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10 Questions with….. Wouter de Monyé

By | Expert Series, News

Dr. Wouter de Monyé is the Medical Director of Radiology at Spaarne Gasthuis. Having graduated from the University of Utrecht in 1996, de Monyé went on to carry out research at Leiden University Medical Center and trained as a radiologist at Leiden University Medical Center and Royal Liverpool University Hospital.

Why do you do what you do? 

My motto first and foremost is to make people better. It’s a broad ambition but importantly it’s not just patients, but people, I strive to better. That’s why I love to teach and train within the hospital. I want to help my fellow medical colleagues come to patient diagnoses faster and more efficiently. 

What was your first job?

Funnily enough, cleaning a hospital when I was 15 years old.  My mother was a nurse and set me up waxing those long corridors. As a child I wanted to be a pilot, but this soon developed into the desire to become a flying doctor. You need to become a doctor first and the aviation part comes later. In the process, I discovered that radiology was my calling. I built computers on the side for a bit of extra money during my studies, but soon had to give this up when I started my research at Leiden University. 

What has been the highlight of your career so far? 

Becoming the Medical Director of my department. This has allowed me to influence systems and process and improve the circumstances we work in as doctors. At some point you think you’re doing your job and you’re being a professional, but ultimately it’s the same process time and time again. If you manage to get a helicopter view, you can see structural changes that could benefit not only one person, but a cohort of patients. I find being able to influence such change extremely rewarding. 

What is the most challenging aspect of your job? 

Getting the diagnosis right, particularly in acute situations. As a radiologist, you need to be able to ascertain what’s normal and abnormal and stick to it. But you also need to be able to know when to convey doubt. That’s the tricky part, especially when you don’t have time for a colleague to have a second look. Sometimes doctors put you on the spot – is it this or is it this? You find yourself having to give black or white answers in situations which are often pretty grey. 

Do you have any coping mechanisms for dealing with the stress of your profession?

That’s difficult to answer. I guess realising life can be over in the blink of an eyelid makes you focus on trying to build its most important elements,  like good relationships and friendships. 

Why is timely diagnosis so urgent in stroke?

The challenge to get things right is critical. Stroke is pretty common and its impact can be huge – everlasting, for the rest of a patient’s life. Quick diagnosis is key, but more and more research suggests even in cases with a larger diagnosis time interval, there is still benefit from intra-arterial thrombolysis. So having been proven in the Mr Clean trial that in acute situations this type of treatment option works, I think we’re now working towards expanding this approach to more patients. We’ll be seeing more situations whereby a possible clot has a chance to be treated in this novel way. I think the Mr Clean trial gets more relevant every year. 

Are there any challenges in the current stroke workflow? 

Getting the knowledge to the image, or the image to the knowledge. Doing the actual scans is no longer a problem. These days the CT scanners are able to produce high quality images in a very short amount of time. The challenge is interpretation. Those many images need to be analysed by an expert. Such professionals (ideally a neuroradiologist) are not always on call and a patient’s scan will often have to be interpreted by colleagues with less professional experience. 

Why is improving image sharing so vital? 

A waste of time is a waste of brain. If we can get an image to an expert as quickly as possible, that can be life altering for a patient. If a colleague needs help with interpretation, the current standard way of sharing images is difficult if you’re relying on your old fashioned Pacs system. You receive a call when you’re out and you have to go home, load up your computer, get the images up-  this can easily lose you 15 minutes which is absolutely critical. The shorter the door to needle time, the better the result. With StrokeViewer, I can immediately receive a patient’s CT scan on my mobile phone wherever I am. That saves time by enabling me to interpret the high quality images on the spot. It’s amazing and something I’ve never experienced with the regular Pacs system. Seamless image sharing makes everything so much easier. 

What are your thoughts on the added value of assisting image interpretation via artificial intelligence? 

 Assisting interpretation of CT images via artificial intelligence brings the bottom of quality up. It raises the bar.  If for whatever reason (timing, location etc.) a less experienced radiologist is interpreting the scans (which is common), AI can help him or her perform like an experienced radiologist. That’s something which is really becoming clear from Strokeviewer and is so helpful. As with any relationship, it takes time to build a relationship of complete trust. And similarly with any new technology, AI will need to prove itself in clinical practice. But we are currently seeing real life applications of artificial intelligence and it is amazing how fast my colleagues are beginning to rely and trust in it. It’s definitely going in the right direction.

How would you describe the current relationship between radiology and artificial intelligence? And how do you see this progressing? 

In radiology we’ve had digital images for quite a long time, more than 15 or 20 years. Even in the early stages there were various computer aided detection promises. But it’s only very recently, in the past 3 or 4 years, that deep learning and artificial intelligence, actually make possible what was promised all that time ago. I’ve worked with systems which have tried to do similar things but in a poor way. As with any relationship, it takes time to build a relationship of complete trust. And similarly with any new technology, AI will need to prove itself in clinical practice. But we are currently seeing real life applications of artificial intelligence and it is amazing how fast my colleagues are beginning to rely and trust in it. It’s definitely going in the right direction.

 

Nico.lab improves clinical practice with innovative and trusted AI. Our product StrokeViewer, is an AI-powered clinical decision support system, offering a complete assessment of relevant imaging biomarkers within 3 minutes.

 

StrokeViewer launches in North-Holland and Flevoland

By | News

Nico.lab is excited to announce that this week StrokeViewer®️ was launched in the North-Holland and Flevoland region in the Netherlands, covering 10 hospital sites. Using advanced Artificial Intelligence (AI) techniques in an innovative cloud infrastructure, StrokeViewer allows for faster and more accurate treatment decisions. This regional approach in using AI to improve the stroke workflow marks a new chapter in improved patient care. 

In the highly acute setting where every minute counts, StrokeViewer instantly alerts radiologists that brain scans from a suspected stroke patient are ready for review. The physicians are then able to immediately view the images wherever they are, even on their mobile phones, saving precious time. The AI immediately shows crucial information on the type and severity of the stroke, which allows for a quick and accurate decision to be made on the best course of treatment.

In many cases the patient must then be transferred to the regional Intervention Center to receive specialised treatment. Until now the region has struggled to safely and quickly transfer the medical images to the treating hospital, a crucial step in allowing Interventional Radiologists to plan surgery before the patient arrives. StrokeViewer uses an innovative cloud infrastructure, which allows peripheral hospitals to securely share medical images in minutes with the treating physicians. 

Nico.lab believes that only through an integral approach addressing the entire stroke workflow significant improvements can be made. That’s why StrokeViewer not only comprises cutting edge AI algorithms, but embeds them in an innovative IT infrastructure that makes life easier for the radiologists. Through this technology and the regional collaboration Nico.lab hopes that many patients recover better and faster from stroke. 

 

Amsterdam UMC and Nico.lab awarded grant to improve stroke treatment with AI software

By | News

Amsterdam UMC and Nico.lab received €800.000 from the Dutch Ministry of Economic Affairs. This subsidy was awarded to develop Artificial Intelligence (AI) methods to accelerate Magnetic Resonance (MR) imaging and analysis in stroke victims using the Google Cloud Platform. The project aims to enable hospitals to acquire brain scans ten times faster, making MR suitable for the acute clinical setting where minutes matter. With this grant, the consortium aims to improve the complex decision-making in stroke and shorten the time that is needed to initiate appropriate therapy, thereby improving the quality of life after stroke.

Fast diagnosis and treatment is key when suffering a stroke to prevent irreversible cell death and concomitant brain damage. CT imaging has been the predominant modality of choice for diagnosis and treatment planning, as it is fast, inexpensive and readily available. Its main limitation, however, is the limited sensitivity in the hyperacute setting. Manifestation of CT features is a process lasting several hours, making evaluation of CT scans difficult. MR is currently only scarcely used in stroke imaging. 

STAIRS

The project STAIRS – Stroke treatment decision support by Artificial Intelligence for analysis of MR images – was established to investigate and develop novel AI techniques to accelerate MR imaging, and enhance its interpretation. Ten times accelerated MRI imaging and robust AI analysis will be developed and tested in the North-Holland, the Netherlands environment to demonstrate a short door-to-treatment time for patients. 

The consortium partners combine experience and expertise to lead the project and transform MR imaging in stroke. Amsterdam UMC, a world-leading stroke center, together with two other Dutch Academic Medical centers initiated and executed the renowned MR CLEAN trial that revolutionized stroke treatment and has extensive knowledge on stroke and MR imaging as such. Nico.lab successfully developed AI algorithms for CT imaging, and has a strong skill set in utilizing advanced AI to tackle medical imaging problems. Google Cloud Platform offers high-speed data access, as well as dedicated High Performance Computing resources, needed to enable MR image analysis by AI in the cloud. The company Qlouder aims at delivering cloud solutions to their partners.

Matthan Caan, assistant professor Amsterdam UMC: “The objective of STAIRS is improving AI-supported treatment planning of acute ischemic stroke based on MR imaging as an alternative to CT, enhancing efficiency of AI methods and exploiting hardware opportunities to its max. This AMC TKI-PPP subsidy allows us to take significant steps to improving decision-making in acute stroke”

 

Press release: Nico.lab to Australian stock exchange and North America

By | News, Press Release

Amsterdam, August 27th 2018 – The Dutch healthtech company Nico.lab prepares for an IPO in Australia after the company has previously collected 3 million euros from Australian investors. In addition, Nico.lab will enter the US market. Nico.lab is the result of a collaboration between Amsterdam UMC and health tech venture builder NLC. With years of intensive clinical research in the Amsterdam UMC, the company has developed StrokeViewer®, a software product that significantly speeds up the diagnosis and treatment of strokes. Nico.lab now focuses on making StrokeViewer based on artificial intelligence (AI) available to more and more patients.

In the treatment of stroke, speed is crucial to limit the brain damage for the patient as much as possible; a patient quickly loses 27 healthy days of life per minute of treatment delay. Using AI, Nico.lab software analyzes brain scans to recognize and accurately assess stroke indicators. This all happens in a few minutes and thus considerably increases the chance of a positive result for the patient. In addition, the algorithm contains self-learning ability, and provides additional knowledge about this common disease and the functioning of the brain in such a serious situation.

This year, StrokeViewer is tested among 3,000 patients in various hospitals in the Netherlands and compared with the current method that has been used for years to diagnose a stroke. In other countries, the results achieved with StrokeViewer did not go unnoticed and Nico.lab recently won a European prize of half a million euros. The company has also been asked to participate in clinical trials in North America and Australia.

In order to meet the growing demands for StrokeViewer, new investments are necessary. The large Australian investment interest has resulted in Nico.lab attracting 3 million euros in investments from various investors. The investment round is part of an IPO in Australia. The IPO of Nico.lab is planned for early 2019. In addition to interest from Australia, there has also been interest from North America. Tech giants, including Google, Intel and HP have entered into a partnership with Nico.lab to prepare for the introduction of StrokeViewer on the US market in early 2019.

Merel Boers, Chief Research Officer at Nico.lab: “We are very pleased with the great interest in our product that combines the latest clinical research results with state-of-the-art AI technology. This movement shows that an impact can be made in health care. We want to work hard on further expanding StrokeViewer in the coming years to help more patients. ”

About Nico.lab

Nico.lab’s StrokeViewer uses Artificial Intelligence to shorten the time of determining the appropriate treatment for strokes to a few minutes, where it can sometimes take hours under the current method. StrokeViewer is now being rolled out in several Dutch hospitals. Nico.lab is the result of a collaboration between Amsterdam UMC and health tech venture builder NLC.

For more information please contact:
020 244 0852 / info@nico-lab.com

Nico.Lab wins grant & approached to use StrokeViewer® in 3 clinical trials

By | News

In July, Nico.Lab won a grant from the European Union in excess of AUD 700,000. The funds received will be used to implement a project together with a Canadian partner, which received an additional amount AUD 450,000. With this subsidy, Nico.Lab will develop and test a new Artificial Intelligence algorithm to significantly enhance and speed up stroke treatment in North America.

Please read this article on Australia’s Wholesale Investor.

Nico.lab welcomes the new European General Data Protection Regulation (GDPR)

By | News

On May the 25th, the new General Data Protection Regulation (GDPR) comes into effect in the European Union. With the GDPR, the EU aims to protect the privacy and personal data of all citizens. The GDPR gives every individual primary control over his/her data, and holds all companies and organizations accountable for safe and legitimate processing of this data.

The GDPR has an important impact on the collection and processing of medical data. As a processor of sensitive medical data, Nico.lab welcomes and emphasizes compliance with the GDPR. Nico.lab incorporates security of StrokeViewer as one of its core values in the development of StrokeViewer, making StrokeViewer secure-by-design. Also, StrokeViewer only shows the necessary information for diagnostic purposes “by default”, and can be tailored per hospital. To ensure the utmost quality of our company Infomation Security Management System (ISMS), Nico.lab is supported by fore-front legal offices specialized in medical technology.

We are happy to answer any questions regarding privacy and security. Please send a message via our contact page. For further information regarding the GDPR, please read the information provided by the EU.

Visit Nico.lab at the European Stroke Organization Conference (ESOC) 2018

By | News

Nico.lab will be present at this year’s European Stroke Organization Conference (ESOC), held in Gothenburg, Sweden from May 16th-18th. The ESOC is one of the world’s leading conference on stroke, enabling learning, discussion, and exchange among European and international stroke specialists. Guided by the motto “The Voice of Stroke in Europe,” the Conference focuses about the latest clinical trials and developments in all areas of stroke management, treatment and prevention.  Visit us in the Exhibition hall at Booth 32b for a demo.

Press Release: Better treatment of stroke using artificial intelligence and blockchain

By | News, Press Release

Amsterdam, 21th March 2018  Every year about 50,000 people in the Netherlands are affected by a stroke. About 10,000 of these patients die and this number continues to increase. In order to reduce mortality, it is crucial to start the right treatment as soon as possible. Innovative technologies such as artificial intelligence and blockchain can help improve the outcome of a stroke.

For this purpose, Nico.lab, a spin-off of the Academisch Medisch Centrum (AMC) and developer of medical artificial intelligence, in collaboration with Tymlez, a provider of enterprise blockchain technology, have joined forces. Both companies are starting a pilot this month with a number of hospitals for superior treatment of strokes. They received funding from the Ministry of Economic Affairs and climate, which underlines the importance of these innovations.

Stroke is the leading cause of death after heart diseases and cancer in our country.

Rapid treatment crucial
Every hour that doctors are going to treat earlier, the number of patients who will recover without major problems increases by 15%. This means not only a significant improvement in the quality of life, but also a decrease in the economic cost of stroke. These amounts are currently more than EUR 1.7 billion per annum for the Netherlands.

A doctor can only choose the right treatment if there is a lot known about the problem in the patient’s brain, as with an infarction, the exact location of any blood clot. Viewing the scans by a doctor is however complex and time-consuming. Moreover, in practice, the analysis of the brain scan does not always lead to the correct diagnosis, which can have major consequences for the treatment and how the patient eventually recovers from the stroke. This also leads to unnecessarily high costs.

Artificial intelligence: fast and precise
The use of artificial intelligence in the treatment of stroke is an important improvement. These algorithms are, by applying the latest computer technology, not only fast, but also precise due to their learning ability. Nico.lab also makes the artificial intelligence solution available via the cloud, allowing hospitals to use it in a low-threshold way. These savings are estimated at over € 200 million on an annual basis, in light of the current costs of € 1.7 billion per year.

Because the computer for this artificial intelligence is not in their own hospital, the scans are encrypted and sent to Nico.lab via an internet connection at lightning speed. After analysis, the specialist receives the notification that he can log in to view the scans and the result itself. It is not important whether the neurologist is in a hospital or in a foreign hotel room while visiting a major medical conference or enjoying a day off at home.

Blockchain technology guarantees patient data confidentiality.
Naturally, confidentiality must be guaranteed when exchanging patient data. Because this is an exchange of privacy-sensitive data in a chain of medical professionals, the use of blockchain technology is the solution. Where many blockchains are known for cryptocurrency such as Bitcoin, the power of blockchain is security in data exchange. Tymlez ensures that all parts in the chain of people and machines are connected to the system via an unbreakable and safe process. The brain scans are then uniquely coded, so that they can only be shared with chain participants who are authorized to do so. The security of patient data is fully guaranteed in this way.

Note for editors:
For more information please contact:
Robert A. Kuipers, CEO Nico.lab: 06 1258 6631.