ARRS 2022 Abstracts

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E1852. A Primer in Blockchain Technology and Smart Contracts: The Radiologist Viewpoint
Authors
  1. Reza Sirous; George Washington University School of Medicine and Health Sciences
  2. Nima Ghorashi; George Washington University School of Medicine and Health Sciences
  3. Raheleh Taghvaei; University of Maryland Medical Center
  4. Matthew Liu; George Washington University School of Medicine and Health Sciences
  5. Muhammad Rheman; George Washington University School of Medicine and Health Sciences
  6. Ramin Javan; George Washington University School of Medicine and Health Sciences
Background
Blockchain is a groundbreaking technology that has not only established extensive applications in business and finance sectors but is also emerging in medicine and specifically medical imaging. As an immutable and encrypted ledger technology, blockchain offers unique and powerful features to create, share, and protect massive data sets that are particularly suitable for the large DICOM files used in medical imaging. However, there are many potential challenges and pitfalls for the widespread implementation of this technology. In this educational exhibit, we will provide an introduction to blockchain technology, its major ecosystems and categories, the pros and cons of each ecosystem, and the applications and challenges in respect to medical imaging.

Educational Goals / Teaching Points
The goals of this exhibit are as follows. Describe blockchain as a decentralized digital ledger technology on a peer-to-peer network. Learn major aspects of smart contracts pertaining to radiology including storage, centralization/decentralization, privacy/encryption, oracle projects that allow communication between blockchains, and distinct non-fungible tokens (NFTs). Become familiar with multiple blockchain ecosystems and their pros and cons for future endeavors. Review challenges and opportunities in radiology as a field revolving around big data. Describe development of a scalable, fast, easily adoptable, decentralized and robust ecosystem of healthcare image sharing network from the ground up, to not only allow for providing high quality care but to re-establish control by clinicians, radiologists, and patients.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The key points of this exhibit include: blockchain and smart contracts (background, evolution, and adaptation by different sectors; functionality; benefits and risks; general applications); pertinent categories of blockchain ecosystems (storage; centralized vs decentralized; privacy and encryption; Oracles; NFTs); blockchain ecosystems pros and cons; and applications in medical imaging and challenges ahead (creating meta-storages for secure storage and sharing of medical images among different entities; accessibility of images among different institutions; smart contracts to enable secure peer-to-peer communication between provider, radiologist, and patient; smart contracts for credentialing, licensure, and radiologist reimbursement; and research).

Conclusion
Blockchain is an extremely powerful tool in the delivery and storage of medical imaging that can empower both the patients and the physicians. The radiology community should engage in promoting and implementing blockchain technologies in future research and patient care.