Virtual clinical trials in medical imaging: a review

Abstract

The accelerating complexity and variety of medical imaging devices and methods have outpaced the ability to evaluate and optimize their design and clinical use. This is a significant and increasing challenge for both scientific investigations and clinical applications. Evaluations would ideally be done using clinical imaging trials. These experiments, however, are often not practical due to ethical limitations, expense, time requirements, or lack of ground truth. Virtual clinical trials (VCTs) (also known as in silico imaging trials or virtual imaging trials) offer an alternative means to efficiently evaluate medical imaging technologies virtually. They do so by simulating the patients, imaging systems, and interpreters. The field of VCTs has been constantly advanced over the past decades in multiple areas. We summarize the major developments and current status of the field of VCTs in medical imaging. We review the core components of a VCT: computational phantoms, simulators of different imaging modalities, and interpretation models. We also highlight some of the applications of VCTs across various imaging modalities.

Moving the goalposts while scoring―the dilemma posed by new PET technologies

“…Recently there has been interest in use of virtual (or in silico) imaging trials whereby the patients, imaging system, and clinical interpretation processes are emulated using computational models [125][126][127]. If properly validated, virtual imaging trials could have a role in evaluating the impact of new technologies on diagnostic and quantitative accuracy, thus decreasing the required size and length of real clinical trials and reducing the length of the transition period.…”

In Silico Phase-Contrast X-Ray Imaging of Anthropomorphic Voxel-Based Phantoms

“…This is useful as more phantoms become available and phasecontrast imaging moves towards clinical imaging. With the increased interest in virtual clinical trials (VCTs) to evaluate medical imaging modalities [18], we show that our strategy opens up for VCT of phase-contrast imaging.…”

“…The recent surge of interest in virtual clinical trials (VCTs) in medical imaging [18] relies to a significant degree on the development of realistic virtual models of human anatomy. Whole-body models (e.g., Virtual Population [19], XCAT [20]) are widely used for investigation of a large range of morphological and molecular imaging techniques.…”

Methodology to create 3D models of COVID-19 pathologies for virtual clinical trials

“…There are different technical approaches available for this, including new detectors, improved antiscatter rejection techniques, rib suppression software, and/or dual-energy acquisitions. Given the urgency of the situation, we have developed a virtual clinical trial (VCT) 4 – 6 platform that will allow for dedicated optimization studies without the difficulties associated with clinical studies on (critically ill) patients. The objective of this work was, therefore, to create a series of COVID-19 models that can be used to generate simulated CXR images for future VCTs.…”