22 Life Sciences Report – Diagnostics Building Today a Healthier Tomorrow Smart4Health is a project of the European Union (EU) with the aim to empower EU citizens with an interoperable and exchangeable electronic health record (EHR) that enables them to actively manage their health data throughout the EU and beyond, advancing their health and wellbeing. The key objective of the project is to place the citizen in the centre of the management of their health-related data, which can contain diagnoses, treatments, medication plans, and fitness data. The citizen is thus empowered with the possibility to share their health data securely with anybody (e.g. clinicians, medical centres, health care providers, family members) both nationally and internationally, as well as to donate their data for research activities. Thus, Smart4Health will fill a gap in EU eHealth and personalized health initiatives. © HPI The Smart4Health consortium consists of 17 partners within the EU from medical, social and technical sciences, and industry and a partner from the US. Prof Dr. Erwin Böttinger, Head of the Digital Health Center at the Hasso Plattner Institute (HPI) in Potsdam, is the scientific coordinator of the consortium. The Smart4Health project started in January 2019 and is funded through the European Union‘s Horizon 2020 research and innovation programme under Grant Agreement No 826117 with a maximum of € 21.8 million over 50 months. For more information, please visit: www.smart4health.eu Alternative contrast agents and patient-friendly imaging devices Innovation in imaging hardware and contrast agents has advanced at a much slower pace than innovation in medical image analysis over the last years. This is only partially related to a lack of research, but rather to difficulties in finding contrast agents that are specific enough to meet a medical need and broad enough to target a large range of patients. Bayer is a major player in the field with more than 20 years of excellent research in molecular MRI. However, several companies and research groups are working hard to develop new contrast agents that can be used as alternatives to iodine, gadolinium or fludeoxyglucose (FDG). This is an important research topic for the German capital region and many regional partners are contributing to the VSOP project. VSOP – MRI contrast agents based on iron-nanoparticles The VSOP project combines two important fields of modern medicine: the development of nano medicine and molecular imaging. The objective of the project “Research and development of a MRI contrast agent based on iron oxide nanoparticles (VSOP)” is the development and testing of contrast agents for vascular diagnostics in magnetic resonance imaging (MRI) in patients with reduced renal function and simultaneous cardiovascular diseases. In such patients, the use of contrast media containing iodine or gadolinium should be avoided as far as possible, as this can cause undesirable effects and health damage. The iron oxide nanoparticles developed in the project are tested for their tolerability, in addition to their efficacy for vascular diagnostics, in order to ensure that there is no risk to human health. The results of the project are part of the pre-clinical development as a prerequisite and basis for the clinical development of the product. Project partners include the radiology department of Charité – Universitätsmedizin Berlin, InnoRa GmbH, Chiracon GmbH, IMTR GmbH, Physikalisch-Technische Bundesanstalt PTB and b.e. imaging GmbH.
Life Sciences Report – Diagnostics 23 © Johannes Loebbert, glas kramer loebbert bda, Gesellschaft von Architekten mbH Berliner Ultrahochfeld-MR-Anlage at ECRC With regard to innovation in medical imaging devices, a similar innovation bottleneck can be observed. Few new devices from the capital region have entered the market recently. The Berlin-based company Xiralite for example has developed a fluorescence optical imaging (FOI) hardware that provides a differential diagnosis of arthritis of the hands. Algorithms providing a differentiated diagnosis Medical image analysis is a broad branch of the image processing field, and it conveys all kind of measurements or operations on the image in order to extract some useful information or prepare the image for an upcoming task. Automation of any of the image analysis tasks is of high importance since it saves time and effort and makes the image analysis tasks easier and simpler to perform. Deep learning is used in many image analysis tasks such as detection, classification and segmentation and it has shown very promising results in terms of accuracy and efficiency. A focus of the DFG graduate programme BIOQIC is the classification and segmentation of prostate cancer zones and lesions. Deep learning is a great tool to automate any manual stage in the diagnostic procedure. The approach uses a convolutional neural network, which requires only the coordinates of the lesion, and then the network will do the rest of the analysis on multiple MR sequences automatically. Segmentation in medical imaging is also a very tedious and time-consuming task; it requires segmentation in a slice-wise manner and highlighting all the relevant pixels for the task. Deep convolutional neural networks have shown great capabilities in this field and what requires minutes or hours to be done manually, the networks can do in matter of seconds. The research shows that deep learning not only does reduce the time and make the image analysis procedure more time efficient, but also can reach a level of performance that is very close or equal to the one achieved by the experienced radiologist and maybe in the near future it will go beyond this level. 6. Showcase oncology: targeted therapies through better understanding Cancer medicine is the best example of how broad basic research leads to a comprehensive understanding of a disease. While a few decades ago the only option for treating a tumour was radiation, surgery and subsequent chemotherapy, today not only these methods are far more precise and associated with fewer side effects. Novel cell therapies are an additional way to combat the second leading cause of death in Germany. However, this progress has only been made possible by elucidating basic mechanisms and the implementation of the results in clinical routine as well as in diagnostic and therapeutic products. The realization that there is not only one type of cancer and that the cells within a tumor have different potentials to form metastases leads increasingly to the fact that the patients have to be divided into smaller groups for a precisely fitting treatment: the way to stratification of patients and personalized medicine. The Berlin-Brandenburg region is home to a large number of companies and research institutions active in this field. The CCCC - Charité Comprehensive Cancer Center is the central point of contact in Berlin for the diagnosis and treatment of tumors. The Alacris Theranostics GmbH uses its technologies CMTA (Comprehensive Molecular Tumor Analysis) and ModCell to optimize the therapy for each individual patient. In many innovative projects the basics are further researched and new ways for diagnostics and therapy are being explored. In 2019, the Wachstumskern (Innovative Regional Growth Core) “PraeMedBio - precision medicine through biomarker-based diagnostics” was launched in Senftenberg. A modular and fully automatic analysis system (PRÆMED.BIO-Scan) is to be developed and constructed in a network of several companies and research institutions. It will integrate all necessary hard-