteen consecutive men aged 46-70 years with organ-confined prostate cancer unde...
Article
The increased willingness of both men and physicians to take part in formal and informal prostate-specific antigen (PSA) screening has given rise to an increase in the diagnosis of prostate cancer at an earlier stage in younger men. It is now the most common cancer in men and the second leading cause of death from malignancy in the UK.1 As more men...
Article
To assess the extent of scrotal pain in men before and after vasectomy, to produce accurate data for the benefit of men considering this procedure, and hence improved informed consent about the outcomes, as chronic scrotal pain after vasectomy is a poorly quantified clinical problem. Between November 2004 and January 2006 nine surgeons carried out...
Article
Full-text available
The current treatment choice for men with localized prostate cancer lies between active surveillance and radical therapy. The difference between these two extremes of care is 5% in terms of cancer-related absolute mortality at 8 years. It is generally accepted that this small difference will decrease for men diagnosed in the prostate-specific-antig...
Article
Objectives: This manuscript reviews the strengths and weaknesses of alternatives to transurethral resection of the prostate (TURP) to treat lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). Methods: The majority of data discussed in this paper were presented at the 2006 annual meetings of the European Association o...
Article
We evaluated 409 patients suffering from localized prostate cancer treated with high-intensity focused ultrasound (HIFU). All patients were followed for at least 12 months after treatment. Biochemical failure was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. None of the...
Article
The current choice for men with localised prostate cancer lies between active surveillance and radical therapy. The best evidence for the difference between these two extremes of care is 5% in terms of cancer-related absolute mortality at 8 years. It is generally accepted that this small difference will decrease for men diagnosed in the PSA-era. Th...
Article
To review the current status of high intensity focused ultrasound (HIFU) therapy in the prostate, in particular the treatment of prostate cancer. Two trans-rectal devices are currently in clinical use; the SonablateR500 and AblathermR. These devices are compared and similarities and differences highlighted. Outcomes from the primary treatment of pr...
Article
To propose a standard for the conduct of visually directed transrectal high-intensity focused ultrasound (HIFU) and to offer a formal description of the changes observed on B-mode ultrasonography (US) during this procedure. We describe our early experience of using two different treatment methods; algorithm-based HIFU and visually directed HIFU for...
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Full-text available
Prostate cancer (PCa) is the most common cancer in men and the second leading cause of death from malignancy in the UK. The number of men diagnosed with PCa is increasing, due in part to an increased willingness of men to visit their family doctors with lower urinary tract symptoms, and also a willingness of physicians to test for it. As the demogr...
Article
To explore the effect of neoadjuvant androgen suppression (AS) compared to no AS on cancer-related outcomes after radical high-intensity focused ultrasound (HIFU) therapy for men with presumed organ-confined prostate cancer. Between January 1999 and January 2005, 250 patients underwent HIFU for presumed localized adenocarcinoma of the prostate; 154...
Article
To explore the association between the prostate-specific antigen (PSA) nadir after transrectal high-intensity focused ultrasound (HIFU) therapy for organ-confined prostate cancer and subsequent treatment failure, as defined by the presence of residual disease at biopsy 6 months after treatment. Between January 1999 and January 2005, 115 patients in...
Article
14645 Background: High-intensity focused ultrasound (HIFU) provides a potential non-invasive alternative to conventional therapies. We have been using the extracorporeal ultrasound-guided Model-JC Tumor Therapy System (HAIFU Technology Company, China) in clinical trials to evaluate the safety and feasibility of treating small renal tumours. Methods...
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Full-text available
High-intensity focused ultrasound (HIFU) provides a potential noninvasive alternative to conventional therapies. We report our preliminary experience from clinical trials designed to evaluate the safety and feasibility of a novel, extracorporeal HIFU device for the treatment of liver and kidney tumours in a Western population. The extracorporeal, u...
Article
High‐intensity focused ultrasound (HIFU) provides a potentially non‐invasive alternative to conventional therapies. We have been using the extracorporeal ultrasound‐guided Model‐JC Tumor Therapy System (HAIFU™ Technology Co, China) in clinical trials to evaluate the safety and feasibility of treating renal and liver tumours. 30 patients have been...
Article
High-intensity focused ultrasound (HIFU) when used clinically to treat liver and kidney tumours is often directed between the ribs. This paper details the construction of a tissue phantom, incorporating ribs, and its use to assess the clinical safety of HIFU exposures. The prefocal, acoustic side-lobes of the ultrasonic beam were studied with and w...