An ageing population and the increasing prevalence of obesity and other metabolic risk factors in younger generations have caused a rapid increase in the incidence of chronic diseases (cancer, cardiovascular diseases, and dementia). Without effective, cost-effective, and non-invasive methods for early detection and treatment, healthcare costs become unaffordable. The Netherlands already spends 9-13% of its GDP on healthcare, amounting to €50 billion (OECD definition) / €75 billion (CBS definition). The Netherlands Bureau for Economic Policy Analysis (CPB) estimates the real increase of healthcare costs to be 4.2% per year, more than twice the average rate of projected economic growth.
In contrast to therapeutic drug development, development of medical imaging devices to date has been driven by potential technical achievement instead of clinical demand. Currently, new diagnostic imaging devices are applied without restriction to multiple clinical problems based on the referring physician’s choice, without validation or comparison to existing technologies. Physicians seldom select the most clinically and cost-effective solution to specific problems. Unexpected findings further increase diagnostic and therapeutic costs, elevating the perception of new or imagined medical conditions in the general population.
The CMI research program aims to redirect this autonomous trend and its high impact on public health and costs. CMI will investigate and develop minimally to non-invasive medical imaging techniques and imaging biomarkers improve existing technologies and optimize their integrated use for diagnostic and therapeutic purposes (theranostics). Cardiovascular disease, oncology, infection and inflammation, and neurodegenerative and psychiatric diseases (Ageing Brain) are the major CMI research themes. Medical imaging innovations have major impact on the individual patient and society, improving healthcare quality and containing future costs. Next-generation imaging technologies will enable early diagnosis of diseases such as cancer, infections and Alzheimer’s disease leading to efficacious early interventions. New and more effective imaging tools and methods will ultimately facilitate non-invasive diagnosis, therapy and monitoring.
Research should be centered on the most pressing and relevant clinical needs, aligning new technological development with clinical demands for early diagnosis, early intervention and minimally invasive therapies in close combination with Health Technology Assessment (HTA) studies. CMI research concentrates on existing and new imaging technologies and tracer development on the various existing and novel imaging platforms, and combinations thereof: magnetic resonance, X-rays/computed tomography, ultrasound, optics, optoacoustics and molecular imaging. Four ‘enablers’ bring a third dimension to the strategic agenda: targeted contrast agents, navigation technology/image guided therapy, medical imaging informatics, quantification / standardization / calibration, and HTA. These ensure that medical imaging maintains accuracy, controllability, efficiency and effectiveness. These are critical in research and development as well as its diagnostic and treatment applications. These platform enablers cover all imaging technology and disease areas.
In its ‘early detection strategy’, CMI focuses on techniques with high predictive power to exclude rather than demonstrate diseases. Biomarkers that can identify individuals who have a negligible risk of developing a disease over the next five or ten years allow these individuals to be excluded from further monitoring and more expensive and/or more invasive testing. CMI’s low cost, high sensitivity tests such as calcium scoring and lung cancer screening are expected to reassure patients, reduce medicalization and contain healthcare cost.