Friday, March 6, 2015

ECR 2015 - personalized medicine in radiology

A. Imaging is everywhere in personalized medicine - van der Lugt
B. Personalized prevention: population-based imaging and image-based screening - Bamberg
C. Integrated diagnostics: towards one diagnostic department - Cuocolo
D. Interventional radiology: a paradigm for personalized medicine - Goldberg

Diagnosis has a prominent position in personalised medicine. Personalized medicine is: Providing the right treatment to the right patient at the right time.
Personalized or Precision medicine is the classification of individuals into subpopulations to optimize treatment. Imaging plays an important role in this classification. Furthermore, imaging can also be applied to evaluate treatment response in order to allow early correction of treatment if needed.
The ESR will in the coming weeks publish a whitepaper on the role of imaging in personalized medicine.

In case of imaging, the right imaging modality and protocol should be determined for a specific patient. ESR iGuide is developed to help clinicians to select the right modality for a specific question.

Thursday, March 5, 2015

ECR 2015 - Imaging Biobanks

A. The biobanks: genomic, moleculomic and proteomic - which link to radiomics? - M. Borra
B. Radiomic: report from the ESR WG on Imaging Biobanks. - H.U. Kauczor
C. Existing imaging biobanks. - A. Jackson
D. Extraction and analysis of biomarkers from medical images. - B. Gibaud

This session discussed the importance of establishment of imaging biobanks and integrating them into conventional biobanks. The imaging can have a large impact on these biobanks and the development of imaging biomarkers. The ESR has established a workgroup on this topic that is currently working on the first whitepaper on this topic to be published in insights into imaging.

One of the main challenges is in the standardization of imaging and postprocessing protocols. This also requires more automatic postprocessing tools. Validation, standardization and integration are the keywords in the developement of imaging biobanks.

Most current imaging biobanks are for research and clinical reference and disease oriented. The number of cases is extremely variable but mainly less then 1000 with mostly CT and MR images and restricted to a specific group of researchers.

One of the first real imaging biobanks is the UK biobank imaging initiative. They started data collection in 2014. Three dedicated imaging centers will be established scanning 21 pts per day to reach the planned participants in the coming six years. A full workup takes four hours for the volunteers in which a number of imaging exams are done. 

Imaging Biomarkers play an important role in imaging biobanks. They can be measurable quantities, measurements instruments, and decision support instruments. Again, standardization and validation are crucial to establish proper imaging biomarkers. Imaging biomarkers should be ontology based (e.g. QIBO, BiomRKRS) but the current ontologies for imaging biomarkers are not yet applicable widely and development of a proper ontology is required. Using the ontologies the implementeration of integrated federated queries to multiple databass is feasible.

Wednesday, March 4, 2015

ECR 2015 - Mobile IT in Radiology - RC105

A. tablet computers: a technical overview
B. reading DICOM images on the tablet
C. mobile teleradiology: radiological features of the tablet-computer

Mobile devices already are around for quite some time, starting from the PDAs and mobile phones to current smartphones and tablets. These devices are gaining ground in medical application in a variety of applications.

This session covered te application of mobile devices in radiology. The recent devices can be used to view CT and MR and are increasingly integrated into the clinical work, even as a natural extension of the PACS workstation.
BYOD however, requires a high level of security when patient data is involved.

A more technical presentation by dr. Fernandez-Bayo showed that the current tablets are pretty close to the requirements normally placed on radiological reading displays when taking into account the diference in size and reading distance.
Recommendation when using a tablet for image review are a 10 inch diameter, 4:3 ratio and QXGA (3MP) displays. Also, it is recommended to use the highest brightness setting and disable the automatic brightness correction.

Tablets can not replace the workstation but could be used as a valuable extension to the workstation. They can display DICOM data with apps and web applications either from local storage or from a server. Increasing scientific prove is arising in numerous posters and publications that shows that clinical use of DICOM image review on tablets is feasible and reliable.

Social media is gaining interest. However, sharing images of patients is not allowed. Figure one is providing a social media platform for doctors that allows a validated and secure way of discussing cases. Social media is a requirement, not an option but security risks should be acknowledged.