Dr Messiou is the Digital Theme lead at the NIHR Biomedical Research Centre at The Royal Marsden and the ICR (BRC) and a Consultant Radiologist at The Royal Marsden, with expertise in imaging for myeloma, melanoma and soft tissue sarcoma. The BRC has helped support Dr Messiou’s research projects and given her the opportunity to develop her leadership skills and support other talented researchers. Image What does a typical week for you look like? My time is divided between clinical and research commitments. The clinical work consists of clinical scan reporting sessions in radiology and multidisciplinary team meetings to review patients with haematological malignancies, sarcoma and skin cancer, which are my areas of expertise. Research also generates a lot of meetings and emails because it’s important to communicate not only with my own team but also collaborators within and external to The Royal Marsden. I also have five PhD students and an Academic Clinical Fellow, so I make time for regular catch ups with them. It’s a real privilege to be able to guide young researchers at such an important stage of their careers and I learn a great deal from them. Although the balance of clinical and research commitments can be challenging, for me, remaining embedded in the clinical teams is absolutely crucial. It’s that interaction that sparks new ideas and provides the opportunities to translate innovation into the clinic. Which areas of research are you involved in? Most of my research centres around using minimally invasive imaging techniques to gain insights into the underlying biological behaviour of cancer to guide personalised medicine approaches. Standard imaging techniques often tell us where a cancer is situated and what size it is, but we now know that next generation imaging techniques can probe the underlying biology of the disease. In order to fully exploit the information in scans, recent experience tells us that we have to treat the scan as “data” rather than just pictures and that is why my research now involves very close collaboration with experts in AI and informatics. What are your current research activities? Much of my research over the past few years has centred around whole-body MRI scans for patients with myeloma. These scans allow earlier diagnosis of myeloma as well as a non-invasive means of visualising and monitoring the cancer which can involve any part of the skeleton. Our research has enabled us to provide this service to our patients for ten years but despite national guidance, only one in ten myeloma treatment centres have been offering whole body MRI. Although this is a dreadful statistic, there are understandable reasons such as lack of expertise but most influentially, lack of MRI scanner availability. In reaction to that we have concentrated our efforts on national training and building informatics solutions that not only make the scans faster but which also support interpretation. Even during the during the pandemic I have been humbled by the efforts radiologists across the UK have been making to offer the service to their patients because we know that earlier diagnosis means that patients not only live longer, but also live with a better quality of life. How does your research help patients with cancer? It boils down to developing imaging techniques that are not only smarter but kinder. Increasingly sophisticated information from scans can be used not only for earlier diagnosis but also to help select the right treatment for the right patient, at the right time. We also want the scans to be minimally invasive and as easy for patients as possible so it’s important that our research maintains that focus. We achieve that by partnering with patients when designing new studies. Patient involvement is particularly crucial in our ongoing work to understand whether imaging scan reports are accessible to patients because they are often peppered with technical language. How has the BRC supported your work? The easy answer is that I received starter funding and infrastructure support to get some of my projects off the ground. However, if I am honest, before I became involved in the BRC my research focus was too insular. The BRC provided me with an opportunity to see how my research fitted into a much bigger picture and it sparked more ideas and collaborations that I could possibly list. It was also inspirational to gain insight into the work that some of my colleagues were doing. More recently the BRC has been an opportunity for me to develop leadership skills as lead of the Digital theme. I am immensely grateful for the opportunity to shine a light on and support other talented researchers, particularly in the imaging and informatics space. AI is going to become a very powerful enabler so it’s a very exciting time. Having the opportunity to shape a strategy in such a new area is a huge responsibility but also a privilege.