The Research Tab provides information about the ACR-PIR research priorities and the survey tool used to develop the priorities.
Research Priorities for Transformative, High-Impact Pediatric Imaging
Single center research studies tend to produce limited impact due to small evaluated patient populations. The ACR-PIR seeks to form inter- and cross-disciplinary research teams that will work together to improve pediatric patient outcomes through multi-center research activities.
1. Substantially reduce or eliminate radiation exposure of pediatric imaging procedures
Christina Sammet, PhD
Kassa Darge, MD, PhD
Donald Frush, MD (initiative advisor)
The image gently campaign has revolutionized the field of pediatric radiology. Given many already optimized procedures, some new research directions in this area target only incremental further improvements. We aim for further major reductions in radiation dose: At least 50% dose reduction for radiographic technologies, sub-mSv acquisitions for computed tomography as well as development of radiation-free imaging technologies.
2. Eliminate the need for sedation for pediatric imaging procedures
Rajesh Krishnamurthy, MD, PhD
The acquisition time of many pediatric imaging procedures, such as CT and MRI, have been significantly accelerated during the last several years. However, many imaging procedures still require sedation or anesthesia of young children because they take too long. New and creative approaches for ultra-fast image data acquisition are required to eliminate the need for sedation.
3. Develop imaging registries for collection of “big data”
Andrea Doria, MD, PhD
Medical research makes increasing use of data-intensive technologies, i.e., there are 4.6 billion mobile phone subscriptions worldwide and there are between 1 to 2 billion people accessing the internet every day. Input from large target populations could allow us to tackle key clinical questions regarding normal child development, patient compliance and therapy outcomes, among many others. In addition, images obtained at pediatric hospitals worldwide could be collected in dedicated image registries, which could be used to obtain normative data about the growing child, monitor and optimize imaging strategies and eliminate redundant or unnecessary imaging tests. Pediatric image registries could be also used to develop standard reporting guidelines that incorporate quantitative and qualitative metrics. These metrics may be used for required external quality and performance reporting as well as internal QA and QI research. Development, participation, and review of imaging protocols should provide a platform for
improving quality and safety standards in pediatric imaging.
4. Develop disease-specific imaging biomarkers
Stephan Voss, MD, PhD
Many imaging procedures result in radiology reports with a wide list of differential diagnoses, i.e., maging approaches for newly diagnosed tumors. The development of new biomarkers are needed to enable radiologists to provide ONE single and correct diagnosis.
5. Advance quantitative image analyses and computational methods for radio(gen)omics
Ashok Panigrahy, MD, PhD
Alexander Towbin, MD
Andrew Trout, MD
Imaging is more than simple morphological information and will increasingly include quantitative data (see RSNA quantitative imaging initiative). These tests shift our diagnostic efforts from an observing, descriptive process (what is) to predictive-imaginative operations (what will be), thereby fundamentally changing how we approach human pathophysiology--from detecting and treating disease to maintaining human health. Advances in bioinformatics can be leveraged to significantly improve the diagnostic yield of diagnostic imaging studies. The development of novel approaches is critical for the generation and integration of quantitative image data sets, genomic and proteomic data, data mining, and artificial intelligence to recommend imaging tests, predict treatment outcomes, and indicate timing for follow-up studies.
6. Develop transformative interventions
Matt Lungren, MD
Anne Marie Cahill, MBBch, BAO
Interventional radiology has reduced the need for invasive surgery for both diagnosis and treatment. Novel treatment methodologies need to be developed. They could be based on disease specific biomarkers, stem cells to regenerate injured body parts such as cirrhotic liver, and targeted drug delivery system (such as lipoid-based), among many others.
7. Nanomedicine for Pediatric Molecular Imaging Applications
Heike Daldrup-Link, MD, PhD
Nanoscale materials can be employed to develop novel platforms for understanding, diagnosing, and successfully treating pediatric diseases. Integrating nanomedicine with novel multi-modality imaging technologies spurs the development of new personalized diagnostic tests and theranostic (combined diagnostic and therapeutic) procedures. Today, nano-imaging technologies, initially developed in basic science labs, are becoming available for the benefit of our pediatric patients.
8. Develop novel data processing tools, such as 3D printing and bioprinting
Katherine Barsness, MD
Laura Olivieri, MD
New initiatives for 3D printing and bioprinting are revolutionizing many areas of the live sciences. Imaging will be an integral part of 3D printing and bioprinting efforts. The ACR-PIR can serve as an enabling hub for new ideas and research efforts around these new technologies.
9. Reduce Costs for Pediatric Imaging Procedures
Sheila Moora, MD
US health care spending far outpaces that of other industrialized countries. We seek creative
approaches for substantial reduction of health care costs without impairment in health care outcomes
and quality of care. Potential projects under this effort include evaluations of first time seizure patients, without focal
findings, who get brain MRI and sedation. How many of those studies have actionable findings, and whether or not it is worth the money and resources to image these children are target research areas. Another important project would be the evaluation of cost benefit ratios of checking urine pregnancy tests in all girls over 10 before imaging, and whether this is a good use of resources.
Research Priority Survey
The ACR-PIR Committee research priorities were developed with broad input from members of the ACR-PIR Committee and Society of Pediatric Radiology. Input was obtained through committee discussions and responses to the survey posted below that was circulated to SPR members.
Link to survey