BENEFIT

Significant impact on business and society

In the clinical use case of cardiac valves, the LUMC evaluated novel 4D flow Magnetic Resonance (MR) imaging protocols and image analysis methods for patient risk assessment. This research has resulted in various scientific papers, increased knowledge on the optimal usage of non-invasive MR imaging techniques and has contributed to the commercial release of a new 4D Flow MRI module for the Medis Suite MR image processing software.

The BENEFIT project also had a significant impact on FEops in terms of technology, funding and staffing. This Belgian SME received CE approval for its TAVIguide product which helps to improve placement of artificial heart valves by pre-operative imaging and simulation. It also recently secured an investment injection of €6 m to help drive commercial adoption of the FEops HEARTguideTM in the fast-growing market for transcatheter valve therapies. FEops has almost quadrupled its number of staff from 4 to 15 people.

For brain vessels, Philips has introduced a new commercial tool to the market for the treatment of cranial aneurysms, based on the research efforts performed within the scope of the BENEFIT programme. An aneurysm is a weak spot in the wall of a blood vessel which gets dilated due to the blood pressure and is at risk of rupturing. It is the first interventional tool to visualise and quantify flow patterns in a vessel and an aneurysm. It predicts the chance of long-term treatment success while the patient is still on the table and the catheter is in place. This means that the surgeon can take immediate additional actions in the event that the chance of success is too low, so that the risk for the patient is reduced as well as the need for repeated treatment. At the end of 2019 more than 250 units had been sold.

Also Erasmus MC, University Medical Center Rotterdam, contributed to stroke treatment by introducing novel tools and charts to increase the information from conventional CT and X-ray images. These tools and knowledge will be used in a subsequent large Dutch project, called CONTRAST (COllaboration for New TReatments of Acute STroke), where Erasmus MC will work with partners on imaging biomarkers for stroke and stroke treatment.

For brain tumour radiotherapy, Elekta received CE and FDA approval for its Leksell Gamma Knife ICON system with Cone beam CT (CBCT) for optimal patient positioning, in part due to BENEFIT. The CBCT positioning system allows frame and frameless workflow in radiotherapy such that patients do not need to carry the stereotactic frame for imaging before treatment planning. Thus it allows more flexibility and efficiency in treatment planning for both clinicians and patients. 107 Systems have been installed and clinically in use as of September 2019. There is also potential in upgrading the existing systems, i.e. over 200 worldwide. The automatic dose planning system that has also been developed and is currently being evaluated by clinical experts, with a partial contribution from BENEFIT, reduces planning time for test cases significantly by an estimated factor of 2 or more, while the inverse planner maintains performance.

In this same use case, Linköping University (LiU) in Sweden has published in BENEFIT a total of 10 journal papers, 3 conference papers and 2 book chapters, including on a new framework for MR diffusion imaging of brain tumours. For functional MRI, the most important publication, published in PNAS (Proceedings of the National Academy of Sciences) in 2016, showed severe problems with statistical methods used to analyse fMRI data. The paper has been covered by Science, The Economist, The New York Times, has been downloaded over 200,000 times and received over 1800 citations. LiU has continued the work in BENEFIT in collaboration with Harvard Medical School (USA) and Lund University (Sweden), for example through an SSF (Swedish foundation of strategic research) funded project about diffusion MRI.

The Dutch SME Quantib gained CE and FDA approval for its brain tumour analysis software and recently secured €4.5 m in fresh funding to support the company in its international expansion ambitions. Improvements developed within this project will continue to flow into future versions of the Quantib™ Brain and Quantib™ ND products. Furthermore, Quantib set up a framework to develop and evaluate deep-learning methods to quickly create prototypes and assess the clinical relevance. Prototypes include automated hip joint degeneration assessment based on X-rays to decrease hip joint replacements, and estimation of body fat percentage based on MRI e.g. to obtain better dose estimation for chemotherapy treatment. The prototypes are currently being evaluated in a clinical setting. From the start of BENEFIT until the present, Quantib grew from 6 employees to nearly 30, developed 4 products including certification, has installations in over 20 countries and initiated partnerships with 3 top medical university centres in the Netherlands.