Future medical
imaging will be an important part of precision medicine. Of medicine of the
National Academy of Sciences (IOM) in November 2011 issued a report, with
particular emphasis on accurate medicine is built on the understanding of
individual genes, environment, way of life based on the model of disease
treatment and prevention methods. We use life science to study this field, that
is, in the protein, gene, or at the molecular level, to explore how much,
whether it can be seen, what is the role of protein and gene.
Precision
medicine, first of all, for the individual, to have the mark, but also have a
pair, while the support of evidence-based medicine, and then the treatment of
large data. Commonly used in biomedical field. Here we can see the electrons,
atoms, molecules, DNA, cells, bees, mouse and human, the best resolution of
PACS in 5 mm, CT and MRI in about 1600, or in the 0.1-0.2 mm, optical
microscope is a little smaller, electron microscopy is smaller. Today, the
development of the gene, gene sequencing DNA this piece, optical and electronic
can observe the virus.
Obviously our PACS
gives us an image of the storage and transmission, does not include our
traditional medical imaging technology and the use of gene matching. That is to
say gene and protein data is a prerequisite for PACS, medical development
before a is no disease, after a period of do is what disease, in what place;
image to be solved is in what place, so the PACS in the aspects of image
processing is worthy of attention. We give some attention to gene sequence,
gene sequencing, protein and so on, which can be observed and compared under
the molecular image.
Generally
speaking, medical imaging has been developed for 120 years the, from the
beginning of the 1970s, for more than 40 years. We mainly refers to digital
image, digital image for PACS a good opportunity, so our transmission can so
smooth. From the perspective of medical digital imaging, the main problems are
spatial resolution, contrast resolution, temporal resolution and energy
resolution. PACS for the image around, is to solve these four resolution.
From a clinical
point of view, PACS mainly to solve three problems, the first tumor, second
cardiovascular and cerebrovascular diseases, third senile dementia. Query the
NIS of the United States as well as the domestic fund research are basically
the three based, PACS is also the mainstream of the disease and the evolution
of the disease. Here to give us the most difficult is the time resolution and
energy resolution, that is to say dynamic. Again, with the process of function
and metabolism, pop and quantization on PACS put forward a new request. As for
the big data, the main thing is to see the metabolism of pop and quantization,
especially quantitative. Images of the 120 years of development though to solve
the problem of resolution, but it is based on morphological indirect tools, not
yet diagnosed in histologic and molecular level. This is what we are now
medical imaging, knowing where the disease, PACS to solve the problem is where
the disease, not to solve the problem of what is the disease.
In biomedical era,
we are faced with three directions: the first point is the individual. Our high
level of hospital can mix the grass-roots hospital of the film, but only a
line, without forming a network, can not be deployed to each other, small
hospitals can not get a third grade class-A hospital of the film, so this is a
challenge to the PACS. We really want to do individual, first of all, we must
change our mode of medical treatment, from family to go to the hospital to
family, circle, diagnosis treatment follow-up, the two are in the family just
PACS is not distributed at both ends, then there is no way to arouse the
participation of society and family involvement. Similarly, we attach great
importance to the network construction, but we actually completed is a line,
above below, under the not above, still do not have a shuttle of, not to
mention the whole network deployment, this is barriers exist. And our
standardization is still to be further built.
Second, the PACS
should pay attention to the integration of imaging diagnosis, also is the
Intergrate, is the laboratory, Department of Pathology, image synthesis or is
the integration of molecular laboratory, we do not have this ability, only by
PACS or TMT to solve this problem. So PACS and TMT in the future for cancer is
a comprehensive medical imaging tools. In the past, we are take information
center to integrate information. Now we have integrated information center can
call for the Intergrate information, we put all the things are integrated together,
but we still in the traditional ideas established a center only, so this is we
consider.
Third, from the
angle of precision medical analogy military in the 18th and 19th centuries,
generally through a duel to settle, now mainly rely on the missile. There is
also a need for GPS positioning, so positioning in the medical field is by PACS
to do, only PACS can solve the positioning problem, TMT technology gave precise
medicine a lot of support, this is I will describe below. As for the reason, I
explain, everyone knows, this is the normal gene. If the gene mutation, you can
said to have the disease, a part of the variation in gene by the immune system
of their own recovery, another part can not be restored, we put this part in
the cancer before the call period canceration, or say is subtle molecular
cancer or cancer cells. After all of a sudden proliferation, we can see from
cancer to death is 1-3 years, we see the image is from the stage of cancer to
death, the scope of genetic testing and protein inspection is not seen. For
example, the Hollywood actress Angelina Julie, the doctor told her that a pair
of genes with 80% of the possible breast cancer, she chose to remove the
breast, this is in the breast is still relatively good solution. But if it is
in the Department of Neurology, a pair of genes that may cause disease, may
lead to glioma, then it can not be as good as the breast to solve, there is no
way to remove. In this case, we greater part do is doing gene and protein data
accumulation and contrast, this aspect of work and data storage needs us to do.
We want to jump out from the simple images, to meet the needs of today. Of
course, we still need to know how much this tumor is, in addition to strengthen
the processing of data. If screening for breast cancer. It is found that the
abnormal genes and alterations in 100 people set up to check, may find the 20
people sick, but if no gene comparison, just simple to how old to how old
people rally to the inspecting may effect is not very ideal. So the integration
of information is very important.
In glioma, for
example, for the currently used in the classification of gliomas is the
classification of the who in 2003, in June this year, we adopt new molecular
classification, we can use big data to images of the past are out of tune, then
we observed the characteristics and the characteristics and molecular typing
have certain relationship. So the PACS can cannot all the data, all features
like computer early diagnosis, early out of tune; can not at the same time, the
MR or CT images were all out of tune, the PACS to do software personnel makes a
request.
For today, we have
to drug development, disease treatment, we see a lesion in any place, but we
know it already exists, so we can not to take out this part of things, and then
we wonder what it is, we'll call you go, let it to mark the place of these
lesions. Even with the treatment of drugs to fight in the diagnosis and
treatment, that is, targeted therapy, this part of the medical image is not,
but the medical image tells us where the disease, followed by the treatment of
drugs. This process also requires big data, there is a standard. This is a
passion, this passion in fact, is the formation of the drug, data and norms of
the building, which is a very important challenge for the future PACS.