Global heart imaging expert joins AI modelling team

The scans patients receive every day contain a lot more information than doctors can use. But that’s changing. 

Advances in artificial intelligence can now extract far more information from medical images than was ever possible before, revealing complex changes in someone’s body that could help clinicians detect disease earlier, monitor treatments more accurately and make better decisions for individual patients.

At the University of Auckland, researchers at the Auckland Bioengineering Institute (ABI) and the Faculty of Medical and Health Sciences are building an internationally recognised imaging programme that combines engineering, medicine and artificial intelligence to better understand heart, brain and multi-organ disease.

Now that work has drawn one of the world's leading heart imaging researchers back to New Zealand. 

After eight years working at the cutting edge of AI and cardiovascular data analytics at King’s College London, Professor Alistair Young is returning to the University of Auckland.

Young’s new role, Professor of Intelligent Bioimaging, is a joint position between the Auckland Bioengineering Institute and the Faculty of Medical and Health Sciences.

For Young, the opportunity isn’t simply about coming home. It's about joining a diverse research programme he believes is helping shape the future of medical imaging. 

"The stars aligned," he says. "There's a really exciting momentum that Auckland has got going with their imaging initiative. The work they're doing is cutting edge.

"The ABI-FMHS vibe has always been inspiring. The vision they have for doing innovative research  within the Medical Imaging Research Centre is something I wanted to be part of again."

Professor Martyn Nash, who leads the internationally renowned heart and breast imaging groups at the Auckland Bioengineering Institute, welcomes Young’s appointment, after his years “embedded in a hothouse of heart imaging research at King’s College”.

"It strengthens the University of Auckland team and connects the Auckland Bioengineering Institute to a vast global network of medical imaging researchers, consortia and companies," Nash says.

"Alistair’s move home will help accelerate and standardise imaging diagnostics and therapeutic monitoring of patients in Aotearoa New Zealand and worldwide," Nash says.

Being back at the University of Auckland shouldn’t be too much of a culture shock. Before leaving for London in 2018, Young was part of the team that established the Centre for Advanced MRI at the Faculty of Medical and Health Sciences.

A series of Health Research Council grants has seen the University of Auckland and the Auckland Bioengineering Institute become internationally recognised for their work in computational modelling and advanced medical imaging.

Heart modelling

Young’s career at the University of Auckland began before bioengineering existed as a discipline.

Born in Hamilton, he studied engineering science because, as he puts it, it was "applied mathematics in disguise". And he liked maths. But it was a chance encounter with internationally renowned Green Lane Hospital cardiologist Dr Peter Brandt that changed everything.

Brandt had a reputation at the time as someone with an extraordinary ability to diagnose heart disease simply by watching moving x-ray images of a patient's heart. He challenged Young with a deceptively simple question: Could an engineer measure what an experienced cardiologist could instinctively see?

That challenge became Young's PhD.

"It's really the same question I've been working on ever since," he says. "How do you measure exactly how the heart is moving?"

Over the next three decades, that question took him from Auckland to the University of Pennsylvania and eventually to King's College London, where advances in machine learning transformed what was possible.

Working alongside clinicians in London's public hospitals, Young helped develop AI algorithms capable of analysing hundreds of thousands of heart scans from the UK Biobank, one of the world's largest health research resources.

Instead of relying on a handful of measurements, the technology creates detailed three-dimensional models that capture the shape and movement of the entire heart.

"The scan itself hasn't changed," Young says. "What's changed is the way we process it."

And that unlocks an extraordinary amount of new information.

Complex patterns that were once invisible can now be measured, helping clinicians detect disease earlier, monitor whether treatments are working and better understand how conditions such as heart failure, diabetes and cardiomyopathy affect the heart. 

While many of these tools are already being used in large research studies and are beginning to appear in commercial software, Young believes the next challenge is making them available to many more patients.

That's where Auckland comes in.

Rather than building a new research programme from scratch, Young will join forces with Nash and colleagues to combine AI techniques developed in London with ABI's internationally recognised expertise in computational modelling and ultrasound imaging.

One goal is to bring sophisticated engineering analysis to echocardiography – the inexpensive ultrasound scans that are already the first-line imaging test for most heart patients.

"Echo is much cheaper and much more widely available," Young says. "If we can bring these engineering models into ultrasound imaging, then many more patients can benefit."

He believes Auckland has an advantage over many of the world's largest medical centres.

At King's College London, Young saw first-hand how engineers, clinicians and researchers worked side by side to accelerate the journey from laboratory discovery to patient care. He believes this could be even easier to do in Auckland.

"The strength here is that everyone knows each other," he says. "You can get the engineers, cardiologists and medical researchers into one room. It's much easier to build those connections and make things happen."

And it is not just about the heart, Young says. “The University of Auckland has a unique community on the cutting edge of imaging for dementia, musculoskeletal and other organ diseases. New state-of-the-art scanners being installed at FMHS will revolutionise patient imaging. Closer links between engineering and clinical medicine are vital for this to work.”

'Brain circulation'

Young's return is also an example of what University leaders globally increasingly describe as ‘brain circulation’, rather than ‘brain drain’.

His years overseas allowed him to help develop technologies at the forefront of AI-driven medical imaging, while building collaborations across Europe. Now he hopes to apply those lessons to New Zealand healthcare.

"I've learned an enormous amount being in one of the world's leading centres," he says. "But New Zealand has a real strength because we're smaller. It's often easier to do something innovative rather than simply following what everyone else is doing."

Auckland Bioengineering Institute director Merryn Tawhai says she’s “excited” by Young joining the heart imaging programme. 

“Alistair is an example of the ‘reverse brain drain’, returning to New Zealand with deep international research and industry networks that will help expand opportunities for collaboration and research translation.”

His appointment also comes as New Zealand prepares to host the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) for the first time next year. The conference is expected to bring thousands of medical imaging research experts to Auckland. 

Young chairs the scientific programme.