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Enabling more impactful radiology solutions for cancer care through co-creation

A model for developing new healthcare tools



corporateblog juliuschapiro

There is a lot of talk in the healthcare industry right now about the concept of “co-creation.” This is the idea that health tech suppliers work in close partnership with clinicians, clinical researchers, healthcare administrators, etc. to develop new tools for the healthcare sector.


As a clinician myself, I think co-creation is – in principle – an excellent idea. It allows the industry to address challenges that neither tech suppliers nor healthcare providers could tackle on their own.


I have first-hand experience of this. Our group was looking at ways to assess more quickly how a patient was responding to cancer treatment. This everyday clinical task remains one of the key issues of patient care in all oncology centers. Previous attempts to address it had proven insufficient. But by teaming up with Philips, and bringing our differing areas of expertise together, we were able to find a new solution: the qEASL* (quantitative European Association for the Study of the Liver) multi-modality tumor tracking concept.


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A Win-Win Situation

I’m sure all of us in healthcare have seen plenty of hardware and software products that were clearly developed by brilliant engineers and programmers in technology companies with no exposure to the realities of healthcare and the actual challenges we face with our patients every day. These tools work perfectly in ideal models, but quickly become a hindrance rather than a help if faced with clinical reality, so they rapidly stop being used and fade from the market.


By getting clinicians and other healthcare professionals involved from the start, co-creation should mean that new healthcare tools are designed with the users’ needs foremost. Tools should be more focused on areas where they can make the most difference or where the need is most urgent. And they should be easier for us to use within our current work flows.


As clinicians we all value our time and cannot afford wasting it with imperfect solutions. After all, technology is supposed to be user-friendly and should make our lives easier. That’s why our team believes that an academic-industry partnership is the best way to develop clinical solutions for a faster, better and thus more cost-effective patient care.


Co-creation will benefit health tech companies as well. They can focus their resources and investments on products they know will appeal to their target markets and so have a greater chance of being successful.


True Partnerships

At least, this is how co-creation should work. Clinicians should always be careful when getting involved with commercial companies. There can be pressure on them to move too quickly towards a saleable product before the concept is sufficiently validated. I’ve also heard stories from colleagues where the health tech companies they worked with really didn’t seem interested in listening to their concerns, thoughts or ideas. This made the “co-creation” experience less than pleasant, and the resulting tools were not as useful as they could have been.


Fortunately, my own experience of co-creation was much happier. Philips has a program where it embeds its own researchers at some of its key partners. At the time, I was working at Johns Hopkins within the research group of Professor Jeff Geschwind, M.D., Chairman, Department of Radiology and Biomedical Imaging at Yale School of Medicine, and the Philips person embedded with us was Ming De Lin, Senior Clinical Site Researcher at Philips.

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Faster Assessment of Cancer Therapies

Our group was part of the leading liver cancer centers world-wide and was interested in developing ways to ensure a patient was on the right treatment plan as early as possible to increase the chance of a positive outcome. That meant assessing the tumor’s response to the current treatment, which in our case was the local tumor therapy called chemoembolization. All the existing methods for doing this are based on manual 1- or 2D measurements on axial slices taken from medical images of the tumor. We started discussing with Ming and his colleagues how we could get more information on the tumor from those images; how to make the measurements 3D and more quantitative.


For me, it was a fantastic experience to be working side-by-side with an Ivy League-based PhD-level engineer. We talked every day, looking at the same clinical issues but from completely different perspectives. All the Philips people we worked with were really keen to listen to and learn from us. They really got to understand the clinical challenges we face in trying to tackle a tumor, and they taught us about the technical options and possible solutions. And throughout the development, we worked as a team. When there were problems we couldn’t solve individually, we could pool our expertise and address them together.


Development for Clinicians, by Clinicians

As a result, we’ve developed a concept of which we are all very proud. qEASL* allows researchers to make a specialized analysis of 3-D imaging scans (e.g. CT and MRI) with the aim to enhance measurement of living and dying tumor tissue by given them a visual indication of how cells respond to therapy.


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Quantitative tumor viability (qEASL*) before and after chemoembolization (TACE). Much of the viable tumor (colored) becomes less enhanced (transparent) after the treatment. Tumor viability percentage (represents the percentage of the entire tumor volume showing enhancement more than normal liver tissue), viability volume and total volume are automatically calculated.


Personally, one of the nicest parts about working with Philips was that at no time did they put any pressure on us to speed up development. They let us clinicians take the lead, and develop a strong first evidence-base on the use of the application. Researchers can now start using qEASL for liver, uterine and brain tumors using a variety of imaging modalities.


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qEASL* is an option for qualified researchers which can be used in conjunction with the Multi-Modality Tumor Tracking (MMTT) application included in IntelliSpace Portal.


We are keen to develop the concept into an official guideline. Here Philips’ large network of clinical partners is a big help and we continue to work as a team along this exciting journey.


For me, the co-creation approach we employed with Philips is an excellent model for future development products. It’s definitely an experience I would be happy to repeat. And it has helped us create an application that is both extremely valuable and useable for radiologists. We know this from the growing number of people and institutions who are keen to participate and lead clinical studies with our tool. I encourage anyone interested in teaming up to contact Philips’ Yossi Kam.


*For research use only.


Philips’ Radiology Solutions will be available for consultation at booth #6736 at the
RSNA Annual Meeting through Dec. 4 in Chicago, Ill. Follow @PhilipsLiveFrom on Twitter or visit for more information on Philips’ presence at

corporateblog juliuschapiro

Julius Chapiro, MD


Co-Director of the Interventional Oncology Research Lab at Charité University Hospital

Dr. Julius Chapiro obtained his MD from the University of Leipzig, Germany. After a research tenure at the Yale University School of Medicine, he joined the Department of Radiology at the Johns Hopkins University School of Medicine and was among the creators of the qEASL* software and criteria in close collaboration with Prof. Jeff Geschwind and Philips Clinical Scientist Ming De Lin, PhD. Currently, he is the Co-Director of the Interventional Oncology Research Lab at Charité University Hospital in Berlin, Germany. His research focuses on creating novel targeted therapies for liver and other GI cancers and developing new 3D quantitative tumor response criteria for image-guided liver cancer therapies.


A recipient of several research grants, including from the German-Israeli Foundation for Scientific Research and Development, Rolf W. Günther Foundation and Charité Clinical Scientist Program, he has authored and co-authored numerous high-impact scientific articles and abstracts on interventional oncology and specifically the treatment of liver cancer in journals such as Nature Gastroenterology and Hepatology, Hepatology, Clinical Cancer Research, Radiology and European Radiology.

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