Search

Background: Advanced imaging techniques play a pivotal role in oncology. A large variety of computed tomography (CT) scanners, scan protocols, and acquisition techniques have led to a wide range in image quality and radiation exposure. This study aims at implementing verifiable oncological imaging by quality assurance and optimization (i-Violin) through harmonizing image quality and radiation dose across Europe., Methods: The 2‑year multicenter implementation study outlined here will focus on CT imaging of lung, stomach, and colorectal cancer and include imaging for four radiological indications: diagnosis, radiation therapy planning, staging, and follow-up. Therefore, 480 anonymized CT data sets of patients will be collected by the associated university hospitals and uploaded to a repository. Radiologists will determine key abdominopelvic structures for image quality assessment by consensus and subsequently adapt a previously developed lung CT tool for the objective evaluation of image quality. The quality metrics will be evaluated for their correlation with perceived image quality and the standardized optimization strategy will be disseminated across Europe., Results: The results of the outlined study will be used to obtain European reference data, to build teaching programs for the developed tools, and to create a culture of optimization in oncological CT imaging., Conclusion: The study protocol and rationale for i‑Violin, a European approach for standardization and harmonization of image quality and optimization of CT procedures in oncological imaging, is presented. Future results will be disseminated across all EU member states, and i‑Violin is thus expected to have a sustained impact on CT imaging for cancer patients across Europe., Competing Interests: Declarations. Conflict of interest: T. Jorg, M.C. Halfmann, L. Müller, F. Stoehr, P. Mildenberger, M. Hierath, G. Paulo, J. Santos, J. Damilakis, I. Kralik, B. Brkljacic, D. Cvetko, D. Kuhleji, H. Bosmans, D. Petrov, S. Foley, P. Toroi, J.P. McNulty and C. Hoeschen declare that they have no competing interests. i‑Violin will only deal with fully anonymized patient data, to avoid any ethical issues. However, each participating clinical site will inform their ethical review board. Ethics approvals will be obtained from the appropriate bodies prior to starting i‑Violin image collection activities according to the requirements of the respective institutions. The study will be performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The supplement containing this article is not sponsored by industry., (© 2024. The Author(s).)