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

计算机断层扫描(CT)扫描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180m包括使用放射造影剂(RCM)。对比增强CTS(CECT)产生了重大的环境影响，即：42,000吨一次性使用包装、900吨外科钢(针)、90,000吨塑料管和150,000,000千瓦时的能源消耗。每一次扫描平均产生9.2公斤二氧化碳。此外，CECT每年在水中产生20万吨碘污染。这是公认的“药品污染”形式。CECTs还可能对患者造成伤害：针头插入、碘化RCM对肾脏的毒性(潜在的肾衰竭)以及过敏反应，在某些情况下，这些反应可能危及生命。医疗保健系统负责全球4.4%的二氧化碳排放(2千兆吨/年)。其中，约300万吨/年来自CECT。欧盟通过欧洲绿色协议宣布了到2050年实现净零排放的目标。我们证明了人工智能(AI，深度学习方法)可以从非对比CT扫描中提取高级信息并以数字方式合成对比的可行性。这避免了为CECT管理RCM的需要。我们寻求在这个地平线奖期间开发和验证CT‘数字对比度’的5个使用案例。通过在全球范围内实施“数字对比度”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，即为可持续健康系统的未来定义可扩展开发人工智能健康工具的参考框架。这是建立在我们之前AICT联盟的努力基础上的，该联盟的成立是为了使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的轨迹，并提升欧盟在医疗保健可持续性方面的全球公认的领导地位。

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