1: Consulting regarding the image modality and acquisition protocol for basic research or clinical studies.

CHM provides expert advice as to which specific image modality and image acquisition protocol is best suited to answer a particular questions and/or purposes. CHM will specify the particular settings at acquisition that are required for quantitative analysis of morphologic or structural outcome measures. Although the responsibility for image acquisition remains with the client or the radiologist in charge, CHM will define the requirements to be met, so that the conditions for image post-processing and analysis are optimized for the specific study question.

2: Development of dedicated software products for quantitative analysis of tissue morphology from medical image data. 

CHM develops a dedicated image analysis software package for quantitative analysis of tissue morphology from medical image data. The focus is on intuitive user interfaces, robustness to user error, traceability of the analysis process, quality control of all processes and results, and adherence to quality system regulations (FDA and IEEE). This software is maintained to meet the highest standards of quantitative reliability.

3: Development of standard operating procedures (SOPs) for quantitative analysis of tissue morphology, including rigorous quality control (QC).

CHM is dedicated to rigorous quality control of the image analysis process. Segmentation of medical image data represents a diagnostic procedure and requires in depth knowledge of normal anatomy and patho-physiology. Therefore CHM has made a strong commitment to standardize, document, and control the quality of all steps in the image analysis process:

» SOPs and documentation protocols are specifically tailored for each study.

» All image data are checked for appropriate image acquisition at data entry.

» All segmentations are controlled - in a slice by slice manner – by an expert, using the dedicated software component “chondrometrics_ works_QC”, before computations are completed and handed over to the client.

» The QCs at data entry and after segmentation are performed on all data sets by senior staff (usually MDs) with a large body of experience in musculoskeletal imaging and disease, who read large numbers of segmented images on a regular basis.

4. Training of expert personal for performing interactive segmentation of medical image

Probably the most important component in the concept of CHM is the training of expert personal for performing interactive segmentation of anatomical structures from medical image data.

CHM profits from the high level of education of medical technicians in Germany. In order to qualify as a medical or radiological technician, individuals have to go through a broad and intense three-year training period, before entering employment in hospitals or research laboratories. This training period entails formal teaching in anatomy, histology, pathology, radiology, and other subjects.

At CHM, individuals are trained using standardized data sets of normal cartilage morphology from anatomical section series and MR images, and training sets of typical changes in OA. Formal training is enhanced by individual sessions with technicians working at the musculoskeletal research group, who are skilled in segmenting medical image data. Because all segmentations are controlled by expert MDs before output variables are entered into the study data base, training is not confined to an initial period, but represents a continuous process at CHM.