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Vol 20, No. 12, December 2016   |   Issue PDF view/purchase
Scanning the Future of Medical Imaging

Over the last five decades, medical imaging has repeatedly transformed medicine. Magnetic resonance imaging (MRI), dual-energy X-ray absorptiometry (DXA) and computed tomography (CT) scans have changed how physicians measure, manage, diagnose, treat, and even think about medical illnesses and conditions. Technological innovations have also made imaging faster, more precise and less invasive to use. Medical imaging is such an essential part of healthcare practice today that it is the standard preliminary step for diagnosing virtually all the major diseases.

In some cases, medical imaging itself is used to treat, manage and predict disease. Oncology, a major area of interest for pharmaceutical companies, is a major market for predictive diagnostic tools because genetic testing enables early identification of the illness and helps physicians take the most appropriate course of treatment. Predictive diagnostics are also beneficial in examining gene composition and interaction in tissues and cells to better understand and determine the progress of the disease as well as the response to treatment, such as in the numerous types of cancer.

Across the world, doctors and researchers are pushing the boundaries of what is possible with medical imaging. Among the recent breakthroughs are those coming out of the Netherlands. As a pioneer in the field of biomedical imaging technology, the Netherlands has groomed many of the big players such as Royal Philips and Qiagen. The Center for Medical Imaging North East Netherlands (CMI-nen), a joint initiative between the University of Groningen (RuG)/University Medical Center Groningen (UMCG), University of Twente (UT), and Siemens Netherlands aims to secure a leading global position in innovative medical imaging, with groundbreaking research and development, education and valorisation. Launched in 2011, CMI-nen combines state-of-the-art research facilities, clinical practice and technology, and innovative education in one center.

All these developments are not surprising since the country has long been known for its excellence in healthcare, often rated as the best in Europe. In fact, it is the only country to be consistently ranked in the top three of the European Health Consumer Index since 2005.

“Medical imaging is consistently held as one of the most important advances in the history of medicine, and is an integral part of the diagnosis and treatment of patients in the Netherlands. Through multidisciplinary collaboration, integration of medical science and clinical practice, we are heavily invested in the next generation technology – to improve the quality of early diagnosis and contain the costs of future healthcare,"says Elmar Bouma, Executive Director - Southeast Asia, the Netherlands Foreign Investment Agency (NFIA). The NFIA provides complimentary consultations to companies planning to open, expand or diversify their business operations in the Netherlands and Europe. Promoting biomedical sciences is one of the agency’s top priorities.

Precise, High Quality Images

The Institute of Cancer Research and The Royal Marsden in London and The Netherlands Cancer Institute recently welcomed Royal Philips’ and Elekta’s high-field (1.5 Tesla) MR-linac system. As members of the Elekta MR-linac Consortium, these leading cancer centres will dedicate their resources to demonstrate the elevated benefits of utilising the MR-linac to capture higher quality images of tumours.

The MR-linac incorporates an innovative radiotherapy system with a high-field MRI scanner and software that allows physicians a clearer, real-time imagery of the patient’s anatomy. Physicians can accurately identify a tumour while reducing the amount of radiation exposure to healthy tissues. The system is so precise in its targeting that it can lock on to a tumour even if the location, size, and shape changes throughout the treatment process. The quality and accuracy of radiotherapy guidance and delivery highly determines the effectiveness of radiation treatment. MRI imaging has emerged as a promising oncology tool for therapy planning, disease diagnostics, treatment guidance and therapy assessment, largely helmed by Dutch efforts and perseverance.

Early Stage Cancer Detection

QVQ in the Netherlands is in the process of developing a pre-clinical technique to provide early stage detection of cancer through imaging with a combination of a new near-infrared dye from LI-COR Biosciences, based in Nebraska, and a small, high affinity single domain antibody fragment (VHH) derived from camelids. The size of the VHH is useful for diagnosing cancer by penetrating a tumour uniformly compared to larger antibodies that can only reach the surface.

Improved distinction between the boundaries of the cancer tissue and the surrounding healthy tissue in patients can be achieved through combining QVQ’s research and LI-COR’s IRDye infrared dye technology. The VHH’s speedier uptake in comparison to existing antibodies leads to the potential for immediate imaging.

“Working together with probe development for cancer imaging is just another step towards integrating near-infrared florescence for intra-operative surgery,” says Bambi Reynolds, Senior Business Development and Intellectual Property Manager of LI-COR.

Another tumour-locating imaging approach has emerged from researchers at Leiden University Medical Center. Florescent dye is used during surgery to detect ovarian tumours invisible to the naked eye. Dr Alexander L Vahrmeijer and his team refined a dye that attaches a molecule found on 90% of the exterior surface of an epithelial ovarian tumour called folate receptor-alpha (FRA).

The increased likelihood of survival is dependent on the ability to remove all traces of the tumour from the patient. Initial testing revealed surgeons were able to remove 29% more of tumours, making surgery more precise and thorough. Dr Vahrmeijer anticipates larger studies will be able to explicitly prove the technique’s survival promoting abilities.

Medical Imaging and Big Data

In recent years, multinationals such as Royal Philips and IBM, both with operations based in the Netherlands, have veered into the field of cloud computations and analytics with regard to medical imaging and disease diagnosis technologies. IBM’s Watson Health plans to alter how machines access and connect unstructured image data generated from tracking progressive diseases. Cognitive computing has the ability to draw from a massive cloud database of existing patients’ disease diagnoses to cross-reference with the physician’s own patient checkup results for more accurate disease prediction.

The debut of Lumify, Philips’ first app-based Ultrasound solution has further expanded their portfolio of cloud-based health technology. Lumify provides care providers with access to high-quality imaging, simply by attaching the ultrasound transducer to a compatible smart device primed with the app for a fully portable, yet comprehensive ultrasound system. Those in an emergency setting without access to a proper ultrasound machine can now rely on this flexible smart device for accurate and instant imaging. Because of the accompanying app, scans can easily be shared, accessed, and integrated via the Philips HealthSuite Digital Platform for improved analytical assessment of the results and thereby, enhanced patient care.

Advances in IoT (Internet of Things) services and technology can help to reduce the industry’s rising costs while also increasing the amount of holistic care patients receive. The analysis of diagnostic information gathered from imaging equipment and personal devices enhances professionals’ decision-making powers. Remote monitoring and predictive maintenance means off-site service contract providers can fix problems before the imaging provider realises there is an issue. In the imaging industry, any machine interruption represents a loss of time and money, neither of which hospitals and patients can afford.

Smart Imaging Data Analytics has boosted the Philips HealthSuite digital platform by enhancing radiology equipment performance through the creation of connected health and IT innovations. The Philips e-Alert service monitors imaging modalities’ statuses to determine the operative state they are in and whether or not they require servicing. Care-giving systems must be perennially functional to discourage hiccups in care delivery, especially in equipment critical to a patient’s wellbeing. These services provided by Royal Philips have proven effective in real life when the Center of Radiology in Germany detected a failure in their cooling water supply that would have put their MRI out of commission.

At the moment, the cost is too substantial for hospital facilities to attain the full array of IoT services but as the number of providers and users increases, prices will decrease. Global research firm McKinsey projects that the use of Big Data in healthcare can reduce expenses by $300-$500 billion.

These advances demonstrate the growing importance of medical imaging in the patient journey. Medical imaging has become the principal tool in early diagnosis – a process that saves lives and eases the strain on the healthcare system.

“With such an important role in today’s medical world, as well as in the future of medicine, the Netherlands continues in its quest to develop new technologies to ensure the best possible outcomes for patients – by providing access to medical imaging that moves away from invasive procedures in favour of efficient, non-invasive services," Mr Bouma reaffirms.

For more information on innovative medical imaging technologies or investment opportunities in the Netherlands, contact: Mr Elmar Bouma, Executive Director-SEA, the Netherlands Foreign Investment Agency (NFIA), Tel: +65 6739 1135, Email: [email protected] or Ms Adeline Tan, Country Manager, Tel: +65 6739 1137, Email: [email protected] or visit www.investinholland.com.

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