I woke up the following morning after being made redundant in the autumn of 1995, called an accountant, met them and created Duncan Hynd Associates Limited or more commonly known now as DHA. I then spoke with some of the companies that I had worked with in my past job and the majority were happy to sign up with me and my new company and so my life as a company director and business owner had started. The entrepreneurial spirit is still alive today and I am still involved in start-up companies and coming up with “good” ideas.
Very used Volvo 240 GL
For me redundancy was a passport to the future and not a negative experience at all. I didn’t have time to worry about the usual things like where will my money come from, how will I pay my mortgage and bills and so having borrowed some money to buy a suitable estate car, a very used Volvo 240 GL that smelt badly of the previous owners dogs but was hopefully a reliable and suitable car for many cheap miles touring the UK and Europe and able to transport equipment, (the company car had now vanished) I started to build a business and innovative product portfolio.
Pic: My Volvo was blue and looked just like this!
Having worked on the coal face in radiotherapy treating cancer patients I also felt that my experiences would help me design and create my own products and services to add value to the business by having its own IPR and so set about designing these, some worked some didn’t. You can play Juke Box Jury later in the blog and see whether my products were a hit or miss!
The original DHA logo was created in “EasyJet” orange which is considered to be a lucky colour and yes, easyJet started out when DHA did and I recall seeing a 737 at Edinburgh Airport at the time and saying to myself that I won’t be getting on one of those, it was BA for me! How wrong I was, I love easyJet now and would not be without them especially as a small business owner flying all over Europe. I just wish I had their money or bought some initial shares then. But the Orange theme stuck and continued to be used for over 20 years.
The first “strap-line” for DHA was “Making Virtual Simulation A Reality” as I had nailed the concept of CT based simulation integrated with new 3D treatment planning tools firmly to the DHA mast. I believed this would replace conventional simulators that were still being installed and updated all over the world to make them more functional with flat panel detectors to create a poor quality CT scan after one complete rotation.
We argued that using high quality CT data and being able to create a digitally reconstructed radiograph or DRR from an online CT scanner and using what were then reasonably sophisticated beams eye view visualisations of 3D reconstructed anatomy and the tumour was the way forward. The final plan was then evaluated using Dose Volume Histograms (DVH) and other tools.
Virtual Simulation started life in the US around 1990 lead by George Sherouse et al and others while one of the original concept papers is available here to read:
I had also just signed a contract for DHA to market the MHTI CT Simulator and to look after the servicing of their European installations and so I hired an engineer and was now employing someone and earning some cash!
I needed an office as working from home was not possible any longer and so took on a lease on a 4 room property in Chinnor above the hairdressers and estate agent that had space for DHA to expand, offices for administrative staff and storage of equipment, spares and products, employed a PA and was now firmly committed to making this venture work. Eventually by the millennium in 2000 some 4 years later DHA had 12 staff, an accountant, 2 service engineers, 2 other directors and 6 company cars and so my main worry was not paying me but paying them each month, some responsibility.
The Render Plan 3D innovation-the “first” truly 3D planning system
In 1996 DHA was approached by a new US based company called Precision Therapy that was created to market the treatment planning system that was the concept of a US Physicist called Dean Renner, called Render Plan 3D and based on some state-of-the-art Silicon Graphics hardware, the ultimate platform for the then evolving creative imaging markets. The system had advanced organ rendering software that automated the process of contouring structures and organs of interest but people argued that the dose calculation model was not entirely 3D. Inverse planning and both collapsed cone convolution/Monte-Carlo commercially available dose calculations were still largely in the future but “trendy” hardware did sell treatment planning systems in those days!
Pic: When the Indy first arrived on the scene, it was tantalizingly close to attainable. Marketed as a “cheap” Unix workstation, it was SGI’s push to get people to use their machines for all types of graphics work, 2D or 3D.
DHA were successful in selling Render Plan 3D into some leading centres in the Netherlands despite the proximity to Nucletron who’s Plato system was considered state of the art at the time and in Dublin, Ireland. Elekta purchased Render Plan in 1998 and the system eventually became Elekta Precise Plan.
This added to the aura that DHA were at the time the UK’s leading independent company involved in supplying Virtual Simulations systems and solutions in Europe.
Nomos BAT system
We also formed an alliance with Nomos to market the BAT system in the UK as we had a good reputation for forging alliances with hospitals with regards to new disruptive technology.
BAT stands for B-mode Acquisition and Targeting and was an inter-fractional tool that could image with ultrasound the prostate prior to treatment, the transducer handle had retro-reflective balls on it that communicated to the cameras above the couch creating a fiducial system and reference for the couch, patient and prostate position.
We had some success and installed a system on trial at the Royal Marsden in Sutton where Jim Warrington, the then head of physics would refer to me as the “Batman” which seemed to stick and was quite amusing!
The system was only able to visualise anatomy prior to treatment and so the new MRI Linac innovation such as Elekta’s Unity that offer real time intra-fraction imaging and dynamic beam shaping have superseded this technology now.
Some DHA designed proprietary products.
Why not play “Juke Box Jury” with some DHA proprietary products: Hit or Miss?
Pic: Do you remember Juke Box Jury in the late 60’s?
Virtual Mask Maker
This was deigned to enable a clear plastic immobilisation mask to be created without having to put the patient through the process of taking a plaster of paris bandage-based impression. A 3D laser scanner would take a virtual impression of the head and neck. The data would be transferred to a CNC or rapid prototyping machine (now called a 3D Printer) and a model produced, the plastic mask would then be formed on the model and made ready for the patient.
Verdict: It was a MISS with no radiotherapy sales as thermoplastic masks were now the future! However, it was very popular in other markets such as forensics and film/animation and a similar DHA sister product called Prima-Facie sold very well.
This was a system that used 2 Infra-Red cameras located on the ceiling of the bunker and reflective balls located on the patient that tracked patient motion and alarmed if the patient moved out of tolerance, recording the position dynamically during the beam on time.
The concept and product really was essentially “years before its time” as subsequently Brain Lab, Vision RT, C-Rad and Varian among many others have all produced and integrated similar motion tracking systems into the treatment room and so the idea was certainly a HIT!
A system that kept vacuum bags at the same vacuum level as when they were formed around the patient. The computer controlled “life support” system connected each bag located on a special hanging system like a coat rack to a special pump that monitored the pressure in each bag and kept it solid by removing the specific amount of air that had entered the bag.
The vacuum bags were made at an adult with learning difficulties centre in the east end of London that kept them gainfully employed and the special pump made in the Highlands of Scotland. Diversity was at the heart of the system!
We sold many vacuum bags in the UK but no pumps and hanging systems as perhaps a step too far but the Raigmore Hospital in Inverness did have a prototype version that they developed hence the name Invac.
Verdict: HIT and MISS!
A website dedicated to radiotherapy professionals and an international forum with a virtual exhibition and congress now called RadPro 365 Live.
Pic The innovative EXPO map of virtual exhibition stands and congress zones. “Together we will give all brands within Radiotherapy a place to show-case their news and products and to support all radiotherapy professionals providing a place to share research and start discussions”
To find out more about RadPro click here: www.radpro.org.uk
The website started in 2003 and is still going strong today! Verdict: HIT
RTrak is a system that simply uses the existing CCTV cameras in the bunker to track unwanted patient motion. You simply put a marker on the patient seen below and capture it using the software that shows the live CCTV image. If the marker/patient moves out of the tolerance you set the system alarms, warns you and the Radiographer can intervene as appropriate.
Verdict: Very unfortunately a MISS
In 1998 DHA signed up with a US company called MMS that were launching a treatment planning system called Therpac Plus for prostate seed implants that were delivered under ultrasound guidance transperineally using a template for the needles. The system was to become the gold standard for the technique and DHA quickly ramped up sales to levels of up to 5 per month all over Europe over a 2-year period. While the technique was old, no one was really practicing it and the new planning system opened up a huge market to be exploited as everyone now wanted to offer this treatment to their patients.
After employing two more specialist technicians to deal with increased sales and installations the system was bought by Varian and eventually became the renowned VariSeed system. DHA continued to partner with Varian for sales while the contract we had slowly expired and the specialist staff we employed moved on. The vagaries of being very successful as a small company all wrapped up in one product!
The VariSeed system now incorporates MRI fusion and PSA evaluations of biopsy tissue samples taken from planned seed and needle positions that allow a truly conformal plan to be delivered based on active tumour positions within the gland.
Increased sales attracts Dragons!
However, the ramp up of sales of high value capital equipment caught the eye of various venture capitalists and business angels. To that end a VCT company handed over £200k for a stake in DHA and I was also invited to Poitiers in France to pitch DHA and its products and services to independent high profile business owners and investors.
The “Dragons Den” was held in a huge old Poitiers Chateaux owned by one of the dragons and we were also invited to stay for the weekend. However, we weren’t told that our accommodation was at a hotel down the road until I had drunk far too much champagne but had to drive there!
The organiser was the daughter in- law of William Rees-Mogg the past editor of The Times newspaper who was present to listen to the presentations and sister in-law to Jacob Rees-Mogg our Brexit nemesis depending on your point of view. She had her own business angel company too and we were one of 5 companies invited to attend.
At the time DHA was looking at other markets for its 3D imaging and laser scanning range and a product called e-Teeth was created that allowed a dentist to take an dental impression of the entire upper and lower teeth, make a plaster model, scan it and create a computer based copy that would be sent to the NHS national commissioning centre for dental payments rather than fill a shoebox with plaster models and post them! This was of great interest to the investors but didn’t catch on.
DHA managed to convince some investors to assist financially and we had a good journey back to the UK, but completely sober this time.
Doors and shielding services.
In 2002 DHA launched a bunker door and neutron shielding service to the UK and installed these at many high-profile UK radiotherapy centres but also to leading non-radiotherapy customers such as the British Museum for a period of 15 years keeping me very busy and latterly my main business focus for DHA until the present day.
Doors for all forms of radiotherapy machines were installed and some very bespoke ones such as the 40 ton door below on a Synchrotron facility!
The future for DHA is bright, the future’s Orange!
In 2006 DHA became essentially a one-man band company again with me as the MD as it was at the start with no employees and with all requisite support outsourced to many third parties and our offices in Chinnor closed but now nice and lean for future efforts!
However, I never forget my roots as a Radiotherapy Radiographer and in 2015 DHA became a CoRIPS member and industry partner with the College of Radiographers and the picture below shows me picking up the “trophy” with SCoR CEO Richard Evans which completes an interesting virtuous circle in that Richard and I were in the same set as radiography students at the Middlesex Hospital in 1980!
Next month – May
The first mobile radiotherapy service in the UK gets on the road for early stage breast cancer.
Also we will ask if the critical shortages of therapy radiographers mean that we are about to be replaced by AI, robots and machine learning systems and that will essentially solve the problem by stealth? We will look closely at Yuval Noah Harari’s predictions in his latest book “21 lessons for the 21st century” that by 2050 not just the idea of a “job for life” but even the idea of a “profession for life” might seem antediluvian and to see why this scenario could happen.