A team of authors led by Dr. Sam Hare of the Royal Free London National Health Service (NHS) Trust in London described how a central COVID-19 imaging repository, launched by the British Society of Thoracic Imaging (BSTI), could enable less diagnostic variation and better patient care, as well as facilitate rapid accumulation of knowledge.
"Such a database would also allow real-time tracking of confirmed CT cases and allow improved understanding of the significance of cases with positive CT findings, but negative reverse transcriptase polymerase chain reaction (RT-PCR) results," they wrote. "This will help collate valuable information for the NHS and Public Health England."
The role for CT in diagnosis, triage, assessment, and surveillance of COVID-19 remains somewhat controversial and subject to change. It's critical to keep the U.K. diagnostic community fully informed of emerging guidance, according to the authors.
"This can be achieved as a collaborative effort by feeding a central library of the medical examples encountered and rapidly sharing expert opinions to frontline medical care staff, nationally and internationally," they wrote.
The platform for the BSTI project has been provided for free by British cloud-based PACS and image software provider Cimar UK and powered by software company Ambra Health. Cimar's cloud platform currently hosts more than 9 billion images worldwide.
"The service is increasingly used by the NHS to solve imaging storage, interoperability, and rapid sharing needs," they wrote.
Any hospital or location can upload anonymized images to the encrypted online portal for patients either confirmed or suspected to have COVID-19. The authors noted that all imaging and supporting data will be stored without any identifiable metadata.
After the referred cases are uploaded and automatically anonymized by the cloud software, they are then routed via a restricted access workflow to a panel of BSTI diagnostic experts for approval and annotation, according to the researchers. Once approved, the cases will be added to the imaging database of known examples of U.K. patients for reference and teaching.
As of 3 April, the teaching library, which is available without having to log in, contained 43 cases. Teaching material will be published and refreshed on a regular basis, according to the authors.
The BSTI hopes to provide a resource that will help to "upskill all radiologists in the evolving clinical climate of COVID-19." What's more, webinars using content from the database are planned in collaboration with the Royal College of Radiologists.
"For the BSTI COVID-19 imaging repository and database to realize its potential in education and research in the U.K. and across the globe, we call on all radiologists to engage and upload cases," the authors wrote. "Every case of COVID-19 counts."
They also noted that the database could be rapidly upscaled to host nested registries for other countries and provide a global perspective on the pandemic.
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