@neurIST: Integrated Biomedical Informatics for the Management of Cerebral Aneurysms

When considered separately from other cardiovascular diseases, stroke ranks third among all causes of death, after heart disease and cancer. Worldwide, 3 million women and 2.5 million men die each year from stroke. Hemorrhagic stroke occurs when a blood vessel, typically an aneurysm, ruptures inside the brain. This often leads to severe disability or death. Despite considerable advances in treatment, rupture is associated with exceptionally high levels of morbidity and mortality (about 33% in each case).

Currently, invasive or minimally invasive treatment is offered to almost all patients because there is insufficient evidence to support a decision of non-intervention. It is the primary thesis of @neurIST that the process of cerebral aneurysm diagnosis, treatment planning and treatment development is significantly compromised by the fragmentation of relevant data. To address this issue, @neurIST is developing a complete IT infrastructure for the management and processing of heterogeneous data associated with the diagnosis and treatment of cerebral aneurysm and subarachnoid haemorrhage.

It will provide seamless access to data spanning the range of scales, from molecular, through cellular, tissue, organ, and patient level, to population level.

@neurIST will transform the management of cerebral aneurysm by providing new insight, personalised risk assessment and methods for the design of improved medical devices and treatment protocols.

@neurIST is a European initiative within the Sixth Framework Programme Priority 2 of the Information Society Technologies IST. This 4 year multidisciplinary project started on January 1st 2006 and involves 28 public and private institutions (including industrial, medical and academic organisations) from 12 European countries.

@neurIST aims to produce a set of integrated software information retrieval, processing and management suites. Demonstration of the benefits of this integrated IT management infrastructure will also provide a platform for the application of this new approach using, complex data fusion, information extraction, processing and inferential deduction to the treatment of other disease processes.

The @neurIST project will:

  • develop a new procedure and IT-support system for cerebral aneurysm management.
  • identify and collect all publicly-available, relevant and strategically important data from scientific studies.
  • deliver a rich, multiscale information processing chain that will provide new diagnostic indexes and insight into the process of aneurysm development and rupture.
  • develop a set of scalable and reusable integrative suites and demonstrate their value for revolutionizing the understanding and management of cerebral aneurysm.

@neuLink will create an IT environment for the identification of genes associated with the disease and for the integrated analysis of genetic epidemiology (providing a template for future genetic epidemiological studies) and clinical data.

@neuFuse will provide an open source environment to fuse diagnostic and modeling data (using state of the art segmentation techniques, multimodal registration and advanced visualisation techniques) into a coherent representation of the patient's condition.

@ n e u R i s k will produce a personalised risk assessment and treatment guidelines by integrating all available information.

@neuEndo will deliver an innovative IT system for supporting the design of implantable devices (such as coils and stents) and, intervention planning by simulation of the structural, haemodynamic and biological response to intervention.

This will include advanced numerical-simulation tools to predict the occurrence of device-related thrombosis and drug elution.

  • Provide an ICT-system for developing, integrating and sharing biomedical knowledge related to cerebral aneurysm as required by the four integrative suites. The @neurIST infrastructure will not only support computationally demanding tasks such as complex modeling and simulation (@neuCompute) but also enable access to health data distributed in public and protected data bases distributed all over the world (@neuInfo).
  • Inspire and promote the development of corresponding systems for other disease processes by demonstrating the personal and economic impact of IT-enabled information integration in the context of cerebral aneurysm management.

Expected Results & Impacts

Owing to the increased use and improved resolution of modern imaging technologies, the number of nonsymptomatic aneurysms found during clinical examinations will continue to increase. This will result in increasing burden on healthcare resources.

Integration of multiple clinical data and use of grid-based IST systems provides the platform to tackle this problem. It is anticipated that healthcare costs can be reduced significantly if the relevant patient population is optimally targeted and unnecessary and potentially risky interventions can be avoided.

The primary aim of @neurIST is to assist the clinical decision-making process by providing an objective measure of risk, based on all available data, and thus to reduce patient anxiety and unnecessary treatment by identifying those individuals who do not have high risk of rupture.

Measurable benefits of @neurIST will include the quantification of risks, including those of intervention and non-intervention. By combining the efforts and expertise of clinicians and industry, patients will benefit from improvements in diagnostics, prevention and treatment including personalized design of endovascular devices.

Aside from improved patient management and anxiety reduction, the potential economic benefit in Europe is enormous: taking into account the prevalence of this disease [1-5%], the annual rupture rate [0.2-1%], and the average treatment and 1st-year follow-up costs of patients [50kEuro], it is estimated that, in Europe alone, the cost of unnecessary interventional or surgical procedures are in the order of thousands of million Euros per annum.

Role of Fraunhofer SCAI in @neurIST

Participation in the @neurIST project is of utmost importance to Fraunhofer SCAI. We are contributing our expertise in text mining to the application suite @neuLINK and we are responsible for the work on semantic data mediation in @neurIST. Working in this multi-disciplinary project with ICT professionals, clinical researchers and biomedical image processing and simulation experts has stimulated lots of new developments at SCAI.

More concrete: we have developed a disease – specific data base harbouring relevant knowledge on genes involved in the disease. Together with our partners at the IMIM institute in Barcelona we have aggregated information on disease – specific genes, their allelic variation and their function as drug targets (if known from the literature). All this disease-centric information has been aggregated fully automatically and we are looking forward to transfer this approach to other disease areas.