Innovative virtual tools allow doctors to diagnose disease wherever they are.
Story by Laura Ly/Photos by Trudie Lee
Imaging technology, such as magnetic resonance imaging and computed tomography scans, produce detailed images of organs, bones, tissues, and blood vessels and can show lesions and areas of disease in the body. These scans can also provide much information about the makeup of lesions and tumours in a patient's body. New technology known as virtual biopsy can use this information to diagnose disease without having to remove tissue through traditional biopsy methods.
Virtual biopsy is a major research focus of Dr. Ross Mitchell, a medical computer scientist at the University of Calgary. "Virtual biopsy uses analytical methods to extract information about a patient's genetics from their images. We can't see genes directly with medical imaging—the spatial resolution is too poor—but medical images can detect other biochemical and physical information related to genes. We may be able to use that information to non-invasively diagnose diseases like stroke, multiple sclerosis, and brain cancer," explains Dr. Mitchell.
The information extracted from medical images could also be used to create customized treatments and personalized healthcare for patients. Virtual biopsy and advanced imaging would allow doctors to optimize care and tailor treatments for patients based on their genetics and molecular profiles.
Dr. Mitchell is the chief scientist and founder of Calgary Scientific Inc. (CSI), a company that aims to make medical imaging data universally accessible. CSI has met that goal through the creation of PureWeb and ResolutionMD (ResMD), computer software programs that allow medical images to be accessed and shared by hospitals and across health regions easily and efficiently.
"Years ago while working with a stroke team, I was discouraged by the length of time it took to get 3-D [three-dimensional] images of a patient's brain to examine if an artery was clogged or not," notes Dr. Mitchell. "The technology is incredibly expensive and, therefore, it's rare. Also, it's tied to an advanced workstation. You have to access the images at the workstation; you can't take this technology and distribute it throughout the healthcare system."
PureWeb and ResMD operate using standard web browsers, such as Internet Explorer. As a result, a patient's medical images can now be viewed on any computer that has internet access, which eliminates the need for an advanced workstation. In addition, ResMD converts medical scans into three-dimensional images with higher quality and more detail for diagnosis. ResMD inspired the creation of ResMD Mobile, a similar program that runs on an iPhone (see Cool tools). Using ResMD Mobile, doctors can view medical images wherever they are and do not need a computer.
For health regions or rural hospitals without an expert on a specific disease or disorder, this innovation is a huge boon. "Suppose you're a doctor in a province or hospital that doesn't have a stroke team: you scan a patient after he or she has had a stroke. Now you might be able to call the stroke team in Calgary and have them look at the scan using ResMD. You wouldn't need to move the images outside of the hospital but the experts—wherever they're located—could easily and conveniently access those images at any time and recommend a treatment for that patient," explains Dr. Mitchell. ResMD software helps patients obtain efficient and high-quality healthcare, regardless of where they live.
Dr. Mitchell founded CSI because he wanted to see his research translated into clinical use. "Typically when scientists describe their work, they say eventually it could lead to a clinical application, but that time rarely seems to come around. Industry is highly regulated; you can't just develop a new piece of technology and use it outside of a research lab. Regulatory agencies like the U.S. Food and Drug Administration and Health Canada require a strict set of guidelines to be followed and met before innovations go to market," he explains. "If you want your research to have clinical impact, you need to have a commercial venture behind it."
CSI and its products have certainly made an impact . ResMD and PureWeb are currently in use in hospitals across North America, with the potential for international use in the future. CSI was recently featured on CNN and was named one of the top 10 Canadian healthcare solutions to watch by the International Data Corporation. CSI also recently signed an agreement with Siemens Healthcare that allows Siemens to incorporate ResMD and PureWeb into their products. Siemens is one of the largest healthcare companies in the world. "My research goal is to see virtual biopsy technology transferred into clinical practice in a number of different disease areas," says Dr. Mitchell. "So this is very satisfying for us to know that the research we are doing and the technology we're creating is being implemented broadly around the world."
Dr. Mitchell attributes his success to funding opportunities unique to Alberta. "It's extraordinarily difficult to fund virtual biopsy research because it falls between the mandates of the NSERC [Natural Sciences and Engineering Research Council] and CIHR [Canadian Institutes of Health Research] federal granting agencies. So organizations such as the Alberta Cancer Foundation, the former iCORE [Alberta Informatics Circle of Research Excellence], and the former AHFMR [Alberta Heritage Foundation for Medical Research]* have been critical for allowing us to do this research. We've been able to do it with support from the province, not the federal government. If it wasn't for these Alberta organizations, we wouldn't be here and Calgary Scientific wouldn't exist."
*iCORE is now part of Alberta Innovates – Technology Futures, and AHFMR is now Alberta Innovates – Health Solutions.