Karen Knapp on translating imaging innovation into clinical impact

Turning emerging imaging technologies into tools that can genuinely change clinical practice requires persistence, trust and close collaboration between academia, industry and healthcare. For Karen Knapp, Professor of Musculoskeletal Imaging at the University of Exeter, that process has become a defining strand of her research career.

A diagnostic radiographer by training, Karen has spent more than two decades working at the interface of clinical practice and research. That background proved critical when, four years ago, medical imaging company Adaptix approached the University through SETsquared Exeter, seeking clinical expertise to help develop a new 3D imaging technology for use in humans.

Early funding applications focused on osteoarthritis were unsuccessful, but by working closely with rheumatology colleagues, the team reframed the proposal around rheumatoid arthritis – an area where improved imaging could deliver clear clinical value. The revised approach secured just under £1 million in Innovate UK funding, supporting a two-and-a-half-year collaboration between Adaptix and the University of Exeter.

That funding enabled the team to focus on translating the technology from concept to clinical application. The system enables high-resolution, three-dimensional visualisation of bone structure, offering new ways to assess changes associated with conditions such as rheumatoid arthritis that are not visible using standard imaging techniques.

Much of the work focused on developing and validating the technology for use in humans. Existing test models were unable to capture the level of bone detail produced by the new system, leading the Exeter team to develop bespoke phantoms and validation approaches. The researchers also worked with donated hip specimens, comparing the new imaging technique with established methods such as X-ray and micro-CT, before progressing to the UK’s first human trial of this imaging technology in rheumatoid arthritis.

Reflecting on the quality of the partnership with Adaptix, she said: “It’s been a really good experience. I’ve developed good working relationships with their Chief Technical Officer and their Medical Technical Officer as well, and I’ve been working really closely with them along the way. It’s been a really nice study to work on, to be honest. The company have been great to work with, and it’s been a real pleasure.”

With Adaptix now securing regulatory approval in the United States, the technology is expected to move into clinical practice there in the near future. Karen sees her role increasingly focused on generating the early clinical evidence needed to support wider adoption.

The project has also acted as a springboard for further activity. New funding applications are in development to extend clinical trials into other joints, including the shoulder, responding to strong interest from clinical collaborators.

Reflecting on what others can learn from the process, Karen said, “Industry work on very different timelines to the university. They expect things to move quickly, and if you don’t deliver, they will look to another university that will.

“At the same time, it’s really important to be clear about intellectual property. By the time companies come to us, they often already have a huge amount of background IP, and we’re contributing our facilities, experience and know-how. That doesn’t always mean the university will have a stake in the product, and being clear about that before you start is absolutely crucial.”

For Karen, the value of the collaboration lies not only in technological progress, but in impact – creating evidence that supports clinical adoption and helping innovative technologies move closer to patients through strong, trusted partnerships.