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How Flywheel’s Reader Studies Module Is Powering Global Pediatric Brain Research

The Bill & Melinda Gates Foundation’s (BMGF) UNITY project, led by King’s College London, is redefining how pediatric brain development is studied in low-resource settings. By integrating Flywheel’s Reader Studies Module, UNITY teams around the world can rapidly assess image quality, empower local researchers and ensure only the best MRI data drives their groundbreaking analyses. 

Studying Brain Development in Developing Regions 

Researchers launched the UNITY project (Ultra-Low Neuroimaging in the Young) to study early brain development in infants growing up in vastly different environments. This crucial work could have a tremendous impact on improving outcomes for children around the world by comparing biomarkers in developing regions with those in higher-income countries. 

But researchers were having trouble collecting enough high-quality imaging due to using MRI scanners that were lower in field strength, plus infants tend to move while being scanned, creating motion artifacts and inconsistent positioning. Resulting scans were often too noisy or distorted to be used effectively in the project. 

To solve this, UNITY needed not only a centralized data platform but also a way to standardize quality control of images gathered and processed across more than 25 global sites.  

What Is the Flywheel Reader Studies Module? 

The Reader Studies module is an extension of the Flywheel imaging data management platform that enables research teams to manage image quality reviews and annotation workflows at scale. It provides everything researchers need to orchestrate and monitor blinded image reviews, from task assignment and adjudication dashboards to custom reader forms and automated data tagging. It’s all confined to Flywheel’s environment, making security and compliance for reader studies easier with granular access controls. 

The Reader Studies module allows research teams to: 

  • Assign images and tasks to readers at the study, subject or acquisition level 

  • Capture standardized feedback with guided forms and visual examples 

  • Compare outputs from multiple readers and adjudicate discrepancies 

  • Export all results in a machine-queryable format for downstream analysis 

  • Automate downstream image processing 

Adding the Reader Studies module gives researchers like those in the UNITY project a complete end-to-end workflow for establishing ground truth datasets for machine learning or validating outputs from automated pipelines. 

How UNITY Uses Reader Studies to Improve Image Quality and Reduce Costs 

Flywheel’s Reader Studies Module ensures only high-quality, verified images proceed through the pipeline. This saves both computational costs and manual labor, allowing UNITY to invest more resources into analysis and local training. 

They use the Reader Studies Module at the front end of the imaging pipeline, after scans are uploaded to Flywheel as DICOMs and automatically converted to NIfTI format with Flywheel Gears. These scans are then routed into reader tasks that local readers can complete online using Flywheel’s built-in viewer. Reader forms include visual references for examples of acceptable quality, helping standardize judgment across diverse teams. 

Once a reader submits their review, Flywheel automatically tags the data. If a scan meets quality standards, it triggers downstream Gears for reconstruction, segmentation and quantitative analysis. Poor-quality scans are flagged and halted before they waste compute cycles or research time. 

“Flywheel really acts as a nice, direct, easy way to integrate across all these sites ... and also harmonize data processing pipelines so that we know everyone’s doing the same thing,” explains Sean Deoni, Ph.D., senior program officer, Bill & Melinda Gates Foundation. 

Empowering Local Researchers  

Part of UNITY’s mission is to build imaging and analytic capacity within low- and middle-income countries so knowledge and publishing of papers can be shared with the sites completing the work. The Reader Studies Module helps do just that. 

By decentralizing image review, Flywheel enables local research centers to assess their own data quality without relying on experts thousands of miles away. Over time, this helps to build regional expertise and independence.   

Standardization, Reproducibility and Global Collaboration 

Across UNITY’s 29 sites, more than 48 researchers are collaborating on two Flywheel instances, having uploaded more than 10,000 imaging sessions and run 300,000+ algorithms to date. 

No matter the site, the Reader Studies Module guarantees that everyone is applying the same standards and workflows. The efficiency researchers gain through standardizing workflows allows them to collect higher-quality images, so the study’s end results are more comprehensive. 

“Getting everyone to have the same analytical pipeline really adds value when you want to scale, incorporate data and compare different regions, conditions and environmental issues,” says Steve Williams, Ph.D., professor, King’s College London. 

With the Reader Studies Module at the heart of their workflow, UNITY ensures its collaborative efforts are completed as efficiently as possible, accelerating important work that can improve outcomes for children everywhere. 

Learn more about Flywheel’s work with the UNITY project. And reach out to speak with one of our experts about how Flywheel and the Reader Studies module can help you optimize your imaging research workflows.