A Disturbing Surge | SWE Pressure | Validating ClearRead CT

“… ignoring life-threatening non–COVID-19 conditions such as cancer for too long may turn one public health crisis into many others. Let’s avoid that outcome.”

U.S. National Cancer Institute’s Norman Sharpless on the pitfalls of delayed screening.

Imaging Wire Sponsors

  • Focused Ultrasound Foundation – Accelerating the development and adoption of focused ultrasound.
  • GE Healthcare – Providing point of care ultrasound systems, from pocket-sized to portable consoles, designed to support your clinical needs and grow along with your practice.
  • 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.
  • 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.

The Imaging Wire

A Disturbing Surge

We’ve been talking and writing a lot about the post-COVID imaging surge like it’s a foregone conclusion that the coronavirus will quickly subside and our biggest problem will be processing all those delayed scans. I know I’m guilty of that, but optimism is one of The Imaging Wire’s core values.

Unfortunately, Dr. Anthony Fauci is less optimistic about the COVID-19 emergency subsiding any time soon, citing the “disturbing surge” of infections across much of the country. Dr. Fauci also broke it to us optimists that “the virus is not going to disappear” and reminded the folks concerned about COVID’s potential second wave that we’re still in the middle of the first wave.

That’s scary stuff, and it’s going to require vastly expanded testing and tracing, plus the eventual rollout of a vaccine (the end of 2020 at the earliest) for us to realistically talk about a “post-COVID surge.” Until then, it may be wise for us to start planning for (and writing about) a “surge” of non-COVID procedures that take place while we’re still caring for plenty of COVID-19 patients.

Quantifying ClearRead CT

It says a lot when a solution works so well for a radiology department that they decide to perform a study to quantify its benefits. That is exactly what happened at the University Hospital of Zurich (USZ), which launched a study on the benefits of Riverain Technologies’ ClearRead CT after implementing the solution into its chest CT workflow.

In the latest Imaging Wire Q&A, we sat down with USZ radiology deputy director Professor Thomas Frauenfelder to discuss how ClearRead CT improved his team’s chest CT reading performance and to learn about his study to quantify these improvements. Here are some of the big takeaways:

  • Origins – USZ adopted ClearRead CT several years ago after evaluating a number of lung nodule detection applications, selecting ClearRead CT due to its high accuracy and workflow advantages.
  • Quantifying ClearRead CT – Upon realizing how much ClearRead CT helped USZ’s chest CT workflow, Professor Frauenfelder and his team launched the study, finding that the vessel-suppressed CTs had 21% greater nodule detection rates, much higher interreader-agreement rates, and significantly shorter average read times. Professor Frauenfelder expected solid results, but was surprised “that the advantages were so significant.”
  • Next Up – With ClearRead CT adopted and its advantages quantified, the USZ radiology team is now working on a study evaluating Riverain’s ClearRead Xray solution for COVID-19 diagnosis.

SWE Pressure Prototype

Shear-wave elastography can produce inaccurate measurements when too much pressure is applied during ultrasound scans, so a team of German researchers developed a pressure-measuring transducer attachment that could help improve SWE imaging consistency.

  • The Prototype – The team’s prototype breast SWE attachment combines layers of interlocking plastic shells with pressure sensors. The attachment surrounds the transducer and provides real-time feedback on the operator’s applied pressure.
  • The Test – To validate the prototype, a radiographer with breast sonography and elastography experience and two radiologists used the device to scan various animal parts. The trio applied increasing pressure throughout the scan process until they damaged the animal tissue or reached maximum pressure. The validation process found that mean elasticity increased as pressure increased, confirming that the prototype can indeed provide real-time feedback.
  • The Significance – We don’t usually cover transducer attachments at the top of an issue, but this one is interesting since there’s currently no way to measure the pressure being applied during ultrasound scans. This prototype could be an important first step towards reducing the role of operator pressure bias in SWE measurements and its measurements could lead to clinical pressure guidelines for SWE imaging.

The Wire

  • ABR Goes Virtual: Folks actually had relatively positive things to say about the American Board of Radiology on social media this week when the certification group announced plans to begin virtually administering exams in H1 2021. Although nearly all of the ABR’s 2020 exams are still postponed and it took a near uprising (and three months) for the ABR to go virtual, this move was widely viewed as a positive step.
  • Siemens’ Intelligent X-Ray: Siemens Healthineers unveiled its forthcoming YSIO X.pree “intelligent X-ray system,” highlighted by the company’s new myExam Companion intelligent UI concept that guides the acquisition process (first introduced in its CT scanners last year), a new AI tool for automated thorax collimation (detects and collimates region of interest), as well as Siemens’ forthcoming AI-Rad Companion Chest X-ray software. The new efficiency / automation-focused system, will launch in the U.S. and Europe this summer pending its FDA and CE approvals.
  • NIP Mammography Advantage: New research out of Germany found that computed mammography systems using needle-based detectors can significantly reduce radiation dosage compared to powder imaging plates, without sacrificing image quality. The researchers compared 360 random mammography exams performed using an Agfa DX-M needle-based imaging plate system (NIP) against standard-dose exams using an Agfa CR85-X powdered storage phosphor imaging plate system (PIP). The NIP-based exams reduced dosage by 29.8% and blind reads performed by two mammography experts found the NIP images to be either “significantly better” or not significantly different than the PIP images.
  • Proprio’s $23m: Computational imaging company Proprio completed a $23m Series A round (increasing its total to $30m) that it will use to expand its development team, support its regulation and commercialization efforts, and install its first systems. Called “the most transformative technology in surgery since the X-ray” in the press release, Proprio’s solutions integrate preoperative imaging and planning data to allow surgeons to operate without looking away from their patients.
  • Bone Structure X-Ray: An international team led by Denmark’s Aarhus University developed a 3D X-ray technique that could provide new insights into the nanocrystal architecture of healthy human bones, potentially leading to new bone tissue research and better understanding of bone biomaterials. The team improved current tensor tomography X-ray technology to create a 3D map of the crystals in bone tissue, allowing researchers to see how nanocrystals are located and revealing for the first time that bones are not uniformly structured.
  • CV19 Imaging Services: A new survey from IMV Medical Information Division covered on AuntMinnie.com detailed how imaging equipment service needs are changing during the COVID-19 emergency, citing increased demand for mobile X-ray service and reduced service activity for many other modalities (e.g. MRI, mammography, and nuclear medicine). Going forward, the firm expects a shift towards strategic servicing, including value-added remote and software-related services (e.g. remote diagnostics, security, remote software repair and upgrades) and suggests that hospitals will prefer post-warranty service contracts that cover multiple modalities / locations.
  • Delayed Consequences: The National Cancer Institute warned that COVID’s mammogram and colonoscopy screening delays (and therefore COVID’s delayed diagnoses and treatments), could lead to 10,000 “excess deaths” over the next 10 years. That’s a 1% increase, with much of the impact happening within the next two years, and it’s assuming screening bounces back after 6 months. With that, the NCI is encouraging patients to return to screening before we “turn one public health crisis into many others.”
  • RSIP’s US AI Rollout: RSIP Vision rolled out a new set of ultrasound AI modules for needle biopsies (helps identify abnormal tissue), cardiac ultrasound (automates measurements and segmentation), 3D reconstruction (builds 3D view of organs with limited data), and patient screening (automates a range of US image analysis).
  • Laser X-Ray Model: University of Nevada scientists developed a numerical modeling method that accurately simulates X-ray images using laser-produced X-rays, without radiation. Although still experimental, modeling like this has the potential to expand the use of laser X-rays to a range of industrial applications and perhaps medical imaging (they mainly focused on industrial though).
  • CorTechs & Subtle Partner: CorTechs Labs and Subtle Medical announced a distribution partnership that will expand Subtle Medical’s automated image reconstruction solutions to CorTechs Labs’ customer base. Subtle’s efficiency-focused SubtleMR and SubtlePET solutions are positions as complementary to CorTechs’ NeuroQuant (MRI) and NeuroQuant (PET) quantitative volumetric analysis software, citing research that found that NeuroQuant performed just as well with images produced with SubtleMR as standard MRI scans (that take 2x longer).
  • Nanox Goes to Taiwan: Nanox continued its global expansion, signing a distribution agreement with Golden Vine International to deploy 500 Nanox.ARC systems across Taiwan (and potentially Singapore). Reportedly worth at least $28.9m in annual service fees, Nanox’s new Taiwan alliance follows shortly after similar expansions into Russia and Belarus (500 units), Italy (500 units) and South Korea and Vietnam (2,500 units). It also comes almost exactly a year after Nanox first revealed plans to expand globally, and although almost all of these new alliances are awaiting regulatory approval, Nanox’s global ambitions now seem a lot more realistic compared to last year.
  • Ambra’s Epic Integration: Ambra Health announced new integration with Epic MyChart, allowing medical image sharing within the massive patient portal network (100m patients), while also rolling out new integrations with other Epic applications (Epic endoscopy, Epic physician portal).

The Resource Wire

– This is sponsored content.

  • When preparing your radiology practice to reenter the market after the dip in imaging volume caused by COVID-19, be sure to evaluate your human resource policies, physician staffing considerations, and scheduling parameters as discussed in this blog article from Healthcare Administrative Partners.
  • Rural hospitals have unique needs and most know that bigger doesn’t always mean better when it comes to healthcare. This Hitachi blog details why its combination of the right features, ROI, service levels, and philosophy make it the right partner for rural hospitals.
  • In this GE Healthcare video, ultrasound users and educators discuss how the Vscan Extend handheld ultrasound combines portability and intuitive design so you can use it in the moment to potentially change patient outcomes.

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