Author: Brian Casey

GE to Buy Intelerad in Massive $2.3B Acquisition

Posted on by Brian Casey

In what could be the biggest radiology IT acquisition in years, GE HealthCare will acquire medical image management software company Intelerad in a purchase valued at $2.3B. The acquisition will bolster GE’s position in the outpatient image management segment, which is rapidly shifting from on-premises PACS models to cloud-based environments.

Intelerad was founded in Montreal in 1999 as a PACS developer and has grown through acquisitions of its own in recent years.

  • U.K. private equity firm Hg took a controlling interest in Intelerad in 2020, and the company soon embarked on a series of acquisitions that rolled up smaller imaging IT companies like Digisonics (2020), Ambra Health (2021), Insignia (2021), Lumedx (2021), Life Image (2022), and PenRad Technologies (2022). 

After taking a few years to digest the new companies, Intelerad began focusing on moving its technology and customers to cloud-based architecture, such as by releasing a cloud-native version of its InteleHeart software and by moving its PACS, VNA, and image-sharing applications to AWS cloud hosting.

GE needs no introduction, of course, but the company clearly sees the attraction of Intelerad’s core market in outpatient imaging, which complements GE’s focus on larger hospitals and health systems. 

In a conversation with The Imaging Wire, Scott Miller, president and CEO, Solutions for Enterprise Imaging at GE HealthCare, explained several of the acquisition’s advantages …

  • Imaging exams are moving from hospitals to outpatient centers due to lower costs.
  • Outpatient facilities are following hospitals in moving their data to the cloud, putting Intelerad at the intersection of two major trends.
  • Intelerad’s geographic focus has been on English-speaking countries, giving GE the opportunity to plug Intelerad products into its international distribution network. 

GE estimates that Intelerad will generate $270M in revenue in its first full year under GE ownership. 

  • Intelerad’s sales have been growing at a rate in the low double digits, and GE expects that pace to accelerate. 

Is the new acquisition a sign of growing consolidation in the radiology AI and image management sectors? 

  • Other recent purchases in 2025 include Radiology Partners’ purchase of Cognita Imaging, Lunit’s acquisition of Prognosia, and GE’s own purchase of icometrix, completed earlier this month. RadNet also acquired iCAD earlier in the year.

The Takeaway

GE’s acquisition of Intelerad offers multiple benefits to the multimodality OEM, from Intelerad’s presence in the outpatient imaging sector to its experience in cloud-based image management and broad product portfolio. The question is whether the purchase spurs other big iron vendors to answer with acquisitions of their own. 

RP Acquires Vision AI Firm Cognita Imaging

Posted on by Brian Casey

Radiology Partners ramped up its investment in AI by acquiring Cognita Imaging, a startup that’s developed AI vision language models for analyzing CT and X-ray images and drafting initial radiology reports. RP executives see the acquisition as going beyond traditional point-source AI models and toward a future where AI automates much of the traditional image interpretation process.

The $80M acquisition expands on an equity stake RP already had in Cognita, which had been operating in stealth mode since its spin-off from Stanford University’s Center for Artificial Intelligence in Medicine and Imaging lab.

  • Cognita was formed by a team led by CEO Louis Blankemeier, PhD, to commercialize Stanford research on vision language models, a type of generative AI that’s far more versatile than the traditional point-source models being commercialized to analyze medical images.

Instead, Cognita’s technology is able to analyze text as well as CT or X-ray images and produce first drafts of radiology reports that just need a radiologist’s review and signature to be complete.

  • Extremely positive clinical tests with Cognita’s VLM models spurred RP to acquire the rest of the company it didn’t already own, said Rich Whitney, chairman and CEO of Radiology Partners. 

Cognita’s technology powers Mosaic Drafting, RP’s new application for helping radiologists draft reports that operates under the company’s recently launched Mosaic Clinical Technologies branding. Early clinical testing has found that Mosaic Drafting…

  • Increases radiologist detection rates by 52%.
  • Results in a fourfold decline in radiologist errors.
  • Reduces radiologist reading times by up to 76%.

RP plans to deploy Mosaic Drafting through Mosaic Clinical Technologies, which the company launched in July as the technological foundation for a massive rollout of AI across its physician practices. 

  • Mosaic Chief Medical AI Officer Nina Kottler, MD, said Mosaic Drafting is currently being used within Radiology Partners under IRB approval, but the company will pursue an FDA authorization – most likely under a de novo pathway – that probably will come sometime in 2026.

In a broader sense, RP sees Mosaic Drafting and other VLM tools as key to the growing mismatch between rising imaging volume and stagnant radiologist supply – a mismatch that can only be solved through greater automation. 

  • And as the largest private radiology organization in the U.S., Radiology Partners has the organizational heft to make VLMs work on a wide scale.

The Takeaway 

RP’s acquisition of Cognita is a major development in putting vision language models on the fast track to real-world clinical use. Unlike point-source AI, VLMs could hold the key to really solving radiology’s volume overload dilemma.

Mammo Screening Deserts Limit Access

Posted on by Brian Casey

It’s no secret that there are sharp regional differences in healthcare access in the U.S. But a new report puts a price on the access problem as it pertains to mammography – nearly 10k additional cases of breast cancer a year due to limited access in “cancer screening deserts” that don’t have mammography equipment. 

Mammography has been a success story among population-based cancer screening tests. 

  • The widespread implementation of breast screening in the 1980s is generally credited – along with improved treatments – with reducing breast cancer mortality by 44% from 1982 to 2022.

But breast cancer is still a lethal disease, killing 42k women a year in the U.S.

  • And screening’s benefits have not been distributed equally, with women in rural areas and those with lower socioeconomic status having lower completion rates.

What would it take to even out the differences? To answer this question, researchers from the Milken Institute analyzed the U.S. mammography installed base at the county level. 

  • They then correlated machine distribution with county population as well as cancer detection rates to find out how efficiently different counties were performing. 

They discovered…

  • High regional variation in mammography machine distribution.
  • The lowest distribution was in the Southwest and southern Midwest while the highest was in major urban areas, particularly on the coasts.
  • 890 counties did not have mammography machines.
  • Counties with the most mammography machines had 7.5% higher breast cancer incidence rates per 100k women compared to counties with no machines (329 vs. 306) – a sign they were detecting more cancers. 
  • There were 155 counties where mammography machine deployment would have the biggest return. 
  • And 9.6k breast cancer cases would be detected if counties with low or no mammography capacity detected breast cancer at the same rate as high-detection counties.

The new results track with another recent study that also revealed the presence of cancer screening deserts in the Southwest.

So what can be done? The Milken researchers proposed that low-resource counties be targeted for investment, but simply installing new machines won’t by itself cure the access problem. 

  • It’s also important to address barriers such as language, transportation, and cost-sharing in order to achieve equal access. 

The Takeaway

The new report shows that mammography access isn’t just an abstract issue – it’s one that is claiming the lives of thousands of U.S. women a year. Fortunately, the Milken researchers have done much of the legwork in identifying the specific areas that deserve attention. 

Opportunistic Screening Takes Big Step Forward

Posted on by Brian Casey

Opportunistic screening took a big step forward this week with new research in Nature Scientific Reports showing how an AI algorithm from Riverain Technologies was able to calculate coronary artery calcium scores from non-contrast CT scans – with performance close to that of radiologists. 

Opportunistic screening gives radiologists the chance to detect clinical conditions other than those for which the original scan was ordered. 

  • Potential use cases include calculating cardiovascular risk from mammograms or undiagnosed osteoporosis from CT exams.

One of the opportunistic applications with the most potential is CAC scoring from CT scans. 

  • CAC scores are a good marker for future cardiovascular risk. But it can be time-consuming to perform separate cardiac CT scans just to acquire CAC data when thousands of abdominal and thoracic CT studies are conducted every day and could serve just as well.

Riverain’s ClearRead CT CAC algorithm uses AI to analyze non-contrast CT exams and produce Agatston scores, the reference standard for CAC analysis. 

  • Previous research found Agatston scores to be predictive for both cardiovascular and all-cause mortality, but generating the scores requires some manual involvement from clinicians. 

In the new study, Mass General Brigham researchers compared ClearRead CT CAC’s performance to ground-truth calculations from radiologists in 491 patients who got non-contrast CT scans at five U.S. hospitals in 2022 and 2023. Researchers found…

  • CAC score agreement between AI and radiologists was high, with a kappa of 0.959 (1.0 is perfect agreement).
  • The association remained strong regardless of sex, age, race, ethnicity, and CT scanner model, with kappa higher than 0.90 for all groups except “other race.” 
  • The AI model’s CAC scores from non-gated CT scans were similar to those from gated cardiac CT exams (kappa = 0.906), which are generally considered the gold standard for cardiac CT but are more complex to perform.
  • The model’s kappa for gated CT exams compared favorably to recent research conducted with other commercially available algorithms.

The results are a boost for opportunistic screening but in particular for Riverain, which got FDA clearance for ClearRead CT CAC in December 2024 and offers the solution as part of its ClearRead CT suite.

The Takeaway

The new results show that opportunistic screening is moving beyond the research phase and that the opportunity could be now for real-world clinical use. 

CAC Research Leads Imaging at AHA 2025

Posted on by Brian Casey

The 2025 American Heart Association annual conference wraps up today, and cardiac imaging has been a major focus in New Orleans. In particular, research has highlighted imaging’s power to predict future cardiac events – and guide treatment to prevent them. 

Coronary artery calcium scoring with CT is a great example, as CAC scores can predict not only cardiovascular but also all-cause mortality. 

  • Another common theme at AHA 2025 has been opportunistic screening, in which data from imaging exams acquired for other clinical indications can be used to detect osteoporosis, cardiovascular disease, and other issues. 

Check out the items below for some of the hottest imaging topics at AHA 2025, and for a deeper dive into non-imaging news from New Orleans, be sure to visit our Cardiac Wire sister site. 

News from the show’s first three days include…

  • A massive study of 40k people found that those with CT-derived CAC scores greater than 0 were 2X-3X more likely to die from any cause than people without any CAC – and more died of causes other than cardiovascular disease. Also, 8.5% of patients had other significant findings. 
  • Community health personnel on a Native American reservation were trained to perform point-of-care screening echocardiography assisted by Us2.ai’s AI algorithms. 
  • Us2.ai’s algorithm was also used with transthoracic echo in the SCAN-MP study to detect transthyretin amyloid cardiomyopathy, a cause of heart failure. 
  • Treadmill stress tests fell short compared to CCTA in screening older master’s athletes for ischemia that could lead to sudden cardiac death.
  • A program in Brazil that used echocardiography to screen schoolchildren for latent rheumatic heart disease led to lower prevalence rates after 10 years (2.5% vs. 4.5%). 
  • Patients with hypertrophic cardiomyopathy who had higher levels of myocardial fibrosis on cardiac MRI were almost 6X more likely to have adverse events over eight years.
  • HeartLung Technologies’ AI tool predicted CAC presence on CT scans in 2.1k participants in the MESA study with higher AUC than other tools (AUC = 0.73 vs. 0.68).
  • Another study used HeartLung’s AI to analyze CAC scans to detect myosteatosis – a sign of systemic metabolic dysfunction – which predicted atrial fibrillation and heart failure. 
  • A program promoting CAC scoring to an urban population brought in people for screening who might have been missed through physician referral. 

The Takeaway

This week’s news from AHA 2025 shows medical imaging’s contribution to early detection of cardiovascular disease – the leading cause of death worldwide. CT-based CAC scoring has especially promising potential, not only for heart disease but also other conditions through opportunistic screening.

Medicare Payment Pushback to 2026 Physician Rates

Posted on by Brian Casey

CMS gave U.S. medical specialists a fright on Halloween with the publication of its final 2026 Medicare Physician Fee Schedule. The new MPFS rates lock in a controversial “efficiency adjustment” for specialist physicians (including radiologists) and continue a decline in Medicare payment rates for specialists.

Physicians have long complained about low reimbursement rates in the Medicare and Medicaid programs, which are tasked with providing healthcare services to an aging population under a budget that’s, by law, limited to a fixed amount.

  • The situation creates a zero-sum game: increased healthcare spending in one area has to be offset by reductions in another.

Physicians thought they won a victory in summer 2025 with the passage of the One Big Beautiful Bill Act, which included a 2.5% increase in the Medicare conversion factor, the complicated formula governing physician payments.

  • But it didn’t take long for the bill to come due. Within weeks of OBBBA’s passage, CMS issued its proposed 2026 MPFS rates, which included the conversion factor bump but also what the agency called a 2.5% “efficiency adjustment” payment reduction.

CMS justified the reduction by stating that it applied to medical services “that have likely become able to be furnished more efficiently over time but still retain valuations based on outdated assumptions” – including medical image interpretation.

  • But the subtext is that the adjustment continues the agency’s long shift away from medical specialties – which CMS believes are overpaid – and toward primary care physicians.

Organized medicine’s response illustrates the rule’s uneven impact. 

Indeed, an ACR analysis of the final rule estimates an overall impact of the MPFS changes to be -2% for radiology, -1% for nuclear medicine, +2% for interventional radiology, and -1% for radiation oncology.

  • That may not sound like a lot, but the reductions come on top of years of similar declines that some observers have likened to “death by a thousand cuts.”

The Takeaway

By finalizing the 2026 MPFS, CMS is locking in a physician reimbursement schedule that continues to shift payments away from medical specialties like radiology and toward primary care. It’s a trend that’s been happening for decades, and is one that this year’s change in administration has done little to reverse. Radiology should buckle up. 

New CT Protocols Reduce Radiation Dose

Posted on by Brian Casey

With patient safety top of mind these days, radiology professionals are correct to focus on performing CT scans with less radiation. To that end, three recently published research studies highlight new protocols to do just that.

Radiation safety has been one of the top radiology stories in 2025 following several studies underscoring the links between medical radiation and cancer. 

  • The irony is that patient radiation exposure can be reduced dramatically using protocols that already exist – it’s just a matter of applying them consistently in the real world. 

In the first paper, published in European Journal of Radiology, researchers share their MINDS-CAD protocol for coronary CT angiography. 

  • MINDS-CAD relies on tailoring contrast dose to patient weight and CT scanner tube voltage using a five-step process. 

MINDS-CAD was tested with 112 obese patients getting clinically indicated CCTA with Siemens Healthineers’ Somatom Force dual-source CT scanner and Bayer’s Ultravist 370 contrast agent. Researchers found that compared to a conventional tube voltage-adapted protocol, MINDS-CAD…

  • Achieved superior image quality according to cases rated “good” or “excellent” (86% vs. 75%).
  • Generated fewer poor-quality scans (3.5% vs. 8.8%).
  • Produced sharply lower radiation dose (99 vs. 386 mGy•cm).
  • Saw no link between vascular attenuation and BMI or tube voltage.

In a second EJR paper, researchers from India tested the ability of an AI-based reconstruction algorithm to reduce dose in cerebral CTA exams.

  • They used Philips’ Precise Image AI-based reconstruction protocol, which produces images resembling traditional filtered back projection scans while reducing noise like advanced iterative reconstruction methods.

In tests with 68 patients who got cerebral CTA at 100 kVp, compared to iterative reconstruction, Precise Image…

  • Improved contrast-to-noise ratio 26%, signal-to-noise ratio 22%, and visual noise 16%.
  • Generated higher image quality scores from radiologists.
  • Generated an extremely low median effective dose of 0.785 mSv.

Finally, a third study – this one in Clinical Radiology – used a “double low” technique of low-energy 50 keV images on GE HealthCare’s Revolution Apex dual-energy CT scanner with TrueFidelity deep learning image reconstruction on 60 patients with cirrhotic liver disease. 

  • Compared with a conventional protocol, the double-low technique had 48% lower radiation entrance dose (4.10 vs. 7.88 mSv) and 32% lower contrast dose (67.3 vs. 99.1 mL), while image quality was rated higher.

The Takeaway

Taken together, the new papers show that radiology’s radiation dose challenge is eminently solvable thanks to the ingenuity of clinicians and researchers who are pioneering new ways to scan.

Malpractice Reform Linked to Less Imaging Use

Posted on by Brian Casey

We all know it happens – medical imaging scans of questionable clinical value, performed not to improve patient diagnosis but to defend clinicians in the event of malpractice litigation. A new study in AJR supports the idea that defensive medicine is driving up imaging use by finding a link between malpractice reform and lower emergency imaging utilization. 

The proliferation of imaging technology throughout the healthcare enterprise – and especially in the emergency setting – gives clinicians a powerful tool that’s just too tempting not to use.

  • Head CT scans can quickly rule out patients who might have a hemorrhagic stroke, for example, while cardiac CT angiography is showing its value for working up patients with chest pain. 

But with great power comes great responsibility. Unnecessary imaging not only drives up healthcare costs but can expose patients to additional radiation as well as complications from working up suspicious findings.

  • Medical-legal experts speculate that malpractice reform through tools such as damage caps could tamp down defensive medicine by limiting physicians’ legal exposure to lawsuits in the event they make a mistake.

In the new study, researchers from the ACR’s Harvey L. Neiman Health Policy Institute tested the idea by analyzing 630k Medicaid encounters for patients with headache presenting to the emergency department in 2019. 

  • They then correlated head and neck imaging volume to various factors that could influence utilization, including whether states had implemented tort reform. 

Their analysis discovered that emergency imaging utilization was less likely to occur…

  • In states with laws on “several liability” (in which parties are only responsible for their own share of damages) (OR = 0.68).
  • In states with malpractice damage caps (OR = 0.79).
  • In states with greater mean malpractice payment (although the effect size was minimal; OR = 0.99).

A couple other interesting findings included…

  • Referring physicians other than emergency medicine were far more likely to order more imaging (OR = 8.45).
  • Facilities with fewer than 100 beds were less likely to order imaging (OR = 0.65).

The Takeaway

The new findings linking malpractice reforms with lower emergency imaging use confirm what many of us have already suspected. Whether they lead to health policy reforms remains to be seen. 

New Cancer Disparity Data Show Socioeconomic Impact

Posted on by Brian Casey

Cancer screening disparities continue to draw scrutiny in radiology. A new study in JAMA Network Open takes a closer look at why some people don’t get screened as often as they should – as well as the factors that contribute to cancer prevalence and mortality. 

There’s extensive research backing the lifesaving potential of the major cancer screening exams, and cancer mortality rates have consistently declined thanks to the combination of screening and better treatments. 

  • But the declines are uneven, prompting researchers to investigate reasons for the disparities, such as in a study earlier this month documenting geographic variations in cancer screening rates. 

In the new study, researchers from the ACR’s Harvey L. Neiman Health Policy Institute looked at how 24 measures like lifestyle, socioeconomic status, and environmental background affected breast, prostate, lung, and colorectal cancer, which account for 50% of new cancer cases.

  • In particular, they examined screening completion rates and cancer prevalence and mortality at the county level in a nationally representative sample of 5% of Medicare fee-for-service beneficiaries, of whom 87% were 65 years and older. 

There’s a lot to unpack in the study, but a few highlights are below as they relate to breast and lung cancer, the two cancers for which imaging-based screening is recommended. The top three factors affecting each (in order of importance) are…

  • Breast cancer:
    • Screening rates – Hispanic population share, levels of insufficient sleep, and poverty. 
    • Prevalence – uninsured status, obesity, and housing insecurity.
    • Mortality – non-Hispanic Black race, environmental justice index, and insufficient sleep.
  • Lung cancer:
    • Screening rates – air pollution exposure, lack of access to primary care physicians, and number of poor physical health days.
    • Prevalence – limited access to healthy foods, uninsured status, and severe housing problems.
    • Mortality – smoking, poor physical health days, and environmental justice index. 

While there are some obvious findings in the data (the connection between smoking and lung cancer mortality, for example), the dominance of socioeconomic measures may take some by surprise (or maybe not). 

  • But they do track with previous research finding that socioeconomic factors account for 40-50% of health impacts.

The Takeaway

The new study – as with previous research – reinforces what we know about the strong connection between socioeconomic status and cancer screening disparities. The new data should give clinicians and public health advocates more detail on the specific factors they need to focus on to improve screening compliance and reduce cancer’s burden on society.

Hologic to Go Private in $18.3B Buyout

Posted on by Brian Casey

Women’s imaging vendor Hologic will go private in an $18.3B buyout led by two private equity firms, Blackstone and TPG. The move is easily the largest acquisition in radiology this year – the question is how it will impact one of the biggest corporate success stories in women’s health. 

Hologic has a long history in medical imaging and was founded in 1985 to develop and market bone densitometry systems. It soon expanded into mammography, molecular diagnostics, and women’s health treatments.

  • The company went public in 1990, and has maintained its independence even as radiology underwent a period of consolidation in the 1990s and 2000s that saw most mid-cap firms get acquired by multinational OEMs.

Much of Hologic’s momentum was driven by the conversion of U.S. mammography facilities from standard 2D mammography to 3D digital breast tomosynthesis. 

  • This shift was led by Hologic’s Selenia Dimensions system, which in 2011 was the first DBT system to get FDA approval. Hologic rode its momentum to a U.S. mammography installed base market share approaching 70%. (Signify Research estimates Hologic currently has a 34% market share of the global mammography market.)

But as often happens to many market leaders, Hologic’s position began slipping in recent years. 

  • The multinational OEMs have improved their positions in women’s imaging, releasing DBT systems that are more competitive with Hologic’s offerings while also benefiting from multiyear purchasing agreements with large health systems in which mammography systems can be bundled with CT, MRI, and other equipment. 

Perhaps as a result, Hologic’s Breast Health segment has become a drag on revenue growth due to lower equipment sales. Breast Health revenues for the most recent Q3 period fell 5.8%, following a 6.9% drop in Q2 and a 2.1% decline in Q1. 

  • Indeed, reports began surfacing in May 2025 that Blackstone and TPG were targeting Hologic for acquisition, with Hologic reportedly rejecting a $16.7B offer. 

The bid was apparently sweetened, with an acquisition price of $79 a share, a 46% premium from before the acquisition rumors started, for a total value of $18.3B. The buyout should close in the first half of calendar 2026.

The Takeaway

Hologic built itself into a radiology success story through a combination of technological innovation and an obsessive focus on a single market segment – women’s health. The question is whether that focus will continue under its new PE-led ownership.

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