The midterm goal of iQ is to have developed, by the end of the IMDI-CoRE funding period, sufficiently sophisticated imaging and quantitative tools to allow healthcare professionals to use them routinely in diagnosis, prognosis and monitoring of therapeutic efficacy thus:
- enabling better, faster, and more affordable diagnosis and monitoring of patients;
- improve therapeutic imaging support;
- enabling image-guided optical biopsies that are more reliable, time-efficient, and less invasive) than standard tissue biopsies.
In addition, a strong basis for continuation of iQ beyond the funding period will have been achieved. This includes optimal use of revenues from IP originating from the research programs. Each program will lead to numerous scientific publications, and exploitation, and dissemination of results will be closely monitored by the Management Team (see Chapter 6). More specific goals are described below in the 9 (research) programmes (pillars), as well as in Chapter 8. Names of the Program Leaders are given in brackets.
An integrated software infrastructure will be developed and maintained, which will be suitable for both rapid prototyping and product development. A data-mining infrastructure will be developed, aimed at detecting and characterizing hypothesis-generating patterns in complex multidimensional data with sparse sampling.
Longitudinal image analysis requires consistent image quality and reliability. A user friendly quality assurance (QA) programme for imaging equipment in the participating centres will be developed and existing quality control (QC) programmes will be modified to accommodate multidimensional quantitative imaging using web-based architecture.
Existing analytical tools are not suitable for use in routine clinical practice, as they either lack robustness or suffer from a lack of appropriate visualization means. Deformation-based image processing techniques will be developed and implemented that enable accurate quantification and characterization of anatomical changes, which are also highly relevant for image-guided interventions. For many diseases, proof of concept studies have been performed off-line, but much more automation is needed to bring it into the clinical arena.
Functional connectivity derived from EEG, MEG, fMRI, concurrent EEG/fMRI and peri-operative multi spectral optical imaging will be integrated with Diffusion Tensor Imaging (DTI) using pattern analysis and graph theoretical techniques, to extract diagnostic and prognostic biomarkers (e.g. functional network parameters) relevant to both diagnosis and monitoring of treatment. The major challenge of this programme is to develop validated tools that are routinely applicable.
Methods will be developed that will allow to compensate for organ motion and yet provide optimal (diagnostic) image quality, essential for longitudinal examinations and for image-guided therapy as well as for longitudinal examinations and in image-guided therapy. In addition, novel methods in time resolved imaging will be developed that will provide quantitative information on perfusion, metabolism, receptor density etc., for instance by allowing for time varying tracer distributions within PET images.
The diagnosis of cancers such as lung and colon cancer is based on multi-modality macroscopic imaging (CT, MRI and PET) as well as on microscopic optical imaging and fluorescence (from endoscopy and images of biopsies). OCT provides 3D microscopic structure in living patients. An image-guided navigator system will be developed so that macroscopic and microscopic images can be correlated and integrated, increasing the specificity of quantitative determinations, and offering new vistas in image-guided interventions.
Microscopic modalities outlined in P6 are characterized by rapid technological improvements. Using mathematical modeling of new and current optical imaging technologies, methodology will be developed to quantify perfusion, vascularization, biochemical composition, and affinity to specific antibodies of normal and diseased tissue. These novel methods will be tailored for clinical use in endoscopy, surgery, etc.
Each newly developed tool will have to be suited for rapid implementation in clinical practice. For instance, improved detection of tumors during optical endoscopy and intra-operative imaging for guided biopsy and diagnosis for various diseases will be evaluated. Guided biopsy reduces the biopsy burden to patients, increasing the probability of correct diagnosis and image-guided therapy. Surveillance of high-risk populations improves long-term outcome by intervention at the earliest phase, before metastases develop.
The development of new medical imaging technology requires training of scientists and engineers as well as clinicians in radiology and nuclear medicine (and eventually other clinicians) in order to deliver tomorrow’s multi-modality imaging experts. iQ partners provide the required educational facilities (e.g. PET training and analysis centre) and participate in Medical Schools of VUmc and AMC as well as in the Amsterdam Graduate School of Sciences with an MSc course in Medical Physics.