Imaging in the Era of COVID-19: Maintaining Safety Above All Dr. - PowerPoint PPT Presentation

Imaging in the Era of COVID-19: Maintaining Safety Above All Dr. Rajarshi Banerjee Perspectum Ltd.

Your speaker: Dr. Rajarshi Banerjee Dr. Rajarshi Banerjee is the CEO of Perspectum, he graduated in medicine from the University of Oxford and went on to complete a Masters in Public Health at the London School of Hygiene and Tropical Medicine, before returning to Oxford, for his doctorate. He developed multiparametric liver MRI techniques at the University of Oxford, which led to the creation of Perspectum. He is an expert on liver imaging and a consultant physician for Oxford University Hospitals NHS Foundation Trust. Rajarshi has many years of experience in running clinical trials and working in multidisciplinary scientific teams to develop applications for cutting-edge imaging technology, and is a keen advocate of adaptive trial design. Perspectum Ltd.

Key topics to cover How the The impact of Prioritising The growing global COVID-19 on safety for importance of pandemic is societal well- impacting outpatient imaging being and medical imaging. biomarkers. healthcare. research. Attendees are encouraged to ask questions throughout the webinar! Perspectum Ltd.

How the global pandemic is impacting medical research Sponsors who are actively running trials Most large pharma companies have suspended Minimize the Lock down recruitment for impact on quality restrictions are likely March non-covid research data collected to ease in Europe When will Non-covid clinical This coincides trials resume? May/ research has been with lockdown in April June suspended in most most geographies academic settings Perspectum Ltd.

How the global pandemic is impacting medical research Sponsors who are starting up studies • Find ways to work quickly. Patients need treatments. • Expect increased enrolment competition when trials resume. • "H "Hey, , we do o what we do o best. . We im improvis ise, all all rig ight?" - Brian O'Connor | Fast and Furious 6 (2013) Perspectum Ltd.

Setting up a study quickly & safely. A case study from COVERSCAN Perspectum Ltd.

Study set up 30 days from initiation to first patient in Start of study protocol drafting C E R e h t o t d e t t i m b u S k c a b d g e n e C i F E t R e l a e o i M t t i n e C I s E C n R E o R p s e R l a v o r p p A C E R y a D y d u t S t s r i F Perspectum Ltd.

First Study Day 28 April 2020 05:00 Arrival of Alliance Medical truck(s) AM 08:30 AM Study Team on site at Gemini 10:30 ITV Meridian AM 11:00 First Participant AM Perspectum Ltd.

Study Visit Flow Maintaining safety above all Step 1 Step 2 Perspectum Ltd.

The Alliance Medical “Kit” Maintaining safety above all Mobile MRI Scanner Mobile Clinical Suite and CT Scanner Perspectum Ltd.

Mobile Clinical Suite & CT Scanner Video cred Vadim Belenov Perspectum Ltd.

Mobile MRI Scanner Perspectum Ltd.

40 minutes scan Perspectum Ltd.

Prioritising safety for outpatient imaging Perspectum Ltd.

Prioritising safety for outpatient imaging PPE: The Mask FFP3 (European standard) respirators filter 99% of particles. FFP2 respirators are specified to filter 94% of particles The N99 (American standard) respirator is an alternative to the FFP3 and filters 99% of particles An N95 respirator is specified to filter 95% of particles and is a close equivalent to the FFP2 Other equivalents: KN95 (China) • P2 (Australia/New Zealand) • DF FFR (Japan) • The Type IIR (European Standard) fluid resistant surgical mask is the “regular” surgical mask often used in clinical settings The Level 2 (American standard) fluid resistant surgical mask is equivalent to the Type IIR Perspectum Ltd.

Prioritising safety for outpatient imaging PPE: The Mask Operator Participant Respirator(N95 non-valved Type IIR/Level 2 &FFP3 valved) Fluid Resistant Mask Perspectum Ltd.

Prioritising safety for outpatient imaging Ultrasound / echocardiography • Ultrasound transducers and cables • Technicians should wear full PPE. should be cleaned and disinfected • Clinicians who are at in increas ased healt alth between patients. ri risk sk should not perform ultrasound • Use only single-use gel packets. procedures • Comordities: Over 60, obesity, hypertension, and diabetes (Richardson et. al., 2020) • Cardiovasuclar disease and respiratory system disease (Yang J et. Al., 2020) Perspectum Ltd.

Prioritising safety for outpatient imaging Ultrasound / echocardiography Perspectum Ltd.

Prioritising safety for outpatient imaging MRI/CT guidelines 3 4 2 5 15 minutes Virtual patient Patient in MRI/ Deep clean Between patients check-in waiting room CT Scan the suite Sanitize the Patient and • • • Social Distancing scanner technologist in Low Patient Volume • Clean coils & table separate rooms • Masks Provided • Remote activations • • Replace fabric chairs available Perspectum Ltd.

Fatty Liver Disease is fundamental to COVID-19 The underdiagnosed, asymptomatic health condition • NAFLD is recognized as the most prevalent chronic liver disease globally, with a well documented association with obesity and metabolic syndrome. • Obesity is the biggest single chronic risk factor for hospital admission for COVID- 19 in patients under 60, in increas asin ing the risk ri sk 2-3-fo fold. • Identifying high-risk patients and "Understanding the impact of COVID-19 on specific patient populations such as those with obesity, assessing multi-organ involvement is diabetes, fatty liver disease and NASH is essential to vital. providing actionable advice to clinicians and patients to provide optimal care and avoid needless deaths.” • NASH awareness may increase as a result - Donna Cryer, President of the Global Liver Institute Perspectum Ltd.

The impact of COVID-19 on societal well-being and healthcare • Best time to invest in healthcare tech is now! • Second chance at missed opportunities. • Eli Lilly’s CEO David Ricks said the biopharma industry has a “o “once in a generation opportunity to reset " its reputation. • Gilead CEO Daniel O’Day believes the pandemic will help for “innovative, research-based companies,” • The public will recognize the industry’s “ability to solve a human crisis like this, because of the decades of investment,” he said. “T “The tone is different in Washington." Perspectum Ltd.

How will COVID-19 affect future endpoints? The growing importance of imaging biomarkers COVID-19 has Now more than ever, Prior it’s important to have highlighted the authorization for Biopsy is a way to diagnose importance of NAFLD/NASH patients NASH will be inherently non-contact, due to the underlying imaging and more invasive comorbidities non-invasive bloods associated with testing COVID-19. Perspectum Ltd.

Questions & Answers Perspectum Ltd.

Thank you Thank you To find out more visit: To find out more information: Perspectum.com Perspectum.com @PerspectumGroup @perspectum.diagnostics Perspectum Ltd.