DM Limits | Interpreting Fatigue | Doc Shortage

“As a specialty, we have more in common than different,”

Radiology Partners CMO, Jay Bronner, MD, responding to the backlash against RP’s JACR paper on corporatization’s benefits.

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

Digital Mammography’s Limited Benefits

The shift from film to digital mammography did not improve breast cancer outcomes. That’s from new research by an Australian team and here are the details:

  • The Study: The team reviewed 24 previous studies, performing meta-analysis on 16,583,743 screening exams (10.9m film, 5.6m full-field digital mammography).
  • The Results: The researchers found that digital mammography improved cancer detection rates by 0.51 per 1k screenings. However, this improvement was greater for non-invasive DCIS cancers than invasive cancers (25.2% vs. 4%), didn’t lead to a significant drop in cancer diagnoses between scheduled screenings (-0.02 per 1k screens), and it increased recall rates by 6.95 per 1,000 screenings.
  • The Benefits: Digital mammography still improved medical providers’ workflow (storage, handling of imaging, etc.), even if it didn’t result in the improved health outcomes that many forecast when DM first came out.

The Wire

  • JACR Conflicts: The JACR is revising its disclosure guidelines after receiving criticism for publishing a paper on practice corporatization’s scale advantages that was written by leaders from Radiology Partners, but didn’t specify that they worked for the mega practice. The JACR contended that it published the RP paper to provide a balanced perspective (it also published anti-corporatization papers), but it will now require authors to identify their practice, employment model, and roles.
  • CMS’ CV19 Relief: CMS announced that it will provide COVID-19 hardship relief to radiologists and other clinicians participating in the 2020 Merit-Based Incentive Program. Providers can apply to have any or all MIPS categories reweighted for 2020, while they also have an opportunity to gain MIPS credits by participating in COVID-19 clinical trials or caring for CV19 patients and submitting their related data for research.
  • qER FDA Cleared: Qure.ai announced the FDA approval of its qER head CT scan product (following qER’s spring 2019 CE approval), marking the company’s first FDA clearance. Qure.ai highlighted qER’s 4-in-1 triage functionality (intracranial bleeds, mass effect, midline shift, and cranial fractures), which actually does set the solution apart compared to the largely specialized head CT solutions currently on the market.
  • NM/MI Career Exposure: A new study in Current Problems in Diagnostic Radiology found that increasing medical students’ exposure to nuclear medicine/molecular imaging would help drive more trainees towards the sub-specialty. A survey of 78 NM/MI trainees and 44 faculty found that only 65% of the trainees were exposed to NM/MI during med school and therefore most (80%) became interested in NM/MI after med school, often due to clerkships and mentorship influences.
  • DeepSpin MRI: German MRI startup, DeepSpin, wrapped up a €600k seed funding round (increasing its total to €1m) that it will use to develop its portable, AI-driven, low-cost, and mass-manufacturable MRI system. DeepSpin is still in the development phase (they were only formed in September 2019), but the company still contributes to a larger shift in attention to portable MRIs, headlined by Hyperfine and other development-stage systems.
  • Clicks and Turnaround Time: After observing a wide variation in X-ray interpretation times (mean turnaround range: 11 to 66 min), a Cincinnati Children’s Medical Center study revealed that longer read times are directly correlated with more mouse clicks. A four-week review of six radiologists’ reads found that the radiologists with the longest and shortest turnaround times per study (5 vs. 1 minute) had a similar variation in clicks per study (43 vs. 8 & 14). The researchers suggested that this inefficiency could be improved through PACS training.
  • Canon’s Russian JV: Canon Medical Systems announced a joint venture with R-Pharm that will allow the Russian medical tech company to sell and service Canon’s imaging systems across Russia and the nine CIS states.
  • LungNet: A Stanford University team developed a machine learning model, called LungNet, that analyzes lung CT scans to help determine lung cancer severity and guide treatment. The team trained and tested LungNet using data from patients with non-small cell lung cancer (NSCLC, four centers, 709 patients), finding that the model accurately predicted survival, defined benign/malignant modules (0.82 AUC), and classified nodules based on cancer progression.
  • Mammography Report Support: A UPenn study presented at SiiM20 found that the addition of text and illustrations help make mammography reports more understandable. Using an online survey, the researchers asked 300 women (46yr avg.) to rate the understandability of radiology reports (1 easy – 5 hard), finding that versions with only annotated text (2.1) and a combination of text and illustrations (2.3) were more understandable than the original report (2.9) and a version with only pictures (2.6).
  • RADNTX Expands: Radiology Associates of North Texas (RADNTX) announced its merger of Tyler Radiology Associates and East Texas Radiology Consultants, adding 28 new radiologists and growing RADNTX to over 200 physicians (the most among Texas PPs, among largest in U.S.). Tyler Radiology Associates and East Texas Radiology Consultants reportedly decided to merge with RADNTX after connecting with its Independent Radiology Network (IRN) resource platform, while citing RADNTX’s infrastructure and IT as key motivators.
  • Physician Shortage: The AAMC (Association of American Medical Colleges) forecast that the U.S. could have a shortage of between 54,100 and 139,000 physicians by 2033, including shortages of both primary physicians and specialists (yes, including radiologists). AAMC attributed the shortage to the U.S. population’s expected growth (+10.4%) and aging (over-65 population +45.1%) between 2018 and 2033, while much of the physician workforce heads towards retirement.
  • Interpreting Fatigue: A new Emory study found that fatigue significantly impacts radiology residents’ diagnostic performance, especially during earlier years in their residencies. Ten 2nd-4th year radiology residents review as many complex CT cases as possible in an hour, once when fresh and once fatigued. As expected, the residents completed more cases when fresh (7.5 vs. 7.3 avg.) and had more true positives for major (29.4 vs. 24.1 avg.) and minor findings (23.3 vs. 18.9 avg.), with 4th year residents producing the most true positives (followed by 3rd year).
  • inHeart’s $4.2M: Cardiac imaging analysis developer inHEART closed a $4.2m seed round that it will use to fund its commercialization in European, expansion to the U.S. and ongoing product development. inHEART’s cloud-based solution transforms preoperative medical images into a 3D digital twin of the patient’s heart, helping cardiologists plan and perform cardiac arrhythmia procedures.

The Resource Wire

– This is sponsored content.

  • In its latest Q&A, Nuance sat down with Imbio founder Mike Hostetler to discuss how Imbio’s lung AI models support lung disease diagnosis and to share about Imbio’s AI Marketplace partnership with Nuance.
  • With orthopedic care growing with the aging population, orthopedic imaging is growing along with it. This Hitachi blog details how more orthopedic practices are bringing imaging in-house and what factors they should take into account as they decide how/whether to add imaging to their suite of services.
  • 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. In this Imaging Wire Q&A, University Hospital of Zurich’s Thomas Frauenfelder discusses his experience and study on Riverain Technologies ClearRead CT.

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