Cancel Culture | Mobile Rads | Distanced CXRs

“Most of my team members are experts in these programming languages.”

The founder of an imaging AI startup during a Series A pitch when asked if his team is competent with RIS, PACS, EMR software. Still might have got funded, though.

Imaging Wire Sponsors

  • Arterys – Transforming medical imaging by reducing the tedium of interpretation and empowering physicians with our web-based AI platform.
  • 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.
  • 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.

The Imaging Wire

Cancel Culture

We might have spent the last few months focused on how to work through the COVID screening / elective backlogs, but the last few weeks brought a reminder that rising COVID rates mean declining electives.

  • Electing to Pause – Hospitals across the country have begun to pause, delay, or reprioritize elective procedures until things clear up. Many hospitals are initially targeting locations near COVID hotspots and/or certain procedures (e.g. electives that require overnight / inpatient stays), while also noting that they will continue to evaluate their elective policies.
  • The Takeaway – It’s a good time to be pragmatic and we’ve learned a lot since the last shutdown. Still, this feels like the beginning of a trend, and it’s going to affect imaging.

The Wire

  • Radiologists on The Move: The latest Neiman HPI study revealed that radiologists are separating from their practices (via resignation, retirement, acquisition, termination) at a far greater rate than ever before. Using public data (n = 25,228 radiologists, 4,381 practices), the study found that 41% of radiologists separated from at least one group between 2014 and 2018, while annual separation rates rose dramatically (13.8% from 2014 to 2015 to 19.2% from 2017 to 2018).
  • CDI Expands to SLC: The Center for Diagnostic Imaging (CDI, 130 imaging centers in 22 states) expanded to the Salt Lake City area with its acquisitions of Open Imaging and U.S. MRI (3 & 5 imaging centers). These represent CDI’s first major acquisitions since the imaging group was itself acquired last year, although CDI suggests that has more M&A planned.
  • Social Distanced CXRs Work: A Yale study found that a modified chest X-ray technique introduced early in the COVID-19 emergency (6-feet away, through a glass door) is effective from a radiation, technologist experience, and diagnostic perspective. The researchers compared 50 standard CXRs with 50 COVID-modified CXRs, finding that patients had the same radiation exposure with both methods (both 169 µGy median), technologists had less exposure with the modified CXRs (0.055 µGy vs. 0.088 µGy), and nearly all images were of “diagnostic quality.” A technologist survey (n = 26) found that they approved of the technique, felt safer because of it, and agreed that it helped conserve PPEs.
  • Riverain Joins Blackford Platform: Blackford Analysis announced the addition of Riverain Technologies’ ClearRead CT and ClearRead Xray lung disease detection tools to the Blackford Platform. The partnership expands Riverain’s growing list of platform alliances (e.g. Nuance, Ambra, GE, Terarecon) and adds to Blackford’s panel of AI partners (e.g. Avicenna.AI, Subtle, VIDA, CorTechs).
  • Metabolic Syndrome AI: A new AJR study suggested that AI algorithms could be used to identify signs of metabolic syndrome in low-dose CTC scans, representing a potential way to screen for the dangerous disease. The study reviewed clinical data from 7,785 patients who received CTCs (738 who met metabolic syndrome criteria) and then analyzed all of the CTC scans with algorithms intended to quantify muscle, fat, and abdominal calcification. The algorithms spotted the 738 metabolic syndrome patients with an 0.93 AUC when measuring both Skeletal muscle index and L1-level total adipose tissue.
  • Volpara & DetectED-X Teach Density: Volpara Health and online radiology training and research company, DetectED-X, announced the launch of their new DensityED online breast density training tool. DensityED integrates Volpara and DetectED-X’s technologies and will be offered by both companies. Partnerships have been a major part of Volpara’s strategy since the start of 2019, previously announcing channel and tech alliances with Fujifilm, Ambry, and Screenpoint.
  • Low Trainee Litigation: A new JACR study found that radiology trainees are involved in just 4% of complex medical malpractice cases that involve trainees (n = 580 cases), falling well below surgery and OBGYN trainees (35.2% & 19.7%). When radiology trainees are involved in litigation, it’s most commonly due to missed diagnoses and procedural complications (60.8% & 30.4%), and defendant radiologists prevailed in 69.2% of these cases.
  • Mammography’s Long-Term Backlog: A new UPenn study found that the mammography backlog created during the COVID-19 pandemic will take at least 22 weeks to work through, but warned of a “worst‐case scenario” where the backlog continues to grow until the pandemic subsides. The analysis of Independence Blue Cross’ patient data found routine screening and diagnostic mammograms reached their respective low points in early April ( -99% & -74%) and rebounded by late July (-14% & 0%), but not by enough to reduce the group’s 45,500 missed mammograms.
  • Canon’s AiCE MRI Faceoff: Canon Medical backed up its years of AiCE image quality claims, revealing that half the radiologists in a study (n = unknown) “had difficulty differentiating” images produced by its Vantage Orian 1.5T MR using its AiCE reconstruction technology compared to standard 3T MRI images. Given the marketing emphasis that Canon’s placed on its AiCE technology over the last several years, evidence like this is a helpful step.
  • Inappropriate in the ED: A team of Brazilian radiologists found that 36.3% of the abdominal CTs and 84.4% of the abdominal ultrasounds ordered by its emergency department were not appropriate (n = 135 CTs and 143 US orders). The ED’s inappropriate imaging orders were far less likely to result in findings that supported initial diagnoses (CT = 20.4% vs. 76.7%; US = 14.4% vs. 38.9%), and they often led to additional imaging orders for a second modality (20% of the US orders, 8.2% of the CT orders).
  • Imaging Biometrics & Mayo: Imaging Biometrics will work with Mayo Clinic to develop its IB Trax AI tool used to track metastatic and primary brain tumors. IB Trax will use Imaging Biometrics’ quantitative technologies, and leverage clinical input from Mayo Clinic for the development of its overall workflow. In return, IB will provide the Mayo Clinic a combination of shares and ongoing royalties.
  • Second Reader Evidence: Research out of Japan found that a Canon-made machine learning-based CT texture analysis solution improves radiologists’ interobserver agreements on scans of patients with COPD, interstitial lung diseases, or infectious diseases. The team trained, validated, and tested the ML model on thin-section CT scans (n = 28, 17, 89 patients). Three radiologists reviewed 350 regions of interest pulled from the test set, achieving far higher agreement rates (κ = 0.91 vs. 0.81) and consensus accuracy (94.9% vs. 84.3%) with the ML model than without. These findings suggest that a solution like this could be used as a second reader.
  • Life Image Goes Small: Life Image expanded its clinical and imaging data network to smaller healthcare providers and healthcare entrepreneurs with the launch of its new Life Image Network Connector (LINC). The new interoperability solution allows smaller organizations to digitally exchange medical images and other health data with larger institutions on the Life Image network.
  • Zebra’s Big Population Health Rollout: Zebra Medical Vision announced that it will deploy its population health AI solutions across Clalit Health Services’ network (Israel’s largest health service organization, 4.5m members), calling it the world’s first cloud-based imaging AI rollout at a large scale HMO. The deployment expands upon Clalit and Zebra-Med’s 6-year collaboration that included related product development, research, and data-sharing efforts focused on population health.

The Resource Wire

– This is sponsored content.

  • Learn how leveraging the right cardiology image and reporting platform drives performance and outcomes in this Hitachi white paper.
  • In its latest Q&A, Nuance sat down with Nines CEO David Stavens, PhD, and medical director Dr. Jean-Paul Dym, MD, to discuss their experiences with PowerScribe One and their perspectives as a Nuance innovation partner.
  • To honor Breast Cancer Awareness Month, Siemens Healthineers hosted a special webinar on Breast MRI featuring Dr. Susan Weinstein. Register to access the recording and watch it at your own convenience.
  • Documentation is critical in order to be properly reimbursed for yttrium-90 (y-90) radioembolization procedures. Learn how to document these procedures for maximum reimbursement in this blog article from Healthcare Administrative Partners.
  • This Bayer Radiology case study details how its Certegra P3T Software automates contrast enhanced abdominal CT injection protocols based on patient characteristics and contrast concentration.
  • Learn how Riverain’s ClearRead CT Vessel Suppress provides a powerful and intuitive view for clinicians through the suppression of vascular structures.
  • This GE Healthcare Insight details how contrast enhanced spectral mammography (CESM) caught one woman’s hidden cancer and helped turn her into a breast density awareness advocate.

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