You won’t be seeing iRobot doing your mammograms when you attend screening any time soon, but Roisin Bradley (Director of Breast Screening at York Hospital) and Jihong Zhu (Lecturer of Robotics at the University of York) are developing a robotic solution to improve access to breast screening for patients with disabilities. At the heart of the project, is a lady named Jane, two robotic arms and a mission to drive change.
After seeing that Roisin and Jihong had attended a parliamentary roundtable on robotics in women's health after spinal cord injury, we simply had to hear more about their exciting projects. We’d love to tell you about it – it’s an excellent example of how collaboration between clinicians and researchers can lead to incredible outcomes.
Roisin told me how it all started - when a lady called Jane came for her screening appointment. “Jane was a wheelchair user and paraplegic. Despite trying really hard to support her through her mammogram, we couldn’t obtain the scans because she had no upper body strength and the patient needs to be able to maintain their own posture.
Jane understandably felt that it was unfair that the service was inaccessible to her. She raised it really effectively, and it got me wondering what more we could do for this cohort of patients. I said to her at the time, I’m so sorry I can’t do anything for you right now but I will look into it and if anything changes I will let you know in future. I think she just thought ‘Oh yeah,’ thinking nothing would come of it!
Not long after, I co-organised a research event with York Medical Society and York University – Jihong presented his work, developing robots that could help people with mobility issues get dressed and I just thought, maybe Jihong could help!”
Jihong said that when Roisin first came to him, he didn’t say yes immediately. “I thought, hmmm this is really interesting. Let me learn more about the mammography process. Roisin and I visited each others’ workplaces to gain a better understanding of what the other did. Roisin came to visit my robotics lab and I went to visit the breast unit at the hospital and saw the mammography equipment. We started thinking ‘OK, there could really be something that we can do here’”
When we asked if they got back in touch with Jane, Roisin said “Oh absolutely – Jane is the heart of the project! Once we realised the project had legs I immediately got back in touch with her to ask her what she thought about it. She was absolutely delighted and she actually joined the project team, offering her valuable insights from a patient perspective!”. Jihong said she came to visit the labs too and gave some great feedback on the designs. Unfortunately, Jane passed away a few weeks ago, but she is still very much the heart of the project.
The team managed to get funding for a one-year proof of principle concept from Cancer Research and are looking for funding to extend the project further. The idea is that the AI-embodied robot will help position a patient and hold them safely in place to allow them to get diagnostic quality mammograms.
I asked where they currently are in the development of the robotics. Jihong explained “So we’ve tested individual components to check the robotics are capable and we designed some, what we call, ‘end effectors’ that help maintain the specific consistency in imaging results that you need for mammography. We have been through several iterations of development with Roisin and her team’s assistance at York hospital.”
I asked Jihong if he could help us visualise what it might look like. He said “So it will be two robotic arms that will come from the back of the chair that emulates the way a radiographer would support a patient’s posture from behind them, being able to manoeuvre the patient appropriately. It won’t necessarily look like a human arm… there won’t be hands on it or anything like that! There will be something fit for purpose for a diverse range of patients.
When it comes to how it will actually work, Jihong explained to me how the robotic arms will analyse the patient’s posture to ensure they are in the optimum position. “Currently we are using infrared to analyse the posture of the patient so that the robotics can read the body position and adjust accordingly, applying the right amount of force and so on, without recording any actual photographs of the patient for modesty. Right now however we don’t have the algorithm that forms the robot’s ‘brain’ as I like to call it – the part that handles the reasoning and interprets the data from the infrared sensors. As Roisin mentioned though, it has just been a one-year proof of concept project, so we are looking to raise funds now to extend the project so we can actually bring this to fruition for the people who need it”
I’d like to say as well that I know there are concerns about AI and robotics and some people worry it will take our jobs and so on, this not going to do that at all – it’s going to complement your job as a radiographer. It will mean less physical strain for you and better access for a huge number of patients as well as improved diagnostic image quality. It’s a tool we can use to make sure people get the best care that they can, and hopefully relieve some of the physical burden on mammographers.”
Next, they’re looking at putting together a team to get all the right people in the room from a patient wellbeing point of view, making sure safety, ethics and patient experience are all considered. Once the ‘robot brain’ has been developed, it will need testing in a variety of clinical situations and disabilities – initially with volunteers and then some patients, to make sure that the images are of diagnostic quality and to get feedback on the patient experience.
The project was first inspired by Jane, but there are so many people who have difficulty safely accessing breast screening, from the frail and elderly to people who have multiple sclerosis or have had a stroke. Roisin says “These physical challenges mean that in these cohorts of patients we often obtain poor quality mammograms or no mammograms at all. Additionally, it can put the radiographers at higher risk of Musculo-skeletal injuries if they are supporting the patient’s posture.”
Roisin is passionate about taking the time to listen to patients who give you feedback on their experience. “The patient really helped me understand that we needed to improve accessibility to our screening programme. I also really believe in the power of collaboration between clinicians and researchers – great things can happen when you work together and each bring your own knowledge and perspective to the table. It’s a real-world problem that I didn’t know how to solve initially, but we’ve all learned so much from each other.”
