“As perverse as it sounds, what the healthcare industry needs to adopt the latest medical advancements is better financial alignment in addition to better outcomes.”

Halo Dx co-founder, Brian Axe, on why multi-modal diagnosis isn’t already a standard.

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Imaging Wire Sponsors

• Arterys – Reinventing imaging so you can practice better and faster.
• Bayer Radiology – Providing a portfolio of radiology products, solutions, and services that enable radiologists to get the clear answers they need.
• GE Healthcare – Enabling clinicians to make faster, more informed decisions through intelligent devices, data analytics, applications and services.
• Healthcare Administrative Partners – Empowering radiology groups through expert revenue cycle management, clinical analytics, practice support, and specialized coding.
• Hitachi Healthcare Americas – Delivering best in class medical imaging technologies and value-based reporting.
• Novarad – Transformational imaging technologies that empower hospitals and clinicians to deliver clinical, operational and fiscal excellence.
• Nuance – AI and cloud-powered technology solutions to help radiologists stay focused, move quickly, and work smarter.
• Riverain Technologies – Offering artificial intelligence tools dedicated to the early, efficient detection of lung disease.
• Siemens Healthineers – Shaping the digital transformation of imaging to improve patient care.
• United Imaging – Our mission, Equal Healthcare for All, pushes us beyond conventional boundaries to help clinicians expand modern, digital, intelligent care to more people within their communities.
• Zebra Medical Vision – Transforming patient care with the power of AI.

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The Imaging Wire

Global Imaging ROI

The Lancet Oncology Commission proposed a massive effort to expand medical imaging across the world’s developing regions, assuring that the initiative’s high up-front costs would lead to far greater financial and ethical returns.

• The Scale Up Cost – The commission estimates that scaling-up imaging fleets, infrastructure, and workforces across the globe’s low-income regions would cost $6.84b over the next ten years.

• The Human ROI – Using a microsimulation model for 11 cancers, the researchers found that this imaging scale-up would avoid 2.46 million deaths from these cancers over the next ten years, saving 54.92m life-years. Meanwhile, adding similar treatment and care improvements to this global expansion would avert 9.55m deaths and save 232.3 million life-years.

• The Financial ROI – The authors estimate that this global imaging expansion would yield $1.23 trillion in productivity gains (that’s a $172 per $1 return), and reach $2.66 trillion in gains when combined with with similar treatment and quality of care expansions (that’s $12.43 per $1). Even when they applied a more conservative human capital calculation, the authors estimate that the imaging and treatment/care scale-ups would still bring $209b and $340b in net returns.

• The Proposal – The authors called for governments and other global health entities to make this expansion happen, and even if that feels like a longshot, there are enough people who care about millions of lives and/or trillions of dollars to suggest that it could be possible.
  

Philips’ Big ECR

Philips established itself as the most active OEM at ECR 2021, ending the week with a series of AI-focused X-ray and CT launches, after starting the conference with a pair of ultrasound and MR announcements.

• Philips Incisive CT’s AI Suite – Philips’ Incisive CT will get “even smarter” with its new AI-enabled Precise Suite (not yet CE or FDA approved), adding a mix of quality and efficiency-focused solutions to the high-end CT’s workflows (image reconstruction, patient repositioning, cardiac image capture, and needle tracking/guidance).

• Philips & Lunit’s INSIGHT CXR Partnership – Philips will integrate Lunit’s INSIGHT CXR solution into its diagnostic X-ray suite (CE-approved, flags 10 common CXR anomalies w/ 97% – 99% accuracy), making the embedded AI solution accessible to imaging team members via Philips’ Eleva radiography user interface. This alliance could certainly enhance Philips’ CXR efficiency / accuracy, while further expanding Lunit’s INSIGHT CXR market reach after partnering with GE Healthcare in mid-2020.

• CombiDiagnost R90’s FDA – Philips also unveiled its FDA-approved CombiDiagnost R90 digital radiography and fluoroscopy system, highlighting the system’s space efficiency, digital workflow, image quality, and dose management advantages.
  

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The Wire

• Halo Dx’s Multi-Modal Capital: Halo Diagnostics just wrapped up a $19m Series A round and established an eight-figure credit line that it will use to acquire more imaging centers (it already has 4) and testing labs (doesn’t have any yet) with the goal of creating a multi-model diagnostics network (imaging + genomics + labs). Noting the structural and financial disconnect between current imaging centers and testing labs, Halo Dx views creating an integrated multi-modal network as a far more effective way to screen for diseases. These next-gen screening services will first target prostate and breast cancers, but could expand to neurodegenerative diseases and other conditions.

• Regular Screening, Far Better than Irregular: Women who consistently attend their mammography exams have significantly lower breast cancer mortality risks than women who occasionally skip exams. That’s from a new Radiology Journal study that monitored 549k Swedish women from 1992 to 2016, finding that the women who didn’t miss either of their two most recent screenings had a 49% lower breast cancer mortality risk than women who don’t attend screenings, a far greater reduction than women who skipped their most recent exam (-28%) or second most recent exam (-33%). The researchers attributed these significant mortality risk differences to regular screenings’ ability to catch early-stage cancers.

• Aidoc’s PE Notifier: Aidoc launched its PE Care Coordination solution (FDA-approved, developed w/ Yale), which automatically notifies care teams (rads, pulmonologists, cardiologists, vascular surgeons) when a scan suggests that a patient is at high-risk of pulmonary embolism. Once the teams are alerted, the solution supports patient management and care coordination with real-time image, data, and text sharing.

• Driving Up MRI Costs: Patients who receive outpatient MRI scans drive past an average of six lower-cost imaging centers on the way to their exam because they often rely on their physicians’ recommendation and rarely compare scan costs (even if they have a comparison tool). That’s from a Journal of Health Economics study that reviewed ~50k privately-insured lower-extremity MRI exams, finding that patients could have cut out-of-pocket and insurer costs by $84 (27%) and $220 (40%) per exam, while calling these largely “undifferentiated” scans a major opportunity to reduce healthcare costs (not to mention commute times).

• Siemens’ First Mammography Solutions: Siemens Healthineers expanded its digital solutions to breast imaging, unveiling its new Mammovista B.smart solution (analyzes multi-modality breast scans and provides cancerous tissue “confidence scores”) and Teamplay Mammo Dashboard (analyzes breast imaging workflow KPIs and identifies bottlenecks).

• Curbing PE Over-Imaging: A JAMA study introduced a new pulmonary embolism evaluation method that uses clinical criteria and optimized D-dimer measurements, and could significantly reduce unnecessary PE imaging. The researchers tested their new 4-Level Pulmonary Embolism Clinical Probability Score (4PEPS) system against a pair of external datasets with high (n= 1,548, 21.5% w/ PE) and moderate (n = 1669, 11.7% w/ PE ) prevalence of PE, finding that 4PEPS would have reduced overall imaging by −19% and −22%, with false negative rates of just 0.71% and 0.89%.

• Zepp Health X-Ray: After several months of signs that Zepp Health (formerly known as Huami) is getting into medical imaging, the smartwatch giant officially launched its first medical imaging device. Zepp announced a partnership with S. Korean X-ray manufacturer Rouumtech, that will start with Zepp selling Rouumtech’s “Europa” portable X-ray system in China and could expand to more devices, co-developed products, and even a global expansion.

• Stroke Settlement in Seattle: Seattle’s Swedish Health Services and Integra Imaging will pay an $18m medical negligence settlement to a local woman after a missed hemorrhage led to a massive stroke. After experiencing sudden/severe headaches, the 61-year-old former Swedish Health nurse underwent CT and MRI exams during two ED visits within five days, but an Integra radiologist concluded that both exams were normal, even though the MRI was later found to show clear signs of hemorrhage. During a third ED visit a week later, an emergency physician released the woman again without treatment based on the incorrect MRI interpretation, and the woman suffered a stroke three days later.

• Quibim’s Prostate MRI FDA: Quibim announced the FDA approval and US launch of its qp-Prostate solution, which aids prostate MRI visualization and quantification, and could improve MRI reporting efficiency, accuracy, and early detection. qp-Prostate is the only prostate MRI tool that provides automated regional organ segment, which Quibim suggests could reduce interpretation times and help define diagnosis per region.

• Inequitable Imaging Rebound: Although imaging volumes rebounded during the weeks after the COVID shutdown ended (869 exams/day before shutdown, 502/day after), imaging inequities became more severe. That’s from a new Brigham and Women’s Hospital study that found that patients that were poor, Asian and Hispanic, unemployed, and/or had a chronic illness were far less likely to undergo imaging during the post-shutdown period.

• LG’s X-Ray Entrance: LG Display just unveiled a pair of large-size oxide-based thin-film transistors (TFTs) intended for use in X-ray detectors (17×17” & 35×35”), calling them 100-times faster, 10-times lower-noise, and lower radiation than current silicon-based TFTs. LG Display is already providing oxide-based TFTs to South Korean detector maker, DrTech, and reportedly has supply contracts with other global X-ray detector companies.

• Ultrasound AI Cuts Unnecessary Biopsies: A new study in the European Journal of Radiology found that an AI-assisted breast ultrasound system can help reduce unnecessary biopsies. The researchers analyzed 173 suspicious breast lesions using conventional ultrasound and two different AI-guided ultrasound stratification approaches. The more conservative AI-guided stratification approach (downgrades lesions if both orthogonal sections could be benign) correctly downgraded 14 lesions from BI-RADS 4A to 3 with no missed malignant lesions, while the more aggressive strategy (downgrades lesions if any orthogonal section could be benign) correctly downgraded 27 lesions but missed two malignant lesions. The study endorsed the more conservative approach, given its lower false-negative risks.

• RefleXion’s Latest $40M: RefleXion Medical added another $40m to its Series D round, bringing the round to $150M, and increasing its fundraising total to $363M. RefleXion will use its new capital to expand its RefleXion X1 biology-guided radiotherapy system (combines CT imaging & linear accelerator for targeted radiation treatment) into the Asian market.
  

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The Resource Wire

– This is sponsored content.

• Learn how Hemet Global Medical Center improved efficiencies, safety, and security when it moved to the Nuance PowerShare Network and #ditchedthedisk.

• If it were just about the machines, things would be a lot simpler. In this video, part two of their RSNA virtual presentation, United Imaging explains how they go beyond the status quo to improve the process of buying and owning medical equipment.

• See why the Medical University of South Carolina decided to use Siemens Healthineers’ AI-Rad Companion with every chest CT scan that the hospital system performs.

• Zebra-Med’s Bone Health Solution helps radiologists automatically identify patients at risk for osteoporosis, allowing HMOs to enroll more patients in bone health programs.

• “Work-flow validation should happen very early in the AI development cycle…” Read on to learn about “Building Radiology AI that Works” featuring Babak Rasolzadeh, Sr. Director of Product & Machine Learning at Arterys.

• Check out this GE Healthcare report detailing how even after cutting MRI scan times by up to 50% with deep-learning MR image reconstruction, radiologists find it “just easier to read through these beautiful images.”

• With radiation dose management now largely considered best practice, this Bayer white paper details the top five benefits of adopting contrast dose management.

• This Hitachi Healthcare blog outlines the criteria providers should consider for their image and reporting platforms, and how the Hitachi VidiStar platform’s features, service, and vendor collaboration meet providers’ needs.

• Check out how Novarad’s enterprise imaging patient storyboard view gives specialists more and better information from across a hospital system to better care for their patients.

• This Riverain Technologies case study details how Einstein Medical Center adopted ClearRead CT enterprise-wide (all 13 CT scanners) and how the solution allowed Einstein radiologists to identify small nodules faster and more reliably.

• 2021 brought a handful of new COVID-related diagnosis codes. Check out Healthcare Administrative Partners’ post on the new codes and how to use them.