Seeing Things Through

Description

Nyein Chan Aung is an industrial designer whose groundbreaking collaboration with X-ray technology company Micro-X is changing the game for stroke diagnosis and treatment.
The idea of a vehicle-mounted mobile X-ray bringing medical imaging to the patient was first envisaged in the early twentieth century. But much like Leonardo da Vinci’s illustrations of a flying machine, it has required the advances of technology to come to fruition. And thanks to a ground-breaking collaboration between Monash Art, Design and Architecture’s Dr Nyein Chan Aung and Adelaide-based company Micro-X, a new era of imaging in stroke care is about to become reality.

Over the past few years, self-described creator of “cool things” Dr Aung has been designing a CT brain scanner small enough to be installed in a conventional ambulance or light aircraft. Scanning a patient’s brain in the crucial ‘golden hour’ following a stroke, rather than waiting until they are transported to a hospital’s CT unit, has been proven to significantly improve outcomes and reduce the risk of death and disability.

“Treating stroke is all about time,” says Dr Aung, a senior design researcher at the Monash Design Health Collab. “The faster you can treat, the better the outcome for the patient. Ultimately, strokes come down to two profiles – is it a bleed or a clot? This scanner would allow us to determine the type of stroke the patient had suffered within minutes of the ambulance’s arrival and potentially (if appropriate) provide treatment on site.”

The first company in the world to successfully commercialise carbon nanotube technology (CNT), Micro-X has been able to create small CNT X-ray heads that are robust, low in power demand and ultra-efficient.

Image: Early concept design visualisation of the Lightweight CT Brain Scanner. Courtesy Monash Design Health Collab.

Image: Visualisation of the CT Brain Scanner integrated in a standard road ambulance. The ambulance interior has been redesigned in this image for improved usability. Courtesy Monash Design Health Collab

“In a current CT, the large X-ray head spins around the person, taking the image from every angle possible. It’s very effective but it’s topography dependent, requiring flat ground. It needs time to warm up, and it needs a lot of shielding and mechanisms,” explains Dr Aung. “With Micro-X, because the X-ray heads are so small, we can have 30 of them in a fixed arc array so nothing is spinning. Getting the machine ready and taking the scan is instant. It’s also topography independent, so the vehicle doesn't need to be stabilised. It’s an incredible project and I still feel giddy and excited every time I talk about it.”

Melbourne does have an existing mobile stroke unit (MSU) – Australia’s only one – which is essentially a modified container truck with a full CT scanner inside. “Melbourne’s MSU is proving phenomenal in terms of outcomes for the patients it does see. But because a conventional MSU is such a specialised vehicle there are only a couple dozen in the world, and they only exist in fairly wealthy cities because they are so costly to maintain,” Dr Aung says. “So the idea came about that if on-site stroke treatment was to become more prevalent, the technology had to be relatively easy to use, robust and stable. It had to be deployable from your standard air or road ambulance. This project is really all about increased access to technology.”

Collaboration has been key to the multi-year project. “It’s crucial to get the clinicians’ input, as design is all about the user workflow,” says Dr Aung. That has meant multiple trips to the Australian Stroke Alliance and many discussions with physicians, scientists and engineers as well as the people on the ground: the paramedics, radiologists and radiographers who can help the project team understand and examine all-important workflows.

“Everyone sees a need for this technology, it just hasn’t been a possibility until very recently. So far, every physician and radiologist and paramedic we’ve talked to has really wanted to see this out there.” The development of the first portable stroke scanner prototype will take place in 2023 – around the size of large travel luggage, it will be able to be secured to the ambulance. Dr Aung expects that ongoing tweaking of the design will continue for another few years, before clinical trials take place.

Concurrently, Dr Aung is working on another project based on similar technology. Together with Micro-X and the US Department of Homeland Security, he is designing an airport security scanner that will completely redesign the airport check-in experience into an advanced self-service system in which both the person and their luggage are scanned at the same checkpoint. “We’re making an effort to prioritise the user’s dignity, so it’s taking into account things like gender sensitivity, medical implants and equipment.”

This is not the first time Dr Aung’s research has taken him into the realm of air travel – his PhD at Monash University saw him explore ways to help passengers sleep better in economy class airline cabins without having to modify the seats.

Image: Early concept design and layout of the airport security checkpoint project shown in scale with passengers. Courtesy Monash Design Health Collab.

His interest in combining technology and design for a user-centred experience has also seen Dr Aung and his wife – geriatrician and endocrinologist Dr Thinn Thinn Khine, who Dr Aung credits with his interest in health, mobility and med-tech – working on a project that is extremely personal to them. After staying with Dr Khine’s elderly mother in a palliative care room at a Melbourne hospital, ill-equipped with the standard patient bed and a couch, Dr Aung was prompted to think about using design for better end-of-life care. Their concept involves a fold-out bed and shelving unit that can easily convert a standard sub-acute hospital or aged care room into a palliative unit that enables a guest to sleep over. Additionally, a digital ‘communications’ module will allow the patient and their loved ones to have virtual connectivity to the outside world.

Born and raised in Myanmar, as was his wife, Dr Aung says he was not aware a design career existed until he went to high school in the US. “An ‘industrial designer’ was unheard of when I was growing up. Even graphic design was not a professional vocation like you would see here,” he says. “To be fair, the job I’m doing today didn’t really exist when I was a kid. There was no design researcher working on med-tech at that time. I knew I wanted to be creative, but it was only when I saw a documentary in art class that I realised the possibilities. From then on, industrial design has been the thing for me. I fell in love with it. I haven't looked back or even to the side, to be honest.”

Nyein Chan Aung is an industrial designer and artist. He completed his PhD in industrial design at Monash Art, Design and Architecture, where he is currently a Senior Design Researcher (Practice-based) in the Design Health Collab.

Larissa Dubecki has been a journalist for 20 years, with a career spanning news writing and specialist food reviewing.