7th Framework Programme
Capacities - Research Infrastructures
Call Identifier: FP7-INFRASTRUCTURES-2010-2
Proposal Full Title: / DIAGNOSTIC ENHANCEMENT OF CONFIDENCE BY AN INTERNATIONAL DISTRIBUTED ENVIRONMENT
Proposal Acronym: / DECIDE
Type of Funding Scheme: / Combination of Collaborative Projects and Coordination and Support Actions: (CP-CSA)
Workprogramme Topics Addressed: / INFRA-2010-1.2.3: Virtual Research Communities
Name of Coordinating Person: / Laura Leone
Coordinating Institution: / GARR
Participant
no. / Participant Organisation name / Country
1 / GARR (Coordinator) / italy
2 / Alzheimer-Europe / luxembourg
3 / Consiglio Nazionale delle Ricerche / Italy
4 / Consorzio Cometa / Italy
5 / Fatebene Fratelli / Italy
6 / San Raffaele Hospital / Italy
7 / University of Genova / Italy
8 / University of Foggia[t1] / Italy
9 / Istituto di Ricerca Diagnostica Nucleare / Italy
10 / Maat G-knowledge / France
11 / Imperial College London / UK
12 / Department of Biomedical Physics, University of Warsaw / Poland
13 / European Consortium for Alzheimer Disease / France
Proposal summary page
DECIDE
Abstract
The field of medical imaging has developed enormously in the past 20 years. Image databases made of thousands of images are now available that can be used as a reference for individual diagnosis, and sophisticated algorithms can extract information from medical images that cannot be appreciated by the naked eye. The field of neurodegenerative disorders can especially benefit from these acquisitions. Neuroscientists have recently learned that highly prevalent and burdensome chronic brain diseases such as Alzheimer’s disease (AD) and other neurodegenerative and neurodevelopmental disorders can be diagnosed early with image-based markers of structural and functional brain changes, allowing early pharmacological or rehabilitative interventions.
Discoveries and clinical exploitation of the above neuroimaging markers is prevented by the use of advanced software for data analysis mainly at biggest university centres and from the lack of large normative databases in little hospitals across Europe, especially in the less industrialized countries. However, all EU citizens have the right to Health and Wealth, even if they live in little cities and towns with no human resources and facilities for the extraction of the mentioned markers.
Aim of this project is to design, implement, and validatethe model of a GRID-based e-infrastructure supporting e-research and diagnostic/prognostic services, based onthe use of large reference databases and advanced algorithms to detect brain disease markers in individual patients suffering from dementia or schizophrenia. These markers will be extracted by the following neuroimaging techniques (non exhaustive list): (i) voxel based statistical analysis of 18F-FDG positron emission tomography (PET) and Tc99-ECD single photon emission tomography (SPET) for the diagnosis of neurodegenerative diseases, (ii) pattern recognition analysis of 18F-DOPA PET for the classification of schizophrenic patients and of structural magnetic resonance imaging (MRI)scans for the diagnosis of neurodegenerative diseases, and (iii) segmentation techniques of MRI images for the extraction of hippocampal volume and quantitative electroenceaphalographic (qEEG) markers for the diagnosis of AD. The neuroimaging markers will be derived by the statistical comparison of the individual data set with large sets of validated reference images of normal persons.
Computer-aided applications will be developed and implemented into a Grid middleware. The GRID infrastructure will allow the following functions: (i) Provide authorized and secure access to largely distributed database for healthy subject data, (ii) Supply efficiently intensive computationally processes as those required by the above applications for research and clinical use, and (iii) Permit clinical images to reside locally and comply with the strict clinical data sharing policies of most hospitals.
The potential impact for research and clinical use of the present e-infrastructure will be on a large scale, by enabling cliniciansfrom local hospitals not owning software and large sets of images to carry out analyses remotely and efficiently by the use a centralized web-Grid service. We will define with National and European regulatory agencies protocols and rules for the qualification of experts enabled to access via Internet portals to the stored software and neuroimaging data within the GRID, for the analysis of the neuroimages for research and clinical use and for the production of the medical reports. These qualified experts could work in SMEs or universities and could establish contracts with the hospitals having no internal human resources and expertise for the extraction of the advanced neuroimaging markers. As an appreciated side effect, the present model of health services is then expected to promoteEU spin-off companies and economy.
Index
Section 1.Scientific and/or technological excellence, relevant to the topics addressed by the call
1.1Concept and objectives
1.1.2. Objectives
1.2Progress beyond the State-of-the-art
1.2.1Enabling e Infrastructures
1.2.2Early diagnosys and new criteria usage in decide
Research and Education Networks (GARR and the NRENs, GEANT)
Underlying Grid infrastructure: architecture and services of COMETA e-Infrastructure
1.2.3Grid enabled applications and existing communities
SPM Applications
qEEG Applications
1.2.4Training and tutoring
1.3Methodology to achieve the objectives of the project, in particular the provision of integrated services
1.4Networking Activities and associated work plan
1.4.1NA1 – Management of the CP-CSA Project [GARR, Laura Leone]
Tasks
Deliverables and Milestones
Resources
Quality metrics
Risk analysis and contingency plans
1.4.2NA2 – Standardization, Liaison and International Cooperation FBF
Objectives and expected outcomes
Activities are organized in five main tasks:
Deliverables and Milestones
Resources
Quality metrics
Risk analysis and contingency plans
1.4.3NA3 – Dissemination, Training and Outreach (Activity Leader: COMETA)
Trans-national Access and/or Service Activities, and associated work plan
1.4.4SA1 – Installation and Maintenance of the enabling network and grid infrastructure MAAT
Objectives and expected outcomes
Tasks
Deliverables and Milestones
Resources
Quality metrics
Risk analysis and contingency plans
1.4.5SA2 – Design, exposure of and access to the reference databases IC
Objectives and expected outcomes
Tasks
Resources
Quality metrics
Risk analysis and contingency plans
1.5Joint Research Activities and associated work plan
JRA1 – Porting of the diagnostic algorithms UGDIST
TJRA1.2 – Pattern recognition of FDOPA-PET, dealing with the implementation on the Grid infrastructure of the application.
TJRA1.3 – Hippocampal segmentation on structural MRI, dealing with the implementation on the Grid infrastructure of the application.
Resources
Quality metrics
Risk analysis and contingency plans
1.5.2JRA2 – Design of the Diagnostic Services CNR
Objectives and expected outcomes
Tasks
Resources
Quality metrics
Risk analysis and contingency plans
1.5.3JRA3 – User Validation and Testing EADC
Objectives and expected outcomes
Tasks
Resources
Quality metrics
Risk analysis and contingency plans
Section 2.Implementation [GARR]
2.1Management structure and procedures
2.2Individual participants
2.2.1Consortium GARR – GARR (Coordinator)
Profile and Role in the project
Key Personnel
2.2.2CNR
2.2.3COMETA
Profile and Role in the Project
2.2.4HSR
Profile and Role in the Project
Key Personnel
2.2.5UGDIST
Profile and Role in the Project
Key Personnel
2.2.6University of Foggia, Italy (UNIFG)
Profile
Role in the Project
Key Personnel
2.2.7SDN
Key Personnel
2.2.8MAAT-G
Profile and Role in the Project
2.2.9Imperial College
Profile and role in the project
Key personnel
2.2.10DBP-UW
DBP UW
Profile
2.2.11EADC
Profile
Role in the Project
Key Personnel
2.3Consortium as a whole
2.4Resources to be committed
Section 3.Impact GARR+FBF+HSR
3.1Expected impacts listed in the work programme
3.2Dissemination and/or exploitation of project results, and management of intellectual property
3.3Contribution to socio-economic impacts
Section 4.Ethical Issues
Section 1.Scientific and/or technological excellence, relevant to the topics addressed by the call
[Recommended length for the whole of Section 1 – forty pages, not including the tables]
1.1Concept and objectives
[Explain the concept of your project. What are the main ideas that led you to propose this work?
Describe in detail the S&T objectives. Show how they relate to the topics addressed by the call. The objectives should be those achievable within the project, not through subsequent development. They should be stated in a measurable and verifiable form, including through the milestones that will be indicated under section 1.3 below.]
1.1.1 The Vision of the DECIDE project
The present project (“Diagnostic enhancement of confidence by an international distributed environment”, DECIDE) reflects the grand vision of some speeches by Mr. David Byrne, European Commissioner for Health and Consumer Protection.
“…So today is really your day. The day of the health community. In a second the floorwill be yours. You will have the full attention of the Commission and, I hope, theworld beyond.But before then I would like to leave you with a few final thoughtsThe role of the EU in health policy is evolving rapidly. We need to mobilize resources and ideas, facilitate cooperation, coordinate where necessary againstcommon threats, use the advantages of scale, and bring together expertise andideas from different Member States in pursuit of excellence.While Member States have the responsibility for running their health systems, theEU can help health systems throughout the Union achieve their objectives. By doingso it will also contribute to economic growth and sustainable development for theUnion.” [C2](Working towards good health for all; Open Health Forum - Brussels, 17 May 2004).
All EU citizens should have access to high-quality early diagnostic and prognostic procedures necessary for selecting the proper therapy, regardless they are in charge to big or little hospitals in capitals or little cities and towns. This may come true by investments of the EU upon GRID-based e-infrastructures that allow sharing information, medical data, and professional expertise across EU hospitals. The DECIDE project is expected to promote clinical research within e-communities and to contribute to reduce inequalities regarding the right to Health and Wealth of European citizens living in little countries with no chance to travel across Europe to meet medical personnel of the most advanced hospitals.
Moreover,Mr. David Byrne said
“…We need to encourage a counter-current in health economics thinking. A new perspective on health as a productive force in economic prosperity needs to take hold in Europe. Based on agreed methodologies and hard data, this new perspective should confirm a few key messages. (omissis) That health is a productive economic factor in terms of employment, innovation and economic growth. That significant reductions in avoidable and costly ill-health can be achieved with relatively modest investments. (omissis) For our European citizens, access to affordable high-quality healthcare is one of the benchmarks of successful modern governance. ("Health equals Wealth"; European Health Forum Bad Gastein, 3 October 2003).[C3]
Indeed, new biomedical technologies and models of health services can be an invaluable powerful engine for the promotion of the economy in the EU and outside.
The DECIDE project also represents an operative proposal as areply to the appeal by Mrs. Anne-Sophie Parent, AGE Director, at the conference on Healthy and Dignified Ageing in Stockholm on 15-16 September 2009.
“The time is right to work together to look for sustainable solutions, through exchange of views and better coordination and cooperation between stakeholders and between countries and regions. AGE hopes that all Member States will support the proposal to have 2012 declared European Year for Active Ageing and Intergenerational Solidarity and that the Swedish Presidency will propose to start to prepare a real European Strategy to be launched in 2012 to ensure that everyone in the EU can enjoy a healthy and dignified ageing.”
[C4]
She pointed out that dementia and its most common form, namely Alzheimer’s disease (AD), represents one of the toughest scientific, health, and social care challenges of our time. Furthermore, the actual management of these medical issues absorbs a lot of financial resources.According to the latest estimates of EU, the cost of brain diseases in Europe in 2004 was of €386 billion, and the global prevalence of AD is predicted to quadruple to 106 million by 2050.
Keeping in mind this premises, theDECIDE project propose an innovative solution to the problem. The DECIDE projectwillexploit and link existing European GRID infrastructures, to develop an innovativemodel of e-community research on diagnosis and prognosis based onadvanced neuroimaging markers of neurodegeneration. The DECIDE projectwill focus on research on early diagnosis/prognosis of dementia and schizophreniaand on the use of these markers in the clinical environment.GRID applications will allow the scientific validation and use of advanced neuroimaging markers to meet the needs of neurologists and psychiatrists of both big and little cities/hospitalsfor earlier and more accurate diagnosis that use validated quantitative assessment of structural and functional brain images such as (non exhaustive list):
(a)Voxel-based statistical analysis of 18F-FDG PET and Tc99-ECD SPET for the diagnosis of neurodegenerative diseases;
(b) Pattern recognition analysis of 18F-DOPA PET for the classification of schizophrenic patients and of structural MRI scans for the diagnosis of neurodegenerative diseases;
(c) Segmentation techniques of MRI images for the extraction of hippocampal volume and quantitative electroencephalographic (EEG) markers for the diagnosis/prognosis of AD.
These markers will be extracted by the comparison between the neuroimaging data of the local patient and large reference databases shared by the hospitals interconnected by the GRID e-infrastructure. Furthermore, they will be validated by scientific procedures.
From a technological point of view, the computer-aided applications will be developed and implemented into a Grid middleware, taking advantage of the Grid. The GRID-based e-infrastructure will allow the following functions:
(a) Provide authorized and secure access to largely distributed database for healthy subject data;
(b) Supply efficiently intensive computationally processes as those required bythe above scientific and applicative purposes ;
(c) Allow clinical images to reside locally and comply with the strict clinical data sharing policies of most hospitals.
The potential impact of the present e-infrastructure will be on a large scale, by enabling researchers of e-communities and clinicians from local hospitals not owning software and large sets of reference neuroimages to carry out analyses remotely and efficiently by the use a centralized web-Grid service.
We will define [C5]with National and European regulatory agencies protocols and rules for the qualification of experts enabled to access via Internet portals to the stored software and neuroimaging data within the GRID, for the production of field research and medical reports. These qualified experts of SMEs or universities could establish contracts with the hospitals having no human resources and expertise for the clinical application of the advanced neuroimaging markers. This model of e-research and health services could promotediscoveries in the field of neuroimaging markers of neurologic diseases and then biomedical economy in the EU. As a result, we expect to improve field research products and savings in costs as well as to ameliorate the quality of life ofpatients and caregivers, especially when the next generation of more effective therapies becomes available for all patients.In this framework, new SMEs[C6]may offerto virtually all EU hospitals services for the advanced analysis of raw neuroimaging data stored into the GRID. The following figure illustrates the mentioned model as proposed by this project.
1.1.2. Objectives[C7]
The main objectives of the DECIDE project are the following:
O1. Link European GRIDs for sharing data analysis software and multimodal patients’ neuroimages for research of e-communities and for clinical applications;[C8]
O2. Develop relational databases of these multimodal neuroimages;[C9]
O3. Design and develop an innovative model of research and clinical use of advanced neuroimaging markers of neurodegeneration (with a special focus on early diagnosis/prognosis of AD). In perspective, such a model is potentially able to bust discoveries on these neuroimaging markers and to aloe the clinical use of these markers to all European neurologists engaged with the diagnosis of AD and other neurodegenerative disorders.
O4. Define and perform training protocols and exams for the qualification of experts enabled to analyze neuroimaging data within the mentioned GRID for research purposes and for the production of medical reports. Legal, ethical, and administrative issues will be discussed with key personnel of National and European regulatory agencies;[C10]
O5. Validate the GRID-basede-infrastructure for research and clinical use;
O6.Disseminate the results to promote the enlargement of the e-community and associated clinical units, and the development of SMEs providing services for the data analysis and for the production of medical reports.
1.2Progress beyond the State-of-the-art
1.2.1Enabling e Infrastructures
The integration of medical diagnostic tools and clinical devices with e-Infrastructures, with the aim of providing specialized services to the medical community, started a few years ago, and has already brought considerable benefits to both the users community (patients) and the specialized physicians, positively impacting on the way the medical praxis is carried out and data are handled.
It contributed to remarkably simplify the global workflow related to the analysis of medical information, to enlarge the global amount of data available for statistical analyses, to distribute the access to the information itself, allowing remote consultation, electronic storage and archiving of relevant images and data, the execution of in-silico experiments and simulations. Many medical disciplines currently benefit from having introduced e-Science in their praxis, research and workflows: cardiology, neurology, drug discovery.
A classical example of the great benefits of e-Science in the domain of medicine is for instance the WISDOM Biomedical data challenge (World-wide In Silico Docking of Malaria), which has been carried out on the EGEE e-Infrastructure in July and August 2005: two reference molecular docking applications have been used to select around 1 Million ligands in the seek for proteins related to the responsible factors for Malaria. The availability of the EGEE infrastructure has massively increased the available computing power, allowing the analysis of 46 Millions ligands, producing 1 Terabyte of final output data, and obtaining in around 1 month results which would have implied more than 80 years of time on single, even powerful, computer.