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With the imaging domain evolving rapidly, Pharma needs to take a more active role in the use of imaging endpoints in clinical trials. An image management infrastructure is a key enabling technology. Open source software has to be part of the strategy, as it plays an important role in integrating the disparate imaging networks.<br>
Novartis has implemented a state-of-the-art image management infrastructure including open source components and has started deploying external algorithms for image analysis.<br>
The practical challenges and solutions, and the future directions, with emphasis on open source, are discussed.