CV19 Update | DBT’s Advantages & Variability

“Unfortunately, they are not taking a break,”

AHA cybersecurity advisor, John Riggi, on how hackers are taking advantage of the COVID-19 pandemic and targeting healthcare AI.

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.
  • Nuance – AI and cloud-powered technology solutions to help radiologists stay focused, move quickly, and work smarter.
  • Qure.ai – Making healthcare more accessible by applying deep learning to radiology imaging .
  • Riverain Technologies – Offering artificial intelligence tools dedicated to the early, efficient detection of lung disease.

The Imaging Wire

CV19 Update: Radiologists Brace, Brands Ramp-up

It was another big few days in coronavirus imaging, as the specialty braced for a double whammy of increased CV19 imaging but much lower overall volumes, the federal government tried to mitigate this threat, and imaging brands rolled out CV19 solutions at a record pace. Cheers to the helpers and to everyone staying home.

  • CV19’s Financial ImpactStrata Decision found that U.S. health systems would lose an average of $2,800 per COVID-19 patient (and up to $10k) without an increase in Medicare reimbursements. There are a number of reasons for this, but it’s largely due to CV19’s greater requirements for protective equipment, cleaning, imaging, medications, and supplies.
  • CMS Expands Payment ProgramCMS expanded its Medicare payment program in an effort to limit CV19’s financial disruption to providers and medical companies. The CMS’ new accelerated and advance Medicare payments can provide emergency funding based on historical payments when providers/companies face a disruption in claims submission and/or claims processing. Healthcare Administrative Partners does a good job outlining these changes and how qualification works here.
  • Lunit’s CV19 Release Lunit will release a special free COVID-19 version of its chest x-ray analysis software. The CV19 version specifically looks for consolidation findings (not other findings like lung nodules) and has already been in use for coronavirus diagnosis and management in South Korea and Brazil.
  • MITA Calls for More Mobile Imaging – The Medical Imaging & Technology Alliance (MITA) called on the FDA to temporarily change its regulatory processes for mobile imaging devices given their contribution to the COVID-19 fight. MITA made a number of suggestions including prioritizing medical imaging devices, expediting the 510(k) process, and granting more flexibility for converting static imaging systems to mobile systems (among others).
  • behold.ai & Wellbeing’s CV19 Partnership – behold.ai and Wellbeing Software announced a collaboration that will introduce behold.ai’s red dot X-ray analysis algorithm across Wellbeing’s large UK RIS client base (700 installations).
  • Speed is Key A new study in AJR used updated CT-based scoring criteria to reveal that shorter diagnosis and treatment times led to faster and better disease resolution. The study (n = 25 CV19 patients) organized patients into two groups based on time from symptom onset-to-diagnosis-to-treatment (< or > 3 days), finding that patients who had faster diagnosis/treatment also healed faster and had lower peak and final CT scores.
  • UI’s CV CT – United Imaging announced plans to deploy transportable CT scanners in the U.S. to support the CV19 fight. United Imaging will offer new mobile CT configurations that it co-developed with AMST and can be installed quickly, support up to 128-slice imaging, and feature easy-to-clean interior walls.
  • Philips’ CV19 Telehealth SolutionPhilips announced a new COVID-19 telehealth solution that supports physicians and healthcare institutions as they handle a flow of potential CV19 patients. Although it doesn’t technically involve imaging, the platform does provide online screening, follow-up questionnaires, and external call center collaborations to prevent unnecessary office visits and support monitoring of quarantined patients.

The Wire

  • DBT’s Advantages & Variability: A new JAMA Open study (n = 198 radiologists) found that DBT resulted in 15% fewer recalls and a 21% higher cancer detection rate than DM, but also found that DBT has more variability than some may expect. In fact, 14% of radiologists had more recalls with DBT (vs. 37% with fewer recalls), prompting the researchers to suggest that practices audit radiologist DBT screening performance and consider additional DBT training for these high-recall radiologists.
  • Dynamic X-ray Elastography: A team of Japanese researchers released the first actual dynamic X-ray elastography images, which uses shear-wave propagation, and could give clinicians another way to image soft tissue beyond MRI and ultrasound. The researchers found that their dynamic X-ray elastography approach was able to achieve far better image resolution than ultrasound and suggested that it could help identify smaller lesions and earlier-stage diseases.
  • ViewRay & VieCure’s Oncology Alliance: ViewRay and VieCure announced a partnership that will combine ViewRay’s MRI-guided radiation therapy system with VieCure’s VCurePrecision EMR decision-support platform to create a personalized oncology solution.
  • Dose Reducing Feedback: A new JAMA Internal Medicine study (n = 864k patients, 1.15m CTs, 100 facilities) found that providing audit feedback that includes suggestions, educational seminars, and best practices helped reduce CT dosage by between 6% and 17.2%. This multicomponent intervention approach was far more effective at reducing dosage versus only using audit feedback, without hindering radiologist satisfaction or image quality.
  • CAD4TB v6 Accuracy: A new study in Scientific Reports found that CAD4TB v6 software can spot TB in chest X-rays with similar accuracy as human experts and with greater accuracy/efficiency than previous CAD4TB generations. The study tested CAD4TB v6 (the first generation with AI) on 5,565 CXR images (854 Xpert positive), achieving 98% specificity at a fixed 90% sensitivity, and scanning 132 subjects per day (vs. 85/day for CAD4TB v3).
  • XRAIT Osteoporosis Analyzer: Australian researchers developed an algorithm that analyzes radiology reports to spot patients with broken bones who are at risk of osteoporosis. The X-Ray Artificial Intelligence Tool (XRAIT) analyzed 5,089 radiology reports, identifying 349 people with fractures that were likely due to low bone mass (vs. 98 using manual methods) and identifying 5-times more major fractures/breaks.
  • Navidea & WorldCare Partner: Navidea announced a partnership with contract research company WorldCare Clinical, which will serve as Navidia’s imaging partner during the development of its rheumatoid arthritis diagnostic clinical imaging workflow. The companies will develop the commercial workflow and infrastructure to support the full-scale commercialization for Navidea’s RA diagnostic agent, with WorldCare managing the imaging components of all upcoming trials.

The Resource Wire

  • The introduction of ultrasound into musculoskeletal care has been a game-changer, revolutionizing the level of precision MSK physicians can bring to patient care. This GE Healthcare profile details how one physician used point of care ultrasound to help improve performance and effectiveness.
  • In this quick video, Einstein Healthcare Network’s Peter Wang, MD describes how Nuance’s embedded clinical guidance delivers streamlined radiology workflow and improves report quality.
  • Healthcare Administrative Partners detailed how relaxed telemedicine rules during the COVID-19 Public Health Emergency could create an opportunity for radiologists to use telemedicine in their practice in this blog post.
  • Sunnybrook Research Institute researchers became the first to use focused ultrasound to deliver a molecule to the brain to revive the function of neurons vital to learning and memory in mice with Alzheimer’s disease.
  • Vessel suppression from Riverain Technologies’ ClearRead CT software was recently found to significantly improve nodule detection, interreader agreement, and reading time with oncologic chest CT scans.
  • This Nature Research study found that Qure.ai’s qXR tool can identify TB-associated abnormalities in chest radiographs with over 95% accuracy, potentially eliminating 2 out of 3 Xpert MTB/RIF tests.

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