Dr Olivier Balédent (University of Picardy Jules Verne) gives an update in his own words.
“The multidisciplinary team is now up and running at the University Hospital of Amiens and the University of Picardy Jules Verne, and the various facets of REVERT are coming together. The equipment has arrived at the Neurosurgery Department, and the infusion tests are being carried out by Dr Capel, who has organised a dedicated system for managing his REVERT patients with his team of nurses.
From one of his first patients, we have retrieved digital files from ICM+, which we can compare with cerebrovascular flow and cerebrospinal fluid dynamics from flow magnetic resonance imaging (MRI). The software analysis tools have not yet been developed to automatically combine these curves, but it is already possible to observe these initial results manually.
It is moving to finally see these ideas, put down on paper two years ago, come to life on the screen. It is moving, but above all very encouraging and rewarding.”
Processing the MRIs
“Over the last few weeks, we have had discussions with the other hospitals involved in REVERT, and the MRI protocol has been installed on the various machines. As a result, we have obtained the first flow acquisitions. We have put in place the software for securely transferring anonymised MRIs, so that Amiens University Hospital can recover the acquisitions from the University Hospitals of Caen and Brest. For Cambridge University Hospital, the MRIs will initially be processed on site before the legal transfer procedure is agreed.
We now have software installed for reading the MRIs produced by each of the hospitals, each of which have different machines. The processing will nevertheless be identical. Dr Pan Liu, the team’s software developer, is working hard to make the software user-friendly. He is currently working on integrating automatic and robust procedures to provide clinicians with dedicated software that only requires a very short training period. In parallel, he is continuing to work on the user documentation, which should soon be accompanied by a video tutorial.”
Numerical modelling of flow and intracranial pressure
“Meanwhile, Dr Kimi Owashi is developing the numerical modelling of the craniospinal system, the focal point of our acquisitions, which will provide new information on the biomechanical properties of this system. The work is complex since it involves the interaction of flows and intracranial pressure in a given morphology, specific to each patient. After having immersed herself in all things REVERT and in the literature around this subject, Kimi presented REVERT to the national research group MECABIO of the CNRS in Grenoble in early December. This small group of about fifty experts in the field of health simulation had discussions with her and advised her on our choice of simulation tool and our strategy for selecting a model.”
Cross-border training visits postponed due to Covid-19
“After a period of relative calm in terms of the pandemic, the end of 2021 saw another strong rise in Covid-19 infections. We therefore had to cancel our visit to Cambridge, which we had been planning for several weeks. Our aim was to train our UK colleagues in the use of the image processing software, perfecting the infusion test training, and reflecting together on the different combinatorial approaches to our results. We have also cancelled the trips initially planned to Caen and Brest. These visits will take place as soon as the health situation improves.
For now, the video conferencing tools we use for our weekly meetings are valuable for communicating and moving the project forward, but I think it is also important to meet in person over a coffee, in front of a whiteboard with a marker pen in hand – to fuel the imagination and let it run free.”
Dr Olivier Balédent