“Appearance-based discrimination has been documented in the business world, where there is data to suggest that attractive people may be more successful, but in medicine, and in higher education more broadly, there is really no justification for it.”
Duke Radiology’s Vice Chairman of Education, Charles M. Maxfield, M.D., after his study found significant appearance-based discrimination in the radiology residency application process, noting that this type of discrimination is especially unwarranted if looks don’t make you better at your job.
Imaging Wire Sponsors
- Carestream – Focused on delivering innovation that is life changing – for patients, customers, employees, communities and other stakeholders
- Focused Ultrasound Foundation – Accelerating the development and adoption of focused ultrasound
- Medmo – Helping underinsured Americans save on medical scans by connecting them to imaging providers with unfilled schedule time
- Nuance – AI and cloud-powered technology solutions to help radiologists stay focused, move quickly, and work smarter
- Pocus Systems – A new Point of Care Ultrasound startup, combining a team of POCUS veterans with next-generation genuine AI technology to disrupt the industry
- Qure.ai – Making healthcare more accessible by applying deep learning to radiology imaging
The Imaging Wire
Here’s to a Year
It’s officially been a year since the first Imaging Wire issue hit inboxes. Thanks to all the readers, sponsors, friends, and family who’ve made this year possible and extra appreciation to the 19 awesome people who’ve been with us since that very first delivery (Angela S, Ben F, Carey F, Casey C, Chuck E, Chuck J, Holly R, Jared R, Kate G, Jeff B, John S, Mark G, Matt K, Robert S, Ron F, Sean C, Teddy G, Terry C, TYF). Here’s to many more.
Volpara’s Big Move
Volpara might bring in about $5 million in annual revenue, but the New Zealand-based breast imaging solutions company is taking advantage of its $232 million market cap to fund an ambitious expansion plan.
- Volpara’s expansion will start with its $14.4 million acquisition of U.S.-based breast imaging clinic management software company, MRS Systems, giving Volpara a presence in 2,100 imaging clinics (~1,700 from MRS) and expanding its access to clinical data for future AI product development.
- MRS Systems is just the first step in Volpara’s expansion, as the company plans to raise $38.3 million to pay for this acquisition and fund ongoing M&A over the next three years.
These are some big investment numbers for a relatively small company that’s still working its way to profitability. However, given the momentum behind breast imaging (particularly density in the US) and artificial intelligence, it appears that Volpara is ready to establish its role as a core part of today’s breast imaging workflow.
Roche and GE Integrate
Roche and GE Healthcare rolled out the first solution to come from their new diagnostic platform alliance. The alliance is intended to combine the companies’ respective strengths in lab testing (Roche) and medical imaging and monitoring (GE) into a diagnosis and treatment decision support platform, and their first collaborative product does just that.
- Roche’s new NAVIFY Tumor Board 2.0 oncology platform now integrates GE Healthcare’s medical imaging viewer, allowing radiologists to upload their reports to the platform (joining data from other specialties) to support more comprehensive tumor board reviews.
- Next up in GE and Roche’s collaborative pipeline is an ICU/ER critical care platform that combines and analyzes available patient information (vitals, blood tests, imaging) and integrates it into clinical workflows to help physicians identify and predict infectious diseases.
The Roche/GE alliance hasn’t received much attention in the imaging media and this remained true following the NAVIFY Tumor Board announcement. However, this seems like a pretty solid step into precision medicine for Roche and GE during a time when lots of companies are talking about precision health, but few have the interdisciplinary capabilities to make it happen (at least without partnerships like this).
SEC Probe Expands to China
Reuters revealed that the U.S. SEC is now investigating GE, Siemens, and Philips for participating in a medical equipment bribery scheme in China, allegedly using local middlemen to negotiate bribes with government and hospital officials to win deals.
- The China scheme – The alleged Chinese scheme was first revealed through a GE shareholder lawsuit in New York that claimed that GE colluded with Philips, Siemens and Toshiba (now Canon) to fix medical device prices and rig tenders through Chinese middlemen. The scheme allegedly allowed them to win deals at 40% above-market prices and then use these additional proceeds to bribe health officials, pay the middlemen, and bring some money back to the manufacturers. A Chinese criminal court already found GE middlemen and participating hospital administrators guilty (GE was not charged), while the New York case is still open.
- If this sounds familiar – It’s because it comes a few weeks after Reuters revealed that the U.S. SEC (along with the FBI and Department of Justice) is investigating the same companies for a Brazilian kickback and price-fixing scheme. In fact, the Chinese and Brazilian probes are reportedly part of a wider effort by U.S. regulators to enforce corruption in the global medical equipment market. The U.S. feds are particularly focused on potential violations of the U.S. Foreign Corrupt Practices Act (prohibits U.S. citizens and companies or foreign companies listed in the U.S. from bribing foreign officials), which typically results in hefty fines for companies who are found to be in violation.
The SEC is still investigating the respective schemes in Brazil and China, suggesting that this story has more chapters remaining.
The Wire
- Researchers from Massachusetts General Hospital found that same-day breast biopsy programs effectively reduce time-to-diagnosis and address related racial disparities. The study looked at 663 patients who underwent biopsy before the team established an optional same-day program and 482 patients who underwent biopsy after implementation, finding improvements in mean time-to-biopsy (9.6 vs. 3.6 days) and patients receiving same-day biopsies (11% vs. 51%), while eliminating racial disparities (non-white previously waited 2.3 more days).
- Radiology Partners expanded its radiology consulting, IT, and revenue cycle management services capabilities with its partnership with Canopy Partners (140 imaging and radiology clients, 35 states), representing a shift from the practice-focused acquisition strategy that RP executed over the last year. Canopy Partners will operate as an independent division of RP, providing services to both RP and non-RP clients.
- Researchers from UT Southwestern Medical Center developed a novel immuno-PET (iPET) imaging test by transforming the immunotherapy drug, atezolizumab, into a diagnostic PET tracer that could identify kidney cancer patients most likely to benefit from immunotherapy. The team labeled atezolizumab with zirconium-89 (a radioactive metal) to visualize whether tumors deploy PD-L1 to suppress immune cells and whether drugs disabling this pathway may be effective. This iPET approach may prove to be a valuable immunotherapy screening tool, given that immunotherapy drugs currently benefit less than 50% of kidney cancer patients.
- A Duke study found that physical appearance was a greater admission determinant for potential radiology residents than traditional med school performance measures (grades, class rank, honor society memberships). The researchers created 76 mock applications that were reviewed by 74 unknowing faculty members across five academic radiology departments, finding that obese or “facially unattractive” applicants were only half as likely to receive an interview. Some may say this as an ironic example of radiologists’ superficiality, but the researchers believe this issue exists across specialties.
- The U.S. Nuclear Regulatory Commission (NCR) proposed a number of changes to training and experience (T&E) requirements for radiopharmaceuticals that require a written directive. In addition to a “status quo” proposal (no change), the NCR proposed either 1) requiring 400hrs of T&E to administer alpha- or beta-emitting radiopharmaceuticals, 2) requiring 400hrs of T&E to administer any radiopharmaceutical unit dose, 3) requiring 400hrs of T&E to administer a specific radiopharmaceutical and 80hrs of T&E for each additional radiopharmaceutical, and 4) that the NCR would evaluate T&E requirements for each emerging radiopharmaceutical.
- Glassbeam announced the launch of its Clinsights AI/ML-powered application suite, providing both radiology and clinical engineering organizations with data-based insights (based on machine log data, DICOM, HL7, CMMS, RIS, etc.) to help maximize imaging and biomedical system uptime and utilization. The Clinsights application suite incorporates Glassbeam’s widely-deployed healthcare analytics solution, while adding mobile support, an expanded library of algorithms, and integrated application workflow to allow deeper collaboration between clinical engineering and radiology groups.
- The president of Ohio-based mobile imaging company, Portable Radiology Services, was indicted for healthcare fraud after billing Medicare and Medicaid for roughly $2 million in X-ray services that didn’t take place (including over 150 on patients that were already deceased). The mobile X-ray segment of our industry has a long history of fraud, due to a combination of their vulnerable clientele (nursing facility residents) and the fact that these scans can be done without physician authorization, suggesting that there’s more of this going on.
- Almost exactly a year after taking a stand against the Chinese tariffs, NEMA urged the U.S. and Mexico to work together to avoid a new 5% tariff on imports from Mexico, noting that many medical imaging equipment manufacturers operate supply chains spanning both sizes of the border.
- MedStar Georgetown University Hospital’s imaging informatics chief found that deep learning language modeling may help automate the radiology-pathology correlation process, which has traditionally been a challenging, but important step in performing research and multidisciplinary patient care. The study used the ULMFiT transfer learning method on 300k radiology and pathology reports (200k for training), correlating the reports with 100% specificity, 65.1% sensitivity, and 73.7% accuracy and closely matching a previous anatomic concept-matching approach (98.0%, 65.1%, 73.2%). Although there’s more work to be done, the fact that these models can rapidly adapt to underlying training labels and be continuously improved and tuned is promising.
- Carestream signed a 4-year, $25 million deal to implement its Vue Clinical Collaboration Platform and digital radiography solutions across a number of healthcare trusts in Italy’s Emilia Romagna, Liguria, and Molise regions (18 health facilities, 1.5m radiologic examinations per year).
- North Carolina-based nuclear medicine equipment service and sales provider, Absolute Imaging Solutions (AIS), announced its acquisition of New England-based imaging parts repair specialist, Northeast Electronics. The deal expands the size and geographic reach of AIS’ field service team, which now includes 30 engineers across the Eastern US. AIS is having an eventful 2019, as it was just acquired by TTG Healthcare in April, resulting in AIS absorbing TTG’s equipment service division.
- Just a few weeks after the major radiology and AI leaders outlined AI’s translational roadmap, which started with defining clinical challenges to solve, the ACR began its outreach effort by asking the healthcare public to submit “problem(s) that may be solvable by AI.” This is what’s supposed to happen after roadmaps like this are created, but it’s at least evidence that the ACR and other members are already executing their AI adoption plan and that a comprehensive list of AI-solvable issues may be forthcoming.
- Change Healthcare doubled its IPO goal to $200 million, adding a new $100m “tangible equity unit” offer to its $100 million common stock offer that it announced in March. The IPO was initially intended to help pay down Change Healthcare’s $5 billion in debt and that’s likely the reason for increasing it to $200 million.
The Resource Wire
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- The Focused Ultrasound Foundation announced the development of a new roadmap outlining the role of focused ultrasound in treating pancreatic cancer. The Foundation held a workshop with 70 industry leaders, defining three specific research directions within the roadmap and revealed plans to fund projects to accelerate the use of focused ultrasound in pancreatic cancer treatment.
- This Qure.ai blog post highlights how its qXR automated chest X-ray solution has helped scale tuberculosis screening to remote regions across the globe.
- In this Carestream video, orthopaedic surgeon Dr. Bryan Den Hartog presents clinical images illustrating traditional CT vs. extremity CT imaging and discusses how the image resolution in the OnSight 3D Extremity System helps in his practice.
- POCUS Systems is approved as a Veteran Owned Business with the US Government Office of Veterans Business Development, paving the way for partnerships with the federal healthcare delivery systems.
- In this on-demand webinar, Nuance details how PowerScribe One frees the radiology team from distractions, interruptions, and delays that get in the way of staying focused, moving quickly, and working smarter.
- How much does an MRI scan cost? According to Medmo, that depends. Scans made with the exact same device on the exact same body part could cost $225 at one facility and $2,500 at another. Medmo also provides some advice to make sure patients don’t pay too much for their scans, including using the Medmo Marketplace where the average MRI costs between $225 and $700.