ABSTRACT – Center for Virtual Imaging Trials
The accelerating complexity of medical imaging devices and methods has largely outpaced the field's ability to
evaluate and optimize their design and clinical use. Doing so through clinical trials is often not feasible or
definitive due to ethical limitations, expense, time requirements, and/or a fundamental lack of ground truth
(exact patient anatomy and condition). Most current approaches to assess imaging technologies outside of
clinical trials rely on simplistic models and subjective perception of image aesthetics, and results cannot readily
predict clinical efficacy. To fill this gap, the broad objective of the Center for Virtual Imaging Trials is to develop
a virtual platform for assessing the effectiveness of medical imaging systems and methods for specific clinical
tasks. The initial focus is on computed tomography (CT), both due to its widespread medical utility and its
status as the largest source of medical radiation. Virtual imaging trials offer an efficient means to evaluate
imaging concepts and technologies in silico by simulating the patient, imaging system, and image evaluation.
Such virtual trials can be conducted quickly and cost effectively on a computer, providing researchers a
practical way to answer fundamental questions using the precise controls and the exact knowledge of a
modeled patient. They also enable objective optimization of current and emerging imaging technologies
(hardware and software) to minimize radiation risk and provide quantitative accuracy. By accelerating and
improving imaging technologies' evaluation and optimization, virtual trials support quality, safety, and effective
practice of patient-centered care.
To achieve its objective, the Center will develop, refine, and disseminate the essential resources to realistically
model and represent a) patients, b) imaging systems, and c) image evaluation. These resources comprise the
three Technology Research and Development (TRD) projects, which work synergistically with and provide
resources to Collaborative Projects (CPs) and Service Projects (SPs). A Technology Training and
Dissemination (TTD) component will distribute the Center's resources and provide the necessary training.
Administration provides infrastructure, oversight, and integration. The overall Specific Aims are to (1) develop,
consolidate, and streamline the required components to enable virtual imaging trials of existing and emerging
CT imaging methods, (2) position virtual trials as an alternative methodology to quantify, evaluate, and
optimize CT imaging, and (3) disseminate to the research community validated tools for efficient virtual trials in
CT and train researchers to use them effectively. Using state-of-the-art simulation and analysis methods, the
Center will provide the first comprehensive platform to assess the diagnostic capability of imaging technologies
in their complete trajectory from design to use. The Center will have a notable impact on rigorous and
reproducible scientific design, prediction, and practice of medical imaging, starting with CT, leading to
measured reductions in radiation dose, improvements in image quality, and advancement of precision imaging.