Expensive Imaging | Super Resolution MRI | Esaote Ultrasounds

“Many patients are going to very expensive providers when lower-price options with equal quality are available.”

Yale health economist, Zack Cooper, commenting on his team of Harvard and Yale researchers’ discovery that most MRI patients are paying way more than they should for imaging procedures.



The Imaging Wire


The Super Resolution MRI
The Institute of Cancer Research in London developed a new ‘super-resolution’ MRI technique that stitches together standard 2D MRI chest images to create ‘super-resolution’ videos of the lungs expanding and contracting. The new technique creates 5-times more detailed images than standard MRIs and could improve lung cancer radiotherapy treatment planning by better predicting tumor locations (this is currently performed by CT scanners). The ICR researchers are also applying this technology to create a combined MRI/radiotherapy system that simultaneously images and treats tumors, like the MR-Linac. Although this ‘super-resolution’ MRI is still in its early stages, it has the potential to disrupt two key applications and is worth keeping an eye on.


Patients Have No Idea They are Paying Way Too Much for Imaging
A report from the National Bureau of Economic Research found that lower-limb MRI patients (and likely most imaging patients) often unknowingly choose higher-cost imaging providers. Amazingly, the typical patient in the study (n=50k) drove past six lower-priced providers on the way to their imaging procedure, leading to 27% higher co-pays and 40% higher insurer costs than if they selected the lowest-cost provider within the same driving distance. There are a few reasons for this, but it mainly comes down to patients’ lacking consumer mindset and referring doctors’ limited focus on costs, as most patients go to whatever imaging center their doctor suggests and less than 1% of patients shop around using price transparency tools. Even with more cost-consciousness among physicians and a better consumer mindset among patients, “pay what you can afford” imaging platform company, Medmo, noted that better price shopping tools will also help address this issue. Medmo indicated that “although most services can identify lower-cost imaging facilities, they don’t guarantee a price and don’t help with an appointment – leaving a lot of work to the patient. . . We let patients tell us what they can afford, then we actually make the scan happen for them at that price.” No arguments on this from The Imaging Wire team – patients and physicians both need to step up their cost control game and greater awareness and better platforms are a solid first step.


The Fight to Own an MRI in North Carolina
In other imaging cost news, a North Carolina surgeon and medical imaging center owner is suing to overturn the state’s “certificate of need” law. Dr. Gajendra Singh launched his medical imaging center last year in reaction to his own experience as a patient, when he received a $1,200 quote for an abdominal ultrasound and decided his community needed lower-price imaging options. However, he quickly learned that North Carolina does not make it easy for imaging centers to buy a permanent MRI machine, forcing him to use a higher-cost MRI rental service several days a week at the expense of his MRI pricing and patient scheduling bandwidth. Dr. Singh claims that this law gives hospitals a monopoly over MRI imaging and other outpatient procedures, which is the main reason that 14 states have already repealed their certificate of need laws (35 still remain). Dr. Singh is trying to make North Carolina the 15th state to repeal its certificate of need laws, but he may also help create change on a national level, as his story has been picked up by a range of media outlets and placed a greater spotlight on these laws.


Third Wave of Q2 2018 Medical Imaging Financials Released
The third wave of medical imaging companies released their financial reports for the April-June period, highlighted by a strong performance from Canon, followed by mixed results from Konica Minolta, Varex, ViewRay, and Lantheus Holdings.

CanonCanon’s overall Q2 revenue surpassed the ¥1 trillion mark ($9.98b) for the first time since 2008, as sales increased by 1.4% and net income jumped 12.3% to ¥77 billion ($691m), due to strong performance from its print, lithography, and medical businesses. Canon Medical returned to positive sales growth, with revenue increasing 6.9% to ¥94.7 billion ($851m), while operating profit surged to ¥1.9 billion from just ¥200 million last year ($17.1m and $1.7m).

Konica Minolta
– Strong print and industrial division performances (plus favorable currency factors) drove Konica Minolta’s 9.8% revenue increase to ¥255 billion ($2.29b), while each of its divisions contributed to an impressive 77% increase in operating profit to ¥15.4 billion ($138m). Healthcare, however, saw a 5% drop in revenue to ¥18.6 billion ($167m), due in part to the discontinuation of unspecified product lines, and continued to lose money with a ¥200 million ($1.7m) operating loss.

– Despite a 12.4% increase in revenue to $191.2 million, Varex’s profits dove down 64.2% to $3.8 million. Varex’s medical division was hindered by the China tariffs, but still saw revenue increase 6% to $143 million.

– A massive revenue increase to $16.4 million (vs. $0.8m) due to three MR-guided installations wasn’t enough to bring ViewRay to a profit, posting a larger $22 million net loss (vs $8.4m).

Lantheus Holdings
– Q2 brought declines for Lantheus Holdings, as revenues fell 3.6% to $85.6 million and net income fell 28% to $9.7 million, although the imaging agent developer did meet its projections.


Esaote Updates Ultrasounds
Esaote made its return to medical imaging headlines with the introduction of the new MyLab X5/X6/X7 ultrasound series, emphasizing a value proposition based on ease of use and reliability. The new systems are believed to replace the MyLab Six and MyLab Seven, potentially making the new Mylab X5 a net new lineup addition. Esaote did not specify regions that the new systems will sell, but it appears that the MyLab X5/X6/X7 series will start off in Europe. Although surely bringing a range of new features, Esaote specifically highlighted the new models’ image quality, intuitive operation, and the efficiency created by their new zero-click automation feature. This is the first announcement from Esaote since its acquisition by a Chinese consortium in April, and although its overall post-acquisition strategy still hasn’t materializing, this latest launch suggests a continued focus on its core modalities (ultrasound) and regions (Europe).



The Wire

  • Visage Imaging signed a 7-year deal to provide its Visage 7 Open Archive solution to the Mercy Health System, adding to the Visage 7 Enterprise Imaging Platform that Mercy adopted last year. Visage views this as “an industry defining deal,” given Mercy’s size (5th largest catholic system, in 4 states, 25m archived images) and its contribution towards Visage’s goal of being “the single enterprise imaging platform for all medical images and multimedia within the healthcare enterprise.”
  • Breast imaging AI company, CureMetrix, took a big step in fueling its computer-aided detection tools for 3D mammography, signing a deal with University of Florida to collect five years of anonymized images and clinical data. UF will also use the CureMetrix software in educational and investigative settings to evaluate its impact.
  • Canon Medical Systems installed its first MR Theater in the US, equipping Florida-based Parrish Healthcare’s Vantage Titan / Zen Edition 1.5T MRI with the patient comfort add-on, which projects “peaceful, virtual reality images onto a dome-shaped screen” inside the MRI bore.
  • ViewRay overhauled its leadership team, naming Scott Drake as president and CEO (replacing Chris Raanes after 6 years) and Shar Matin as COO (replacing Doug Keare after 3 years), while awarding Drake and medical industry exec D. Keith Grossman seats on its board of directors. Drake and Matin were previously executives at Spectranetics (now owned by Philips) and were cited for their experience managing growing medical companies.



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