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医学影像和核医学:《柳叶刀》肿瘤学 委员会

已有 450 次阅读2021-4-16 15:51 |系统分类:医学科学

医学影像和核医学:《柳叶刀》肿瘤学委员会。Medical imaging and nuclear medicine: a Lancet Oncology Commission
Medical imaging and nuclear medicine: a Lancet Oncology Commission

癌症患者的诊断和治疗需要获得影像,以确保准确的管理决策和最佳结果。我们对影像和核医学资源的全球评估发现,设备和劳动力严重短缺,特别是在低收入和中等收入国家。一个11种癌症的微模拟模型显示,在2020年至2030年期间,影像的放大将避免全世界7600万由模拟癌症引起的死亡中的3.2%(2460万),挽救5492万生命年。影像、治疗和护理质量的全面提升将避免9550万(12.5%)由全球癌症模型造成的所有癌症死亡,挽救2.32亿个生命年。在2020-30年间,扩大影像规模将耗资60.84亿美元,但在全球范围内可获得1.23万亿美元的终身生产力收益,每投资1美元可获得179.19美元的净回报。将影像、治疗和护理质量的扩大相结合,将带来2.66万亿美元的净效益,每投资1美元,净回报12.43美元。在使用保守的人力资本方法的情况下,仅扩大影像规模就可带来209.46亿美元的净效益和31.61美元的净回报。综合规模扩大后,采用人力资本法的全球净效益为340.42亿美元,每投资一美元的回报率为2.46美元。这些改善了的健康和经济成果在所有地理区域都适用。我们建议采取行动和进行投资,以增强获得影像设备、劳动力能力、数字技术、放射性药物以及低分子量集成电路的研究和培训方案的机会,从而产生巨大的健康和经济效益,并在全球范围内减轻癌症的负担

图10:人工智能驱动的癌症患者成像工作流程
简化的人工智能驱动的成像工作流程的图解,其中数字技术使从患者注册到成像采集和解释的每个步骤实现自动化,标准化和优化
Figure 10: Artificial intelligence-driven workflow for imaging in patients with cancer 
An illustration of a streamlined, artificial intelligence-driven imaging workflow, in which digital technologies enable the automation, standardisation, and optimisationof every step, from patient registration to imaging acquisition and interpretation

The diagnosis and treatment of patients with cancer requires access to imaging to ensure accurate management decisions and optimal outcomes. Our global assessment of imaging and nuclear medicine resources identified substantial shortages in equipment and workforce, particularly in low-income and middle-income countries (LMICs). A microsimulation model of 11 cancers showed that the scale-up of imaging would avert 3·2% (2·46 million) of all 76·0 million deaths caused by the modelled cancers worldwide between 2020 and 2030, saving 54·92 million lifeyears. A comprehensive scale-up of imaging, treatment, and care quality would avert 9·55 million (12·5%) of all cancer deaths caused by the modelled cancers worldwide, saving 232·30 million life-years. Scale-up of imaging would cost US$6·84 billion in 2020–30 but yield lifetime productivity gains of $1·23 trillion worldwide, a net return of $179·19 per $1 invested. Combining the scale-up of imaging, treatment, and quality of care would provide a net benefit of $2·66 trillion and a net return of $12·43 per $1 invested. With the use of a conservative approach regarding human capital, the scale-up of imaging alone would provide a net benefit of $209·46 billion and net return of $31·61 per $1 invested. With comprehensive scale-up, the worldwide net benefit using the human capital approach is $340·42 billion and the return per dollar invested is $2·46. These improved health and economic outcomes hold true across all geographical regions. We propose actions and investments that would enhance access to imaging equipment, workforce capacity, digital technology, radiopharmaceuticals, and research and training programmes in LMICs, to produce massive health and economic benefits and reduce the burden of cancer globally.

Hricak H, Abdel-Wahab M, Atun R, Lette MM, Paez D, Brink JA, Donoso-Bach L, Frija G, Hierath M, Holmberg O, Khong PL, Lewis JS, McGinty G, Oyen WJG, Shulman LN, Ward ZJ, Scott AM. Medical imaging and nuclear medicine: a Lancet Oncology Commission. Lancet Oncol. 2021 Apr;22(4):e136-e172. doi: 10.1016/S1470-2045(20)30751-8. Epub 2021 Mar 4. PMID: 33676609.

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