oncology and genetics

Name: Professor Ken Miles MBBS FRCR MSc (Nuclear Medicine) MD

Academic position: Professor of Medical Imaging

Research: Cancer imaging

Contact details:

Clinical Imaging Sciences Centre
Brighton and Sussex Medical School
University of Sussex
Falmer
Brighton BN1 9PX
UK

Tel: +44 (0)1273 877574
Fax: +44 (0)1273 876721

E-mail:

Biography:

MBBS 1982. Guy's Hospital Medical School
MSc 1991. University of London
MD 1994 University of Leicester
Consultant Radiologist in Nuclear Medicine, Addenbrooke's Hospital, Cambridge and Associate Lecturer, University of Cambridge 1992 -1995
Specialist in Radiology & Nuclear Medicine, Southernex Imaging Group, Queensland, Australia 1995 – 2003 & Adjunct Professor in the Centre for Medical, Environmental& Health Physics, Queensland University of Technology 1999 - 2003
Professor of Imaging. 2003-present, Brighton and Sussex Medical School
Director of Clinical Imaging Sciences Centre

Teaching focus:

Use of diagnostic imaging to support teaching of anatomy & basic sciences.
Teaching of undergraduate and post-graduate diagnostic radiology & nuclear medicine.

“The use of imaging to enhance the learning of anatomy gives immediate clinical relevance to the subject matter and enables correlation of structure and function whilst highlighting differences between morbid and living anatomy.'

Research focus:

The imaging of tumour angiogenesis, its relationship to tumour metabolism and the tumour microenvironment and its application in drug development and clinical oncology.

“The imaging of tumour angiogenesis illustrates how modern imaging research can correlate the findings on diagnostic images with the bio-molecular processes of the underlying disease.'

Current research:

Diagnostic imaging has an established role in the cancer care, particularly in determining the tumour stage and in monitoring response to therapy. For both applications, imaging currently is based on simple morphological criteria such the size of the primary tumour and regional lymph. The variability of clinical course amongst patients with the same tumour stage has led to a concept of personalised cancer care in which the patient’s treatment is tailored to biological characteristics exhibited by his or her individual tumour. Deriving tumour biological profiles from tissue samples, for example by DNA micro-array analysis, is constrained by the biological heterogeneity of cancer. Different tumour sites within one patient and different regions within the same tumour mass may exhibit different behaviours that change over time and thus multiple tissue samples would be required to obtain a full picture. In contrast, image-based profiling of tumour biology offers non-invasive assessment of larger tumour volumes and multiple tumour sites at several time points in a patient’s clinical course. Using imaging to characterise angiogenesis can provide an important indicator of tumour behaviour as the degree of vascularisation affects tumour aggression, metastatic potential, likely response to radiotherapy and the delivery of chemotherapeutic agents. The tumour vascular system itself has also become a therapeutic target. The development of imaging methods that profile tumour angiogenesis is a major focus of imaging research at the Brighton & Sussex Medical School.

This research programme focuses upon two widely-available techniques to depict tumour vascularity: contrast-enhanced computed tomography (CT) and radionuclide perfusion imaging. Both techniques have been shown to correlate with the density of tumour microvessels as assessed by histopathology. A profile of tumour angiogenesis can be obtained by integrating several physiological parameters such as tumour perfusion, relative blood volume and vascular permeability. More detailed profiles can be derived by assessing vascular heterogeneity with techniques such as histogram analysis and fractal geometry, and by relating angiogenesis to other biological features accessible to imaging, such as glucose metabolism and expression of multi-drug resistance (MDR). Decision tree analysis can be used to support the introduction of these profiles into clinical practice by modelling cost-effectiveness.

Key/recent publications:

Review articles and editorials:

Miles KA, Charnsangavej C, Lee FT, Fishman EK, Horton K, Lee T-Y. Application of CT in the investigation of angiogenesis in oncology. Acad Radiol 2000;7: 840-50

Miles KA. Functional computed tomography in oncology. Europ J Cancer 2002;38: 2079-84

Miles KA, Griffiths M. CT Perfusion: A worthwhile enhancement? Br J Radiol 2003 Apr;76(904): 220-31

Miles KA. Cancer imaging - making the most of your gamma camera. Cancer Imaging 2004; Volume 4 Issue 3. DOI: 10.1102/1470-7330.2004.0005

Miles KA. Cancer imaging – Is it cost-effective? Cancer Imaging 2004; Volume 4 Issue2. DOI: 10.1102/1470-7330.2004.0017

Full papers:

Fuentes MA, Keith CJ, Griffiths M, Durbridge G, Miles KA. Hepatic haemodynamics: interrelationships between contrast enhancement and perfusion on CT and Doppler perfusion indices. Br J Radiol. 2002 Jan;75(889): 17-23.

Keith CJ, Miles KA, Pitman A, Hicks RJ. Solitary pulmonary nodules: Accuracy and cost-effectiveness of sodium iodide FDG-PET using Australian data. Eur J Nucl Med 2002; 29: 1016-1023

Comber LA, Keith CJ, Griffiths M, Miles KA. Solitary pulmonary nodules: impact of quantitative contrast-enhanced CT on the cost-effectiveness of FDG-PET. Clin Radiol. 2003;58: 706-11.

Other information:

Chair of BSMS Quality Assurance Sub-Committee
Member of the Specialist Advisory Committee in Nuclear Medicine to the Joint Committee on Higher Medical Training
Member of the Clinical Imaging Committee of the British Institute of Radiology
Radiology Trainee Assessor for the Royal College of Radiologists