Helpful links





Working group:

Prof. dr. Gabriel P. Krestin

Prof. dr. Aad van der Lugt

Prof. dr. Wiro J. Niessen

Prof. dr. Hilleke Hulshoff Pol

Prof. dr. ir. Boudewijn P.F. Lelieveldt

Prof. dr. Mark A. van Buchem

Ir. Marcel Koek

Ir. Annegreet G. van Opbroek

Dr. Daniel Bos


Contact European Population Imaging Infrastructure:

Erasmus University Medical Center
Department of Radiology

Room Hs-220
PO Box 2040 / ‘s Gravendijkwal 230
3000 CA Rotterdam / 3015 CE Rotterdam
The Netherlands

T +31 (0)10 70 31442
F +31 (0)10 70 34033



Access to Research Infrastructure

Access may be requested to the following facilities of the Research Infrastructure:

  1. Image datasets
    • Access to the image datasets is provided based on scientific excellence. In order to gain access to the image datasets a written two-page research proposal is required which includes the aims of the research and the methods. For more information, please contact:
  1. Image-analysis tools
    • Access to the image-analysis tools is free (broad access).
  1. Image-analysis pipelines
    • Access to image-analysis pipelines is provided based on scientific excellence and require a written one-page proposal. In case the analyses are putting a substantial burden on the analysis-team, these costs are required to be covered. This will be determined based on the abovementioned proposal.

Ethical considerations

Imaging is increasingly used both in research and in clinical medicine, and hardware and sequences are continually being improved. These advances are likely to result in the detection of unexpected, asymptomatic abnormalities, such as brain tumors, aneurysms, or subclinical vascular pathologic changes. Consequently, a large amount of literature has been published on the prevalence of incidental findings, but also on the psychosocial consequences and impact of communicated incidental findings. Below, we present some further reading on this topic.

  • Incidental Findings
    • Meta-analysis on Incidental Findings on Brain MRI
    • The Rotterdam Study
    • SHIP-Study
      • Schmidt CO, Hegenscheid K et al. Psychosocial consequences and severity of disclosed incidental findings from whole-body MRI in a general population study. Eur Radiol. 2012. (
      • Hegenscheid K, Seipel R et al. Potentially relevant incidental findings on research whole-body MRI in the general adult population: frequencies and management. Eur Radiol. 2013. (
    • The NEO Study



Many common diseases, including Alzheimer’s, asthma, arthritis, cancer, cardiovascular disease, diabetes, hypertension, obesity, Parkinson’s, and psychiatric disorders, are complex conditions that not only cause major human suffering but also represent a burden to society in terms of healthcare cost and loss of economic productivity. Successful treatment of these diseases remains elusive because they do not have roots in single defects but are caused by a large number of small, often additive effects arising from genetic predisposition, lifestyle, and the environment. The development of new prevention strategies, leading to the promotion of health, requires several steps: establishment of diagnostic biomarkers, elucidation of the molecular processes involved, understanding of the causal pathways, and identification of high risk groups. In all these steps biomedical imaging at the population level plays a key role.

Searchable repositories of bio-medical data from population-based, prospective health surveys — repositories which include imaging together with associated information about the individual subject — have thus become indispensable to elucidate molecular processes and causal pathways, be they genetic or environmental, and to translate biomedical research into real improvements in healthcare. Dedicated facilities will enable data collection and increase the volume of data which can be collected, enlarging the size of the data repositories. With larger repositories and with more data able to be directly compared and communally analyzed, biomarkers for rare pathologies will be able to be detected, with the accompanying benefits for personalized prevention and/or early treatment.


The Netherlands, in a European and global perspective, is at the forefront in basic and applied biomedical imaging sciences and has extensive expertise both in imaging and in handling and processing large imaging databases. With its varied and well-documented populations and its widely-acknowledged, large  population based studies, it is a center of excellence for Europe. All university medical centers (UMCs) have strong research programs in biomedical imaging, covering a wide range from fundamental research to large clinical and population studies.

Creating a Population Imaging Infrastructure in the Netherlands will contribute to the objectives of the Dutch government with respect to research, innovation, and health policies. It will create an enormous, uniform repository that can be exploited scientifically for many years to come. It will also be of great value to industry and public-private partnerships like CTMM, Ti-GO and TI Pharma in their translation into clinical practice. The Dutch Federation of University Medical Centers (NFU) supports this Dutch/European initiative. In the opinion of the NFU, the Netherlands should play the leading role in the population-based imaging hub of Euro-BioImaging (The European Biomedical Imaging Infrastructure – The need to organize sustainable imaging infrastructures for European research is well known among and has been explicitly expressed by the members of the European imaging community and European policy makers. EPI2 will be one of the cornerstones of the Euro-BioImaging initiative. Euro-BioImaging is one of only 10 biomedical sciences infrastructure proposals included on the European Strategy Forum for Research Infrastructures (ESFRI) Roadmap. The objective is for the Netherlands to host the Population Imaging Infrastructure within Euro-BioImaging. To strengthen its position, the Netherlands needs to expand the research facilities for population imaging with dedicated, state-of-the-art, imaging units, uniform data handling facilities, and processing capacity.


Biomedically-relevant, quality-assessed imaging data as well as associated biomolecular and clinical resources are essential for generating knowledge about the causes of human disease, both common and rare. This knowledge leads to improvement in diagnosis, prognosis, treatment, and prevention of these diseases. Population surveys and data collections are the driving force of technological development, proactive health programs, and preventive medicine.

Bio-medical imaging allows non- or minimally-invasive assessment of structural and functional changes in humans that may reflect specific pathology. Recent developments in image data acquisition and analysis enable use of these techniques on a large scale. This makes it possible to investigate specific pathophysiological substrates of disease in a pre-symptomatic phase and at the population level. Population imaging is the large-scale application and analysis of medical images in controlled population cohorts. Population imaging aims to find imaging biomarkers that allow prediction and early diagnosis of diseases and preventive therapy.

The European Population Imaging Infrastructure (EPI2) will provide a dedicated environment for coordination of data acquisition at different locations or different time points to be directly compared and communally analyzed, thereby exponentially increasing the impact of population imaging studies.


The Population Imaging Infrastructure consists of dedicated equipment and technical personnel. While these can easily be integrated in the existing infrastructure of the UMCs, the physical core of the population imaging units needs to have state-of-the-art imaging modalities uniquely dedicated to population research. Most  imaging equipment currently available is used full-time for patient care, leaving little time for research imaging, and is usually fully integrated in a hospital environment. The uniform image archiving and analysis infrastructure will cross-link the individual population imaging studies. It will focus on the requirements for common data acquisition, storage, exchange, and analysis. The Netherlands Forum for Biomedical Imaging (NFBI) will play a central role with

respect to the image analysis part of the infrastructure; however, dedicated hardware and software infrastructure is required to address these challenges. Finally, an initiative such as the Population Imaging Infrastructure demands that standardized procedures are created and followed, as the added value resulting from a concerted effort in population imaging comes mainly from the possibility to analyze composite data from different sites and/or different time points as well as from the availability of common analysis tools and methods.

The key to success is the efficient management of coordinated activities between the participants whilst allowing local management the freedom to continue their proven research strategies. The infrastructure per center will therefore differ depending on the nature of the population imaging studies to be performed, and it can comprise different combinations of imaging modalities. The strategic infrastructure agenda is strongly coupled to the strategic research goals of the leading population studies in the Netherlands. Establishing a functional, central e-science infrastructure as well as the appropriate governance structures for communal, standardized acquisition of population imaging data will cement the position of the Netherlands as the future leader of European population imaging research. Combination and exchange of data, together with the expansion of the number of facilities over the years will add to the leadership position of the Netherlands in both population studies and medical imaging.

Over a period of 15 years (2011-2025), the Population Imaging Infrastructure in the Netherlands will need a substantial capital investment. This investment is  needed to cover the costs of equipment, as well as the costs of establishing a dedicated infrastructure for handling and storage of large image datasets, for data  processing based on GRID technology, and related IT activities. The requested investment also includes technical personnel and maintenance costs throughout the project. Additional operating costs and the costs of scientific personnel will be covered by the participants from their direct internal funding and from externally subsidized projects.

Conclusion: The objective is for the Netherlands to host the European Population Imaging Infrastructure (EPI2) within Euro-BioImaging, for which we are in an excellent position. To strengthen this position, the Netherlands needs to create new or expand existing research facilities for population imaging with dedicated, state-of-the-art imaging units, data handling, and processing capacity.

Research based on population imaging studies will lead directly to improvements in disease prevention and treatment. There will be important economic impacts in terms of reducing the need for healthcare resources and increasing productivity through a healthier workforce. Such benefits more than justify the investment that will be required to establish and maintain the pan-European Population Imaging Infrastructure EPI2 in the Netherlands.


The European Population Imaging Infrastructure is an initiative of the Dutch Federation of University Medical Centres (NFU) and the Erasmus University Medical Centre Rotterdam, Department of Radiology, chaired by Professor Gabriel P. Krestin. The NFU has made available initial funding for the development of this initiative.

The European Population Imaging Infrastructure closely cooperates with the European Biomedical Imaging Infrastructure Project EURO-BioImaging which is currently being developed.

The ultimate aim of the infrastructure is to help the development and implementation of strategies to prevent or effectively treat disease. It supports imaging in large, prospective epidemiological studies on the population level. Image specific markers of pre-symptomatic diseases can be used to investigate causes of pathological alterations and for the early identification of people at risk.

More information on this infrastructure and on the role of the European Population Imaging Infrastructure in this can be found in the Netherlands Roadmap for Large-Scale Research Facilities, the applicaton for funding of the Roadmap Large Scale Research Facilities Application form of the Roadmap EuroBioImaging, and on the Euro-BioImaging website.

In order to further develop the European Population Imaging Infrastructure initiative and to explore the interest and needs of the Dutch scientific community, a 1st Workshop was organized on March 26, 2009.  For a full report of this meeting, please click here.

As a result of this workshop, a working group was formed in April 2009 to further develop the initiative. A survey was held regarding the larger Dutch Population Cohorts to measure their potential for population imaging. The results of this survey were presented at a workshop on March 25, 2010. Furthermore, we have been constructing a position paper entitled  ‘European Population Imaging Infrastructure. A Proposal for the Netherlands’ .

The importance for setting up the European Population Imaging Infrastructure (EPI2) in the Netherlands was underlined during the workshop on March 25, 2010. Key representatives from Dutch medical sciences, industry, government, and research councils discussed the initiative of EPI2 in the Netherlands, also in the context of Euro-BioImaging. There was general agreement on the importance of population imaging, building on the strong position of the Netherlands both in population studies and biomedical imaging. EPI2 will be embedded in a strong knowledge infrastructure encompassing also public/private partnerships like CTMM, TI Pharma and Ti-GO. The latter was considered as one of the key factors for success.

All participants agreed on the basic principles laid down in the position paper. In the coming months this position paper will be finalized and a consultation process will be initiated to discuss funding opportunities and further steps.

Gabriel P Krestin