“Getting it Right First Time” with Dr. Vineet Prakash

What is your background?

I am a dual accredited Diagnostic Radiologist and Nuclear Medicine Physician here at Ashford and St. Peter’s Hospitals NHS Foundation Trust (ASPH).


What research are you currently involved in?

ElaTION is the first study at ASPH where a Radiologist has been the Principal Investigator (PI). We have directly influenced the study protocol, with our constructive feedback by working closely with colleagues in Research and Cytology at ASPH and Histopathology at the Royal Surrey County Hospital.


What is the ElaTION study all about?

ElaTION aims to find out whether a new ultrasound method called Real Time Ultrasound Elastography (RTE), will detect cases of benign thyroid nodules better than the current standard method of ultrasound diagnosis and reduce unnecessary diagnostic thyroid operations.

The study is a multi-centre randomised controlled trial, based at the University of Birmingham. One group will have the new treatment and one group the standard treatment which will be allocated at random (like tossing a coin). If proven effective in reducing the false positive rates and the need for Fine needle aspiration cytology, then RTE has the potential to reduce patient distress and healthcare costs significantly.


Why is this study important?

Thyroid lumps are very common but only about 1 in 20 are cancerous. Currently the recommended way of getting a diagnosis is to guide a needle by ultrasound into the lump to extract cells. Sometimes it is difficult to be absolutely sure of the diagnosis and then further investigation and treatment is needed.

Ultrasound imaging is an important mainstay in patient management and this research study is a good example of the “Getting it right first time” quality improvement programme that the NHS is promoting (https://improvement.nhs.uk/news-alerts/getting-it-right-first-time-recruits-new-clinical-leads/)


Which other Research studies excite you?

A recent publication in “Nature” entitled “Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution” is the publication that most appeals to me currently. Working with the P.I, Charles Swanton, my fellow colleagues were also co-authors on this paper; Dr Irvin-Sellars, Dr Ismail, Dr Ezhil and myself. This makes it an even more satisfying read!