AI in 2021 | CT + EMR | Bone DBT

“The vaccination rollout, all well-intentioned, hit the perfect storm.”

Stanford Medical Center after its vaccine prioritization algorithm skipped over many frontline residents and fellows.

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The Imaging Wire

Combining ABUS + DBT

Researchers from Germany’s Heidelberg University evaluated a prototype breast scanner that combines 3D automated breast ultrasound (ABUS) and DBT in a single system, identifying promising workflow benefits.

  • Introducing the FUSION-X-US-II – The FUSION-X-US-II system combines Siemens’ ACUSON S2000 Automated Breast Volume Scanner and MAMMOMAT Inspiration DBT system (both FDA and CE approved) within a single unit. The new FUSION-X-US-II succeeds the previous FUSION-X-US-I prototype, adding compression and positioning enhancements.
  • The Study – The researches scanned 152 women with the FUSION-X-US-II prototype (101 successfully), measuring machine performance, exam time, and lesions identified.
  • The Results – Radiologists identified 33 of 34 malignant breast lesions (97.1%) with images from the FUSION-X-US-II, rating its ABUS image quality as “diagnostically useful” in 86 of 101 cases (85.1%). The ABUS scans added 40 to 60 seconds to each exam.
  • ABUS Improvements – The FUSION-X-US-II’s ABUS scanner achieved 80% breast coverage, up from 66% with the previous generation system.
  • Areas for ABUS Improvement – The FUSION-X-US-II’s ABUS scanner still isn’t ready for prime time, as ABUS scans couldn’t be completed in 51 out of 152 exams due to software and hardware problems. The team also noted that the ABUS scanner’s current transducer limits its image quality.
  • The Takeaway – If DBT + ABUS exams become a screening standard, the researchers suggest hybrid systems like the FUSION-X-US-II could offer “practical and logistic advantages” over using separate systems.

The Wire

  • Identifying PE with CTPA + EMR: A Stanford team developed a deep learning model that uses CTPA images and patient history data from EMR systems to accurately spot pulmonary embolism. The team’s multimodal deep learning model (CTPA + EMR) identified PE with an AUROC of 0.962, far greater than their image-based (0.833) and EMR-based models (0.921) on their own.
  • Philips & InSightec’s MRgFUS: Philips and InSightec announced a partnership that will make Philips’ 3.0T and 1.5T MRIs compatible with InSightec’s Exablate Neuro platform for MR-guided focused ultrasound neurosurgery (Essential Tremor, other neurological disorders). Philips and InSightec expect the compatible systems to launch in 2023, supporting both new and existing Philips MRI installations.
  • ICH AI Works: A new study out of Yale detailed how using an ICH stroke AI tool to peer review non-contrast head CTs can help identify ICH and reduce false negatives. The researchers used the FDA-approved AI tool to review 5,585 CTs that were initially found to be ICH-negative by radiologists, identifying 28 scans with signs of ICH, including 16 scans that later proved to be ICH-positive (1.6% false negative rate, most commonly in cerebral convexity and parafalcine regions).
  • Fujifilm’s CT Win: Fujifilm announced that Illinois-based urology practice UroPartners (top-5 U.S. urology practice, 37 locations) will use Fujifilm’s Persona CT system for oncology treatment planning. We don’t cover new customer wins often, but this is a milestone for Fujifilm’s first CT system in the U.S., which debuted in late 2018 and was limited to its first installation before now.
  • Same Day Risk Benefits: A new Banner MD Anderson Cancer Center study highlighted the results of their breast cancer risk assessment and genetic testing program, which asks women to fill out risk questionnaires on the same day as their imaging exams, and performs genetic tests on higher-risk women. Of the 3,345 women who completed risk questionnaires, 1,080 met genetic testing criteria, 416 completed their genetic testing, and 38 were found to have pathogenic mutations. Thirteen of the women with mutations began risk-reduction programs because of the proactive testing program.
  • Hologic’s 3D Breast Ultrasound Software: Hologic added 3D breast ultrasound imaging software to its SuperSonic MACH 40 ultrasound system, combining new 3D volumetric data with the system’s elastography imaging tech to help clinicians visualize breast anatomy and characterize lesions. The SuperSonic MACH 40 is Hologic’s first ultrasound to come out of its 2019 acquisition of SuperSonic Imagine, and the ultrasound (plus software additions like this) help round out Hologic’s breast imaging portfolio.
  • DBT Bone Screening: Henry Ford Health System researchers found that DBT technology could be used for bone density screening, potentially allowing breast cancer and osteoporosis screening during the same appointment and with the same modality. The researchers performed digital wrist tomosynthesis (DWT) imaging using a DBT scanner, finding that DWT measured wrist bone density, cortical thickness, and microstructural properties with similar performance as DEXA and microCT screening (and with high repeatability). They also found that exam staff and patients performed DWT scans without challenges, in under five minutes.
  • AI in 2021: An auntminnie.com guest post from Aidoc CEO Elad Walach detailed his three big predictions for imaging AI in 2021. Here they are: 1) AI adoption will continue to grow, while AI’s ROI will become clearer; 2) The COVID-19 pandemic’s strain on hospital budgets will accelerate the imaging AI company consolidation trend (via acquisition and liquidation); 3) The industry will start viewing AI as different categories rather than lumping all solutions together as “AI” (e.g. triage/notification, screening, population health). Predictions are hard, but these make sense.
  • COVID’s LDCT Impact: We can add LDCT lung cancer screening to the list of imaging-based screening exams that declined during the COVID pandemic. That’s from a new University of Cincinnati study that analyzed their LDCT screening database (Jan 2017 – Feb 2020 vs. Mar – July 2020), finding major declines in total monthly screenings (146 to 39) and new screening patients per month (56 to 15). Patients with suspicious lung nodules increased significantly after screening operations resumed (8% vs. 29%).
  • Deadly Imaging Denial in the UK: A 28-year-old British man died of cancer last week, after Leeds Teaching Hospitals NHS Trust reportedly denied his imaging requests early in the COVID emergency due to workflow constraints. The man reportedly “begged” for an MRI scan to diagnose his leg pain during 13 visits from March to May before a May 26th scan revealed a tumor on his pelvis and 30 small lung tumors.
  • CEUS for Liver Transplant Risks: New research out of China revealed that contrast-enhanced ultrasound (CEUS) can help determine short-term transplant complication risks. The researchers performed CEUS on 52 liver donors, finding that donor livers with lower CEUS enhancement levels had nearly 16-times greater odds of primary graft dysfunction (PGD) within a year of the transplant.
  • Ultrasound Stroke Care Simulator: South Korean researchers developed a wearable, lightweight (20g), and wireless low-intensity focused ultrasound brain stimulator that can treat brain nerves damaged by stroke. The new system represents a notable advancement from previous prototypes that were heavy and fixed, limiting their animal testing options. This isn’t our type of ultrasound, but imaging is certainly involved in the stroke care pathway and it’s a great example of ultrasound’s expanding value across healthcare.

The Resource Wire

– This is sponsored content.

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