Caption’s NTAP | Nanox Acquires Zebra

“While the Zebra has changed its stripes, the mission remains very much the same.”

Zebra Medical Vision CEO, Zohar Elhanani, regarding the company’s acquisition by Nanox.

Imaging Wire Sponsors

Arterys | Bayer Radiology | Blackford Analysis
Canon Medical Systems | Fujifilm Healthcare Americas
GE Healthcare | Novarad | Nuance
Riverain Technologies | Siemens Healthineers
United Imaging | Zebra Medical Vision

The Imaging Wire

Caption’s NTAP

Caption Health just became the second imaging AI vendor granted a Medicare New Technology Add-on Payment (NTAP), representing a major milestone for Caption Health and for the business of imaging AI.

  • Caption NTAP Basics – Starting on October 1, 2021, providers who use Caption Guidance to guide a wide range of cardiac ultrasound exams can receive add-on payments for each qualified inpatient use (in addition to the corresponding DRG reimbursement).
  • NTAP Qualifications – In order for a patient to qualify, they must be covered by Medicare, have inpatient status, and their per-exam cost for Caption Guidance must be more than the associated DRG reimbursement.
  • NTAP Quantifications – Although Caption Health didn’t specify its reimbursement levels, CMS documents suggest that Caption Guidance’s maximum NTAP reimbursement would be $1,868 per qualified use (65% of a provider’s avg. Caption cost per exam). Again, that’s the maximum.
  • Caption’s NTAP Impact – According to the same CMS documents, we can expect roughly 2,592 NTAP-qualified Caption Guidance exams and $4.82m associated add-on payments annually.=
  • Another AI Milestone – It appears that Caption Health is the only AI player among the new 2021 NTAPs, but two active NTAP-qualified AI tools is still a big milestone (Caption & Viz.ai), especially considering that imaging AI reimbursements were a futuristic idea this time last year.

AHP’s Case for Arterys Cardiac MR

See why American Hospital of Paris radiologist, PR Olivier Vignaux, says Arterys is his “favorite post-processing tool for cardiac MR,” in this user interview.

– Sponsored.

Nanox Acquires Zebra & USARAD

Nanox became the talk of the industry this week, announcing its acquisition of Zebra Medical Vision and signing a letter of intent to acquire US telerad practice USARAD Holdings.

  • Acquisition Details – Nanox will pay up to $200m for Zebra-Med (all in Nanox shares, half based on future milestones) and up to $30m for USARAD ($21m in shares, $8.5 based on milestones).
  • Nanox’s Goal – Zebra-Med and USARAD would play key roles in Nanox’s vision to create a “globally connected, end-to-end radiology solution” built around the Nanox.ARC imaging platform.
  • Zebra’s Contribution – Zebra Med’s team and technology would definitely support Nanox’s goal of creating AI-enabled scanners and diagnostic workflows. Zebra-Med would also give Nanox its first regulatory-cleared products (7 FDA, 10 CE marked), some big-name clinical alliances (Oxford, Intermountain), and an influx of experienced and well-connected team members.
  • USARAD’s Contribution – Nanox’s acquisition of USARAD would bring the two very close business partners even closer, allowing Nanox to further integrate USARAD’s Telerad services (300 U.S. rads) into the Nanox.ARC platform. USARAD would also give Nanox its first revenue-generating business line.
  • Zebra Milestone – This is perhaps the most significant acquisition in imaging AI’s short history, considering Zebra’s role as an early imaging AI trailblazer (founded way back in 2014) and its long list of accomplishments since then. Although Zebra Med’s founders and VCs might have planned for a different exit, getting an up to 3.5x return and a longer runway to achieve its population health AI goals makes sense.

Aquilion ONE / PRISM CT Adds One-Beat CV Imaging

Canon Medical’s Aquilion ONE / PRISM Edition CT system now supports one-beat cardiovascular imaging, allowing healthcare providers to acquire whole-heart spectral images in one heartbeat (0.275 seconds).

– Sponsored.

The Wire

  • 9/11 Liver Risks: Mount Sinai researchers analyzed CT scans from 1,788 September 11th rescue workers, finding that the rescuers’ arrival dates at the World Trade Center directly correlated with their risk of hepatic steatosis (aka fatty liver disease). Over 14% of responders showed signs of hepatic steatosis, with the highest rates among responders who arrived at the WCT immediately after the attack (9/11 = 17%, 9/12 = 16%, 9/14 – 9/30 = 10.9%, after 10/1 = 9%).
  • Siemens’ Lung Cancer Pathway: Siemens Healthineers added a lung cancer pathway to its AI-Pathway Companion clinical decision support platform (joining prostate cancer). The new AI-Pathway Companion Lung Cancer supports multidisciplinary teams’ decision-making throughout the non-small cell lung cancer treatment process, including organizing patient management and case reviews within a single dashboard, ensuring important patient information is available, and enabling the documentation of relevant notations.
  • CAC Scores Predict TAVR Deaths: A new RSNA study showed that coronary artery calcium scoring can independently predict patient survival following transcatheter aortic valve replacement (TAVR), suggesting that CAC scores should be added to current risk models. The researchers evaluated pre-TAVR CT scans from 309 patients (none w/ previous revascularizations), finding that patients with ≥1,000 CAC scores had far higher all-cause mortality risks at 30-days (hazard ratio 4.5 vs. <1,000 CAC scores) and at 1-year (HR: 4.1 vs. <99 CAC scores).
  • GE Edison True PACS: GE Healthcare unveiled its cloud-native Edison True PACS, targeting it at small imaging centers and community hospitals who are adopting cloud PACS for the first time. Edison True PACS appears to be quite flexible (SaaS or on-premise, three tiers) and addresses some top priorities for smaller imaging providers like security (AWS Cloud), remote access (web-based diagnostic viewer, a zero-footprint clinical viewer), and AI readiness (integrated with GE AI marketplace).
  • PE AI’s False Positives: German radiology researchers detailed a commercially-available pulmonary embolism detection AI tool’s extremely poor performance with their own emergency CTA scans. The researchers used the AI tool to review 1,229 exams (182 w/ PE, 504 total emboli), producing just 258 (8 %) true-positives and 3,073 (92 %) false-positives. That’s an average of 2.25 false-positives per study.
  • DeepMind Bully: Google’s AI corporate culture was on the wrong side of the news cycle again last week after it was discovered that DeepMind’s cofounder (Mustafa Suleyman) was placed on leave for bullying… and then promoted to Google’s VP of AI Policy and given a seat on Google’s AI ethics board. Bullies get promoted all the time, but this one has people upset considering that Google recently fired a pair of well-liked AI Ethics leaders for doing what many consider “the right thing.”
  • Prostate MRI AI Accuracy: A new EJR study highlighted a deep learning algorithm that can detect significant prostate cancers in biparametic MRI scans comparably to many human radiologists. The researchers compared 121 patients’ AI findings and PI-RADS assessments, finding that the model diagnosed clinically significant cancer better than residents and similar to less-experienced radiologists, but was far less accurate than expert rads (AI AUROC = 0.828 vs. 0.706 & 0.060-0.661 & 0.914).
  • Windsong’s Buffalo Acquisition: Western New York’s Windsong Radiology acquired local imaging center company Buffalo MRI (1 location, 4 radiologists), marking Windsong’s first public acquisition since it became part of US Radiology Specialists (USRS) in late 2020. It’s likely that we’ll see more northeast U.S. acquisitions from Windsong and/or US Radiology Specialists, given USRS’ focus on M&A and its plans to expand in the region.
  • Post-Surgery Adherence: Johns Hopkins researchers detailed the factors that make women less likely to adhere to surveillance imaging recommendations following breast conserving surgery. Among 1,082 women who underwent breast conserving surgery, 34% didn’t attend recommended imaging exams during their three-year surveillance period, with the lowest follow-up adherence rates among Black women (1.36x less likely), women with Medicare coverage (1.84x less likely), and women with benign breast disease (“significantly less likely”).
  • Siemens Medicalis Adds Patient Scheduling: Siemens Healthineers added patient self-scheduling to its Medicalis Referral Management solution, allowing patients to schedule their own outpatient imaging exams based on time and location convenience, and providing patients with pre-exam instructions and reminders to reduce no-shows/cancellations. This is a notable expansion to Medicalis, which previously focused on referrals and internal scheduling management.
  • 18F-FET PET/MR for Brain Tumor Management: A new study out of Germany (n = 189 patients) found that 18F-FET PET/MR imaging accurately detects malignant brain tumors and identifies true tumor progression (85% & 93% accuracy), suggesting that it could prevent unnecessary procedures and improve treatments. They also found that 18F-FET PET/MR improves management of patients who previously had inconclusive exams, leading to clinical management changes for untreated lesions and tumor progression (33% & 53% of these patients).
  • Ambra & Health Gorilla Integrate: Ambra Health will integrate its medical image management suite into Health Gorilla’s healthcare API platform, making medical image viewing available on Health Gorilla’s clinical records application for the first time.

Vidistar’s Evolution

Learn how Fujifilm Healthcare’s VidiStar PACS system evolved to meet the needs of pediatric cardiologists in this Imaging Wire Q&A.

– Sponsored.

The Resource Wire

  • This European Radiology study highlighted Riverain Technologies’ ClearRead Xray – Detect as one of just two imaging AI products to achieve the FDA’s most stringent premarket approval level. See how they measured up against the other 99 AI tools here.
  • See how New Jersey’s Ramapo Radiology Associates overcame their CD burning problems and improved their physician and patient experiences with Novarad CryptoChart.
  • Check out this Blackford Analysis video detailing how its AI platform streamlines AI adoption and workflows, allowing radiology teams to achieve AI’s clinical benefits without operational sacrifices.
  • More efficiency and accuracy – less burnout and IT overhead. Those are the key results from adopting cloud speech technology detailed by Nuance in this infographic.
  • Room for more efficiency in your breast imaging operations? Check out this GE Healthcare post detailing how new technologies are improving patient experiences and making breast imaging teams more efficient.
  • Why United Imaging’s MI (uMI)? Every United Imaging molecular imaging system features its “uEXPLORER Inside” technology platform, which is designed for total-body scanning, is scalable for clinical systems, and excellent in an MR environment – you’ll see a big difference and your patients can benefit from their focus on coverage, clarity, and sensitivity.

    – Sponsored.

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