Laurie Wilson PhD: Ultrasound & Telehealth

Historical Article

From Ultrasound: Achievements and Recent Contributions.

(Prepared by Jack Jellins AM, Adjunct Professor, Faculty of Health Sciences

The University of Sydney)

The Australian ultrasound community has known Laurie Wilson since 1978 when he joined the Ultrasonics Institute (UI) in Sydney. With a background in cosmic ray physics, Laurie demonstrated a systematic approach to problem solving that enabled him to bridge the gap between mathematics and real world clinical problems. At the Institute, Laurie dedicated himself to research, and applied his expertise in developing new computational methods for signal and image processing of ultrasonic data to extract information about tissue pathology. A unique feature of the Institute was that the research scientists and engineers contributed not only to the technical frontiers of the ultrasound but also to its rapidly growing clinical implementation.

Whilst Laurie’s professional interests during his career were devoted to ultrasound research and science education, he continues to contribute to healthcare technology by actively participating in the rapidly growing area of telehealth. Laurie’s significant contributions to biomedicine over a period of four decades have placed him in the upper echelon of research scientists in Australia. 

Fascinated by astronomy, Laurie aspired to be a scientist from the early age of nine. Towards the end of his school years, Laurie was accepted by the Harry Messel Summer Science School at the University of Sydney, and that strengthened his resolve to undertake studies in science.

After graduating in 1973 with a PhD from the University of Sydney, Laurie took a position at the University of Oxford in the Department of Atmospheric Physics. Working closely with NASA, the group was at the forefront of observations using satellites to measure atmospheric temperature profiles, clouds heights and distributions, and concentrations of atmospheric constituents. In this role, Laurie developed new computational methods to analyse satellite data to determine cloud properties.

Returning to Sydney in 1975, Laurie joined the Department of Physics at the University of Sydney, and then in 1978 accepted a position with the Ultrasonics Institute led by George Kossoff. Computing at that time was still restricted to large organizations, and home computers were only just appearing in the market. Laurie’s prime responsibility at the Institute was to develop computational analysis for the acquisition, processing and display of ultrasonic data.

As a member of David Robinson’s Advanced Techniques Section at the Institute, Laurie’s primary interest over a ten-year period was the characterisation of tissues from the measurement of ultrasonic parameters. The research can best be divided into four mainstream areas: (1) attenuation measurements, (2) sound speed measurements, (3) small deformations and displacements in tissues, and (4) detecting and displaying areas of degeneration in atheromatous plaque. In 1982, Laurie was senior author on the first journal paper in what was to become the active field of elastography, in which tissue properties are inferred from the way tissue moves and deforms under external forces.

The growth of clinical ultrasound created a strong need for education, and an important aspect of the Ultrasonics Institute and the Australasian Society for Ultrasound in Medicine (ASUM) was the Diagnostic Ultrasound Training Course, and Laurie became course coordinator in 1982 until 1990. Prominent international speakers and local faculty members provided both theoretical and practical tuition. Laurie produced and managed a library of videotaped lectures from the course, and these were made available to ASUM and its members. For the first time, members anywhere in Australia could access high quality teaching materials. In addition to ASUM’s educational activities and scientific meetings, Laurie also held positions as Treasurer from 1995 to 1998 and Secretary of the NSW branch, as well as a member of the DDU Examination Board from 1984 to 1997.

From 1988 onwards working closely with Rob Gill, Laurie’s research moved into Doppler ultrasound. Laurie made significant contributions through the real-time implementation of automatic vessel recognition that simplified Doppler measurements, and make them less operator dependent. He developed techniques for measuring in real time the “true” velocity vector of blood flow, and devised a unifying description of Doppler ultrasound using the two-dimensional Fourier transform which progressed to a further development that became known as “Broad-band Doppler”. This technique was successfully incorporated into ultrasound imaging systems manufactured by the Philips company.

Towards the end of the 1980s, the world changed for Laurie and other members of Ultrasonics Institute when the Commonwealth Department of Health decided that the Institute should be moved to the CSIRO’s Division of Radiophysics forming the Ultrasonic Laboratory within that organization. This provided Laurie with a new range of challenges.

Intravascular ultrasound became a reality at the beginning of the 1990s, and this allowed different pathologies of plaque to be characterized without the loss of image quality due to the detrimental effects of overlying structures. Laurie’s research devised attenuation mapping and demonstrated correlation with plaque degeneration, and enabled the implementation of intravascular arterial wall elasticity measurements. A collaboration was set up with the Department of Vascular Surgery at the Royal North Shore Hospital, and several pioneering papers were published demonstrating differentiation of plaque types using attenuation and elasticity measures. Plaque characterisation now has several commercial implementations.

Other avenues of research included the automatic recognition of cancers in screening mammograms using advanced image processing and pattern recognition. Two further projects used an innovative knowledge based approach: the first was an expert assistant for recognizing abnormities in chest X-rays; the second an automated 3D visualization of abdominal aortic aneurysms. This work also led to a research interest in virtual reality surgical training using haptic devices that provide feedback to give a tactile sensation in medical simulation.

During this period, CSIRO Radiophysics was looking for ways to combine its expertise in telecommunications with the rapid rise of eHealth (that is combining healthcare practice with internet-based communication systems), and Laurie took responsibility for two projects in this new and developing area. This included:

• A personal monitoring project that involved wireless-based devices for monitoring human vital signs. This was done in the late 1990s, and foreshadowed the rise of mHealth (an abbreviation for mobile health) seen as addressing some of the issues involved in the aging population by improving the health outcomes via mobile communication systems.

• The Australian Department of Communications foreshadowing that Australia would eventually have a much better communications infrastructure funded a number of demonstrator projects to show the power of advanced networking systems. Laurie was given the task of identifying innovative applications in medicine, and this resulted in the development of two programmes: – 

1. A virtual critical care unit connecting two hospital emergency departments in Western Sydney, Nepean and Katoomba enabling existing resources to be better utilized by reducing unnecessary transfers, and allowing more timely interventions. This project was the forerunner of telehealth (defined as the use of telecommunication technologies to support and promote long-distance clinical health care) introduced later into many other emergency departments in Australia. 
2. A project known as ECHONET – EchoCardiographic Healthcare Online Networking Expertise in Tasmania – connecting intensive care units (ICU) in Hobart and Burnie by high speed internet to support intensive care teams in a regional and rural hospital. Advantages of using the broadband telemedicine technology included the ability to hold virtual bedside conferences that resulted in better treatment of remote patients, and improved teaching and benchmarking of staff at the Burnie Hospital.

It became clear that the success of these projects resulted as much from a rigorous attention to “human factors” as it did to technology, and in 2005 Laurie set up and managed a human factors group, dedicated to understanding and evaluating the factors that contribute to successful implementation of technology in a real-world setting.

When CSIRO formed the ICT Centre in 2003, Laurie was appointed to lead one of the six programs of that Centre, responsible for research streams that included: medical imaging; collaborative surgical training: personal monitoring; and telehealth.

Laurie was also appointed Acting Research Director to set up the e-Health Research Centre in Brisbane – a joint venture with the CSIRO and the Queensland Government. This organization is now known as The Australian E-Health Research Centre (AEHRC), and through its research programmes, the AEHRC develops and deploys leading edge information and communication technology innovations to improve health services and clinical treatment for Australians.

Whilst Laurie retired from full time employment with the CSIRO in 2008, he continued as a Post-retirement Fellow until 2013, and completed a number of review publications. In addition, Laurie recognized that telehealth was in a similar position to the way that ultrasound had developed in the 1970s, and based on his experience with the Australasian Society for Ultrasound in Medicine, Laurie decided there was a need to establish the Australasian Telehealth Society which he founded in 2008, and is still today the Honorary Secretary. The Society has grown to more than 600 members, and in 2017 held its 8^th successful annual meeting attracting more than 200 participants.

In 2009, Laurie was awarded a Lifetime Achievement Award by the CSIRO ICT Centre in recognition of his “significant contributions to medical ultrasound and health care”. Laurie currently is an Adjunct Professor with the School of Computing Engineering and Mathematics at the Western Sydney University, and previously was Adjunct Professor with the Interaction Design and Human Practice Laboratory at the University of Technology.

Laurie’s extensive career was not limited to research but also included memberships of professional societies, numerous educational activities, invited scientific presentations, lectures at clinical meetings and university courses, journal reviews, and invited attendances at national and international meetings. Laurie was awarded five patents, and also held honorary appointments at the University of New South Wales. In recognition of achievements with the Virtual Critical Care Unit under Laurie’s leadership, he received two prestigious awards: one from the Health Informatics Society of Australia, and one from the Australian Information Industry Association.

Laurie’s interests extended beyond research with swimming, photography and family responsibilities taking his spare moments. He has been married to Vivien since 1972 and enjoys being “Grandpa” to two grandchildren.  Laurie still is a keen competitive swimmer in ocean races, and an ardent photographer focusing on nature. He was always eager to explore the boundaries of science, and to contribute to the wellbeing of individuals by integrating technology into medical practice in order to provide better healthcare – in Laurie’s words “the journey has been rewarding”.

References.

1. D. J. McCleese and L. S. Wilson. Cloud Top Heights from Temperature Sounding Instruments.Quarterly Journal of the Royal Meteorological Society, 102, pp. 781-790, 1976.
2. L. S. Wilson and D. E. Robinson. Ultrasonic Measurement of Small Displacements and Deformations of Tissue. Ultrasonic Imaging, 4, pp. 71-82, 1982.
3. L. S. Wilson, D. E. Robinson, K. A. Griffiths, A. Manoharan and B. D. Doust. Evaluation of Ultrasonic Attenuation in Diffuse Diseases of Spleen and Liver.Ultrasonic Imaging, 9, pp. 236-247, 1987.
4. L. S. Wilson. Description of Broad-Band Pulsed Doppler Ultrasound Processing Using the Two-dimensional Fourier Transform, Ultrasonic Imaging, 13, pp. 301-315, 1991.
5. M. S. Brown, L. S. Wilson, B. D. Doust, R. W. Gill and C. Sun. Knowledge-based interpretation and analysis of medical images: application to chest X-rays.Computerized Medical Imaging and Graphics, 22, pp. 463-477, 1998.
6. L. S. Wilson, D. R. Stevenson and P. Cregan. Telehealth on Advanced Networks. Telemedicine & eHealth, 16, pp. 69-79, 2010.

Copyright © 2018, Laurie Wilson <laurie.wilson@optusnet.com.au>

J Jellins AM PhD (Hon)MD, 7 August 2018

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