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The unfortunate ending of the Tower of Babel construction project and its effect on modern imaging-based cancer patients’ management

Posted in Imaging-based Cancer Patient Management, tagged biopsies, brain lesion, breast biopsies, breast biopsy, breast cancer, breast cancer mortality, breast cancer screening, breast screening, CANCER BIOLOGY & Innovations in Cancer Therapy, cancer patient management, Clinical trial, cost efficient cancer diagnosis, cost efficient cancer treatment, cost efficient solution, CT scans, directed biopsies, DW MRI, efficient business, european congress of radiology, evidence based medicine, free hand biopsies, guided biopsies, hands on appoach, health, healthcare, healthcare business, imaging guided biopsies, imaging in cancer, Imaging-based Cancer Patient Management, Imaging-based Cancer Patient Management | Tagged biopsies, innovation in health, innovation in healthcare, Magnetic resonance imaging, magnetic resonance imaging mri, magnetic tracking, mammography, Medical Devices R&D Investment, medicine, MRI, MRI imaging, multi-functional MRI, mutation, open mri systems, personalised medicine, prostat cancer screening, Prostate, Prostate biopsy, Prostate cancer, prostate guided biopsies, prostate hisoscanning, Prostate-specific antigen, radiographically dense breasts, research, science, tagged biopsy needles, tagged cancer, tracking, Transrectal ultrasonography, Triple-negative breast cancer, TRUS, ultrasound guided breast biopsy breast biopsy, ultrasound imaging, ultrasound imaging Bio Instrumentation in Experimental Life Sciences Research on October 22, 2012| 4 Comments »

The unfortunate ending of the Tower of Babel construction project and its effect on modern imaging-based cancer patients’ management

Curator: Dror Nir, PhD

The story of the city of Babel is recorded in the book of Genesis 11 1-9. At that time, everyone on earth spoke the same language.

Picture: Pieter Bruegel the Elder: The Tower of Babel_(Vienna)

It is probably safe to assume that medical practitioners at that time were reporting the status of their patients in a standard manner. Although not mentioned, one might imagine that, at that time, ultrasound or MRI scans were also reported in a standard and transferrable manner. The people of Babel noticed the potential in uniform communication and tried to build a tower so high that it would reach the gods. Unfortunately, God did not like that, so he went down (in person) and confounded people’s speech, so that they could not understand each another. Genesis 11:7–8.

This must be the explanation for our inability to come to a consensus on reporting of patients’ imaging-outcome. Progress in development of efficient imaging protocols and in clinical management of patients is withheld due to high variability and subjectivity of clinicians’ approach to this issue.

Clearly, a justification could be found for not reaching a consensus on imaging protocols: since the way imaging is performed affects the outcome, (i.e. the image and its interpretation) it takes a long process of trial-and-error to come up with the best protocol. But, one might wonder, wouldn’t the search for the ultimate protocol converge faster if all practitioners around the world, who are conducting hundreds of clinical studies related to imaging-based management of cancer patients, report their results in a standardized and comparable manner?

Is there a reason for not reaching a consensus on imaging reporting? And I’m not referring only to intra-modality consensus, e.g. standardizing all MRI reports. I’m referring also to inter-modality consensus to enable comparison and matching of reports generated from scans of the same organ by different modalities, e.g. MRI, CT and ultrasound.

As developer of new imaging-based technologies, my personal contribution to promoting standardized and objective reporting was the implementation of preset reporting as part of the prostate-HistoScanning product design. For use-cases, as demonstrated below, in which prostate cancer patients were also scanned by MRI a dedicated reporting scheme enabled matching of the HistoScanning scan results with the prostate’s MRI results.

The MRI reporting scheme used as a reference is one of the schemes offered in a report by Miss Louise Dickinson on the following European consensus meeting : Magnetic Resonance Imaging for the Detection, Localisation, and Characterisation of Prostate Cancer: Recommendations from a European Consensus Meeting, Louise Dickinson ^a,b,c,*, Hashim U. Ahmed^a,b, Clare Allen^d, Jelle O. Barentsz^e, Brendan Carey^f, Jurgen J. Futterer^e, Stijn W. Heijmink^e, Peter J. Hoskin^g, Alex Kirkham^d, Anwar R. Padhani h, Raj Persadⁱ, Philippe Puech ^j, Shonit Punwani^d, Aslam S. Sohaib^k, Bertrand Tombal^l,Arnauld Villers^m, Jan van der Meulen^c,n, Mark Emberton a,b,c,

http://www.europeanurology.com/article/S0302-2838(10)01187-5

Image of MRI reporting scheme taken from the report by Miss Louise Dickinson

The corresponding HistoScanning report is following the same prostate segmentation and the same analysis plans:

Preset reporting enabling matching of HistoScanning and MRI reporting of the same case.

It is my wish that already in the near-future, the main radiology societies (RSNA, ESR, etc..) will join together to build the clinical Imaging’s “Tower of Babel” to effectively address the issue of standardizing reporting of imaging procedures. This time it will not be destroyed…:-)