The dark cloud that was peak COVID-19 contained a number of silver linings. One of these, still coming to light, has been radiology research: As the field adapted to withstand the pandemic’s challenges, it morphed in some decidedly beneficial ways.
A panel of vice-chairs of research convened by RSNA has considered the specialty-wide response and written a report summarizing the findings. Academic Radiology published the work Jan. 5 [1].
Along with insights and strategies the group gleaned and captured during the early, middle and late states of the public health emergency, the article presents research patterns uncovered in a dedicated literature review.
It also offers some salutary observations of new funding opportunities conceived in the COVID era.
Finally, the paper itemizes several “emerging research areas of excellence with high potential for future growth.” Among these:
Artificial intelligence. Lead author Mai-Lan Ho, MD, of Ohio State University, senior author David Mankoff, MD, PhD, of the University of Pennsylvania and colleagues note that imaging AI was already a hot topic when the pandemic descended. However, they point out, many pre-COVID AI projects were “clinically irrelevant” as well as questionably generalizable, for various reasons.
For example, most radiology AI publications “investigated diagnosis of COVID-19 based on chest radiography, but the majority of imaging trials utilized CT to evaluate disease severity or prognosis,” they write.
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To support AI algorithm development, there was a universal push to share anonymized health care data across institutions. Multiple North American radiology organizations have supported and funded the creation of large, high-quality and diverse COVID-19 imaging datasets. These efforts helped to establish national/international consortiums and advance big data science.”
Anticipating pandemic-propelled momentum in the months ahead, the authors predict AI will help multidisciplinary researchers “mine increasingly large and diverse multiplex databases of radiology, genomics, radiology, electronic health records, survey results, laboratory values and physical data, enabling precision medicine approaches with individualized risk assessment, diagnosis, prognosis and treatment.”
3D printing. During the pandemic, radiology-based 3D printing operations worked with referring physicians and relevant vendors to develop prototypes, conduct bench lab testing, design clinical trials and patent new technologies, the authors write.
“Open-source electronic model sharing via websites, social media, and file repositories saved a great deal of design time for end users,” they add, citing as an example the RSNA/ACR 3D printing registry, which helped yield such useful outputs as model constructions, printing techniques and verifiable clinical impacts.
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These activities broadened the international reach of 3D printing, with prioritization of low-cost printers and accessible stocks of surgical-grade materials enabling distributed manufacturing. Ongoing investigations in 3D printing include next-generation laboratory tests, drug manufacturing, biomaterials, sustainability, and virtual/augmented clinical trials.”
Teleradiology. Practice shifts in remote work spurred by social-distancing guidelines “broadly impacted radiologists’ personal and professional lives with emotional and physical stressors; introduced quality issues with home viewing environments; and revealed service gaps related to rapidly changing staffing and workload volumes,” the panel points out.
These issues prompted several research projects in the realms of virtual/hybrid education, quality improvement, healthcare disparities (and radiologist well-being.”
Novel imaging innovations. The authors cite published studies documenting such promising advances as multicontrast imaging to interrogate various tissue properties, advanced tomosynthesis for low-dose and high-information scanning, microscale/nanoscale technologies to assess viral-level pathology, and portable or remote-controlled scanning of infectious or critically ill patients.
“There is also a role for interventional radiology using image-guided interventions for combined diagnosis and therapeutic delivery via intranasal, intravascular, or intrapulmonary routes (theranostics),” the authors write.
Further, they state, radiology informatics “played a major role in COVID-19 mitigation, planning, response and recovery,” suggesting informatics will likely expand its contributions along these lines going forward.
The panel concludes:
Understanding of imaging research challenges and solutions during and after COVID-19 is critical to prepare for future disruptive events. Agility and effective communication among research principal investigators, vice-chairs of research and healthcare administrators is critical for successful leadership of academic radiology departments.”
The report is available in full for free.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.