NetZeroAICT Digital Contrast for Computerised Tomography Towards Climate Neutral and Sustainable Health Systems

计算机断层扫描（CT）是医疗保健中最常见的医学成像之一，每年全球进行3亿次CT扫描。其中，约1.8亿包括放射性造影剂（RCM）的使用。对比度增强CT（CECT）对环境产生了重大影响，即：42，000吨一次性包装，900吨手术钢（针），90，000吨塑料管和150，000，000千瓦时的能源消耗。这些设备每次扫描平均产生9.2千克二氧化碳。此外，CECT每年在水中产生20万吨碘污染。这是一种公认的“制药污染”。CECT也可能对患者造成伤害：针头插入、碘化RCM对肾脏的毒性（潜在肾衰竭）和过敏反应，在某些情况下可能危及生命。医疗保健系统占全球二氧化碳排放量的4.4%（2千兆吨/年）。其中，约3百万吨/年来自CECT。欧盟已通过欧洲绿色协议宣布其到2050年的净零目标。我们证明了人工智能（AI，深度学习方法）可以从非造影CT扫描中提取高级信息并“数字化”合成造影剂的可行性。这避免了对CECT实施RCM的需要。在此次Horizon大奖中，我们寻求开发和验证CT“数字造影”的5个用例。通过在全球范围内实施“数字造影”扫描，我们的目标是到2033年将CECT产生的二氧化碳和碘RCM废物减少30%。NetZeroAICT有一个宏伟的愿景，即为可持续卫生系统的未来定义一个可扩展的AI健康工具开发参考框架。这是建立在我们之前的AICT联盟的基础上的，该联盟的建立是为了使CT成像更安全，更有效，更公平和更可持续。NetZeroAICT将加速欧盟迈向NetZero的进程，并提升欧盟在医疗保健可持续发展方面的全球公认领导地位。

Computerised Tomography (CT) scan is one of the most common medical imaging performed in healthcare, Each year, 300 million CT scans are performed globally. Of which, around 180M include use of radiocontrast media (RCM). Contrast Enhanced CTs (CECT) create a significant environmental impact, namely: 42,000 tonnes of single use packaging, 900 Tonnes of surgical steel (needles), 90,000 tonnes of plastic tubing and 150,000,000 kWh in energy consumption. These generate on average 9.2 kg of CO2/ scan. In addition, CECTs generates 200,000 tonnes of iodine contamination in water/yr. This is a recognised form of ‘pharmaceutical pollution’. CECTs may also harm patients: needle insertion, toxicity of iodinated RCMs to kidneys (potentially kidney failure) and allergic reactions, which in some cases can be life-threatening. Healthcare systems are responsible for the 4.4% CO2 global emissions (2 Giga tonnes/yr). Of this, ~3 Mega tonnes/yr are generated from CECTs. The EU has declared its NetZero targets of by 2050 through the European Green Deal. We showed feasibility that artificial intelligence (AI, deep learning methods) can extract high level information from non-contrast CT scans and synthesise contrast ‘digitally’. This avoids the need to administer RCM for CECTs. We seek to develop and validate 5 uses cases of CT ’Digital Contrast’ during this Horizon award. By implementing ‘Digital Contrast’ for scans globally, we aim to reduce 30% of the CO2e and iodine RCM waste generated from CECTs by 2033. NetZeroAICT has a grand vision to define a reference framework for scalable development of AI health tools for a future of sustainable health systems. This builds on our prior efforts of AICT consortium, which was established to make CT imaging safer, more efficient, more equitable and more sustainable. NetZeroAICT will accelerate the EU’s trajectory towards NetZero and advance EU’s globally recognized leadership position on Healthcare sustainability.