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PURPOSE To improve outcomes for lung cancer through low-dose computed tomography (LDCT) early lung cancer detection. The International Association for the Study of Lung Cancer is developing the Early Lung Imaging Confederation (ELIC) to serve as an open-source, international, universally accessible environment to analyze large collections of quality-controlled LDCT images and associated biomedical data for research and routine screening care. METHODS ELIC is an international confederation that allows access to efficiently analyze large numbers of high-quality computed tomography (CT) images with associated de-identified clinical information without moving primary imaging/clinical or imaging data from its local or regional site of origin. Rather, ELIC uses a cloud-based infrastructure to distribute analysis tools to the local site of the stored imaging and clinical data, thereby allowing for research and quality studies to proceed in a vendor-neutral, collaborative environment. ELIC’s hub-and-spoke architecture will be deployed to permit analysis of CT images and associated data in a secure environment, without any requirement to reveal the data itself (ie, privacy protecting). Identifiable data remain under local control, so the resulting environment complies with national regulations and mitigates against privacy or data disclosure risk. RESULTS The goal of pilot experiments is to connect image collections of LDCT scans that can be accurately analyzed in a fashion to support a global network using methodologies that can be readily scaled to accrued databases of sufficient size to develop and validate robust quantitative imaging tools. CONCLUSION This initiative can rapidly accelerate improvements to the multidisciplinary management of early, curable lung cancer and other major thoracic diseases (eg, coronary artery disease and chronic obstructive pulmonary disease) visualized on a screening LDCT scan. The addition of a facile, quantitative CT scanner image quality conformance process is a unique step toward improving the reliability of clinical decision support with CT screening worldwide.

Erdheim–Chester disease is a rare form of non-Langerhans cell histiocytosis characterized by foamy histiocyte infiltration of the skeleton and viscera. A case of Erdheim–Chester disease that was initially mistaken for Ormond's disease is presented with a discussion of the tests required to differentiate between the two diagnoses. Background A 54-year-old man presented with fever, abdominal pain, anemia, elevated C-reactive protein level and decreased renal function. Idiopathic retroperitoneal fibrosis (Ormond's disease) had been diagnosed in the past, leading to surgical ureterolysis. Re-evaluation of the CT scans and histological biopsy samples revealed unusual sclerosis of the long bones and diffuse infiltrates of foamy histiocytes in the bone marrow and the retroperitoneum. Investigations Physical examination, laboratory tests including hemoglobin concentration, erythrocyte sedimentation rate, C-reactive protein level, β2-microglobulin level, creatinine level, CT of the chest and abdomen, bone scintigraphy, bone marrow and soft tissue biopsies and immunohistochemistry. Diagnosis Erdheim–Chester disease with retroperitoneal fibrosis and bone sclerosis. Management Treatment with glucocorticoids failed. The patient's symptoms improved significantly after initiation of interferon-α therapy.

This chapter is a series of short essays composed by key researchers and advocates of computed tomography colonography from several different countries. I hope this will help document some important historical information regarding the development of computed tomography colonography on a global scale. This information is not available in print in any single source and often incorporates a historical perspective never before appearing in print. Each section has its own style, content, and references. The essays are listed in alphabetical order of the country discussed: Argentina, Austria, Belgium, Canada, France, Germany, Ireland, Israel, Italy, Japan, Korea, Sweden, and the United Kingdom. Authors provided photographs of themselves and/or their research team, which are provided in an appendix at the back of the book.