COLUMN. The new Imaging and Intervention Center (BOIC) will serve as a regional center for medical care and will continually be developed through scientific research and education. Sven Ekholm, who has been assigned as dean to lead the academization of the center, offers his view of how BOIC has developed and how the academic aspects will continue to evolve.
The Imaging and Intervention Center (BOIC) increases interest in research as well as awareness of the opportunities for research. By focusing on BOIC, the entire region and its universities gain access to modern and functional facilities, with access to the majority of today’s high-tech equipment for image-guided diagnostics and treatment. Above all, it will benefit patients. The closer cooperation between clinics and universities will also improve every aspect of research, development and education.
My work as an advisor for education to the academization of BOIC began in 2013 through the establishment of a Scientific Advisory Board appointed jointly by Sahlgrenska Academy (SA) and Sahlgrenska University Hospital (SU). I was in charge of calling meetings, and the assignment for the board was to evaluate the resources available in Gothenburg and provide recommendations on which investments to make so that we could live up to the region’s intentions with BOIC. The board concluded that extra facilities and extra equipment for research/teaching were needed, but even more important was shoring up staff, including adding several senior academic positions. I’m happy to see that that two open professorships within Radiology have recently been announced, a direct result of our analysis. The advisory board also noted that cooperation in the region needed expanding, both between different medical units and local organizations, as well as with other universities in western Sweden and the rest of Sweden.
BOIC would be a flexible building, designed to be adaptable to future changes. The new, modern spaces are now filled with a range of modern imaging equipment for both diagnosis and treatment. The common and most important denominator to every activity at BOIC is imaging. I see the need for continued investment in imaging functionality that increases efficiency and safety. An important factor in this is access to a well-functioning image register that stays within the limits of patient data privacy laws, while making images available for academic studies and industry conducting health care research. Such a register could store all captured images to allow retrieval of the data in its original form. This would allow new analysis as needed. For this, we have high hopes for the new image and function register (BFR), which is under development in the region.
Today modern diagnostic imaging includes studies of more functional character, where large amounts of image data are evaluated, such as by obtaining actual information about how fluids are transported in different tissues (diffusion) or by bleeding into different tissues (perfusion). These and other new functional techniques are developing rapidly and have become increasingly important, not only for diagnosis of diseases, but also for the evaluation of different treatments and treatment options. Analysis is primarily carried out today by our radiologists, who are receiving increasing numbers of images to review for each individual patient. Many other major medical centers at other universities around the world have solved this by establishing imaging labs, something I think would be an effective solution here in Gothenburg. This type of an image diagnostic laboratory is entirely dedicated to providing various image analyses, including reformatting and volume analysis of various structures. In the long term, such an effort would lead to lower costs, since the reduced workload of doctors can allow them to conduct more patient exams.
Through BOIC, the region and Sahlgrenska University Hospital are gaining access to more equipment, which allows us to set aside some for research and development. Right now, the magnetic resonance building is most appropriate for this R&D, both because of its facilities and for its location—near BOIC with direct access from the street level for outpatients as part of research studies. In the long term, the building will likely be demolished, when the health system needs new patient wards. It would be preferable to have access to more and centralized premises adjacent to BOIC, where we can pull together all the academic aspects linked to developing diagnostic imaging and image-guided therapy.
MedTech West (MTW) was established in 2009 by VGR, SU, the University of Gothenburg, Chalmers University and the University of Borås as a network and a platform for medical technology in western Sweden. The region has long had a number of established research front lines associated with different units within universities/colleges and health care services in the region. Today MTW has more than 40 collaboration projects aimed at solving clinical problems and challenges. An interesting example of this is a new technology advancement in magnetoencephalography (MEG) and magnetocardiography (MKG) that goes under the name of “Focal-MEG”. This new technology is based on a completely new type of sensors compared to what is found in today’s MEG cameras, such as those used at the Karolinska Institute. The new technology means that the distance between the sensors and the skin shrinks by replacing refrigerant (today helium) with nitrogen. This allows smaller sensors and higher image resolution. The project has now reached a stage where partial studies of brain function and studies of electrical conduction in the heart can now begin. Through the injection of additional research funding and a suitable facility, SU researchers hope to develop a finished product here in Gothenburg, which would benefit the entire region. “Stroke Finder”, a stroke helmet, is another good example of a product being developed at MedTech West. The development of these and similar products requires well functioning clinical trial units and support for applications and patents. The region has shown foresight and established, among other things, Gothia Forum and the Innovation Platform, both of which will have great significance for research and development within BOIC.
To optimize and benefit from our diversity, we should now strive to bring together all our academic activities within image development into one building, including radiology, clinical physiology and neurophysiology, MedTech West, MFT and even training simulators for health professionals. This increases our potential for interaction, and the different expertise can support each other through this symbiosis of clinical practice and academia. In addition, it would be appropriate to located a future image lab here to support both research and clinical practice throughout the region.