ABSTRACT – Center for Virtual Imaging Trials The accelerating complexity of medical imaging devices and methods has largely outpaced the field's ability to evaluate and optimize their design and clinical use. Doing so through clinical trials is often not feasible or definitive due to ethical limitations, expense, time requirements, and/or a fundamental lack of ground truth (exact patient anatomy and condition). Most current approaches to assess imaging technologies outside of clinical trials rely on simplistic models and subjective perception of image aesthetics, and results cannot readily predict clinical efficacy. To fill this gap, the broad objective of the Center for Virtual Imaging Trials is to develop a virtual platform for assessing the effectiveness of medical imaging systems and methods for specific clinical tasks. The initial focus is on computed tomography (CT), both due to its widespread medical utility and its status as the largest source of medical radiation. Virtual imaging trials offer an efficient means to evaluate imaging concepts and technologies in silico by simulating the patient, imaging system, and image evaluation. Such virtual trials can be conducted quickly and cost effectively on a computer, providing researchers a practical way to answer fundamental questions using the precise controls and the exact knowledge of a modeled patient. They also enable objective optimization of current and emerging imaging technologies (hardware and software) to minimize radiation risk and provide quantitative accuracy. By accelerating and improving imaging technologies' evaluation and optimization, virtual trials support quality, safety, and effective practice of patient-centered care. To achieve its objective, the Center will develop, refine, and disseminate the essential resources to realistically model and represent a) patients, b) imaging systems, and c) image evaluation. These resources comprise the three Technology Research and Development (TRD) projects, which work synergistically with and provide resources to Collaborative Projects (CPs) and Service Projects (SPs). A Technology Training and Dissemination (TTD) component will distribute the Center's resources and provide the necessary training. Administration provides infrastructure, oversight, and integration. The overall Specific Aims are to (1) develop, consolidate, and streamline the required components to enable virtual imaging trials of existing and emerging CT imaging methods, (2) position virtual trials as an alternative methodology to quantify, evaluate, and optimize CT imaging, and (3) disseminate to the research community validated tools for efficient virtual trials in CT and train researchers to use them effectively. Using state-of-the-art simulation and analysis methods, the Center will provide the first comprehensive platform to assess the diagnostic capability of imaging technologies in their complete trajectory from design to use. The Center will have a notable impact on rigorous and reproducible scientific design, prediction, and practice of medical imaging, starting with CT, leading to measured reductions in radiation dose, improvements in image quality, and advancement of precision imaging.

NARRATIVE – Overall The broad objective of the Center for Virtual Imaging Trials is to develop and provide a comprehensive virtual platform to assess the clinical performance of medical imaging technologies or applications from design to use. In its first phase, the Center focuses on Computed Tomography (CT). The Center will provide essential resources to optimize the design and use of CT technologies for improved human health.