A Digital Twin for Imaging Clinical Trials: Design through a Multidimensional Conceptual Framework and Case Study
Poster
AAPM_2026_digital_twin_framework_poster.pdf Hosted by AAPM · 1.0 MBAbstract
Purpose
The growing adoption of Digital Twin (DT) technologies in healthcare highlights the need to define how medical imaging tools (physical and digital phantoms, real and simulated CT studies, etc.) integrate with the virtual components of DTs. A recently introduced conceptual Framework defined functional, technological, and operational aspects that characterize DTs in healthcare. This work proposed the design of a clinical trial Digital Twin, grounded in this Framework, and applied it to a real case supporting the comparison of images acquired in real and virtual CT studies.
Methods
The Framework was applied to the design of a clinical trial Digital Twin comparing photon-counting CT (PCCT) and energy-integrating CT (EICT) scanners in chest imaging studies. In particular, PCCT and EICT were compared using a physical phantom (Mercury-3.0), five anthropomorphic computational phantoms (XCAT), and real patients undergoing chest CT on both PCCT and EICT.
Results
The application of the conceptual Framework to the case study defined a Physical Twin consisting of the enrolled population, the Mercury phantoms, the CT scanners, and the CT procedure workflow. The corresponding virtual replicas defined the corresponding Digital Twin, thereby enabling simulation and trial optimization functionalities through the analysis of the obtained results. Most imaging tools occupied intermediate positions between static digital models and fully realized Digital Twins. Their classification depended less on the imaging modality than on the presence of continuous data flows, bidirectional updating, and functional integration for decision support.
Conclusion
A clinical Digital Twin in healthcare can represent the real scenarios through an integrated combination of real patients, patient simulators, and medical imaging systems, highlighting their relevance for Digital Twins of Organizations. Moreover, this work demonstrated how imaging tools can be integrated within a unified Digital Twin Framework to design and operationalize an imaging clinical trial Digital Twin, enabling simulation and trial optimization.