OBJECTIVES: The use of medical images has become a great tool that enables a rapid diagnosis, aids in taking relevant decisions early in the process, facilitates the formulation of a second opinion in cases of doubt. Solid tumors are very rare in children and individual clinician experience is often quite limited. Yet the treatment decisions which must be made can be complex and diagnostic dilemmas are common.   METHODS:

Supported by a grant from EU-funded Project ENCCA (European Network for Cancer Research in Children and Adolescents), representatives from SIOPEL, GPOH, COG, and JPLT developed the Virtual Consultation System. VCS is a novel tool developed by Cineca Interuniversity Consortium to support clinical challenges in management of complex cases, which require the consultation among experts coming from different hospitals or countries. VCS allows to assess complex cases using relevant medical information from structured data (e-CRFs) and diagnostic DICOM images.

VCS can be customized according to specific requirements in all of its components such as user roles, process flows, and the input and output information (i.e. e-CRFs, images, consensus form) linked to the different tasks in the review process. RESULTS:

The main output is a report containing the collective findings, conclusions and recommendations for the further treatment of the patient. The use of a web-based consultation system is an essential component of excellence in diseases care because it enables patients to have access to the best available global expertise. This tool is particular important for rare tumors where clinicians need to get consultation from other colleagues in different areas of the world.   CONCLUSIONS:

This consultation service represents an opportunity to enhance the care of children with rare tumors and facilitates education of clinicians caring for such challenging patients. Such a consultation service may serve as a model for cooperative management of other rare malignancies.