“Robust ML running at scale in high-consequences settings is a different beast.”

Raym Geis MD, of the ACR’s Data Science Institute comparing narrow / controlled AI that performs well in the lab with solutions that are ready for use in the real world.

---

Imaging Wire Sponsors

• Bayer Radiology – Providing a portfolio of radiology products, solutions, and services that enable radiologists to get the clear answers they need.
• 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

FastMRI Evidence

Facebook and NYU announced a study revealing that images from 5-minute MRI scans that are reconstructed using their co-developed FastMRI deep learning technology are “just as effective as” and “diagnostically interchangeable with” traditional MRI. Given image reconstruction’s recent momentum (and recent criticism), this is a pretty big deal.

• The Research – The AJR-published study had six radiologists review 108 knee MRIs captured using the 5-minute scans and again using 108 scans from traditional MRI sequences. The study found that the FastMRI and traditional scans would result in the same radiologist interpretations at least 96% of the time. Interestingly, all six readers also found that the FastMRI scans had better image quality.

• Significance – As NYU and Facebook put it, these results suggest that FastMRI (and perhaps other reconstruction solutions) could “significantly improve the patient experience, expand access to MRIs, and potentially enable new use cases for MRI.”

• Next Steps – With FastMRI’s MSK performance established, the FB & NYU researchers will now study how their reconstruction approach works with the brain and other vital organs. The team also made its data, models, and code available open-source to support further research or even to develop commercial solutions.

• The Facebook Effect – We cover plenty of image reconstruction studies, but Facebook’s involvement helped get FastMRI in front of a much wider audience than normal, including coverage in the Wall Street Journal, Fast Company, and The Verge (plus the typical health publications).

---

The Wire

• Change’s Big Cloud Step: Change Healthcare took a big step in its cloud-based enterprise imaging strategy, acquiring Nucleus.io. Change Healthcare was far from understated in its announcement, proclaiming that the addition of Nucleus.io (and its zero-footprint diagnostic viewer & medical image exchange solution) will allow it to deliver a “first of its kind end-to-end, cloud-native Enterprise Imaging platform.” It also connects Change Healthcare with Nucleus.io’s 7,500 customers.

• COVID’s MRI Alternative: A new study in Academic Radiology shared perhaps the strongest evidence yet supporting the use of MRI for COVID-19 diagnosis and assessment, particularly as a way to reduce radiation exposure during follow up assessments. The study compared thorax CT and MRI results from 32 COVID-19 patients, finding “near complete overlap” between the two modalities in terms of lung involvement (both 96.9%), nodule detection (12 vs. 11 patients), glass opacities (both 29 patients), consolidation (both 14 patients), and lesion location.

• Siemens’ MR AI: Siemens Healthineers announced the FDA approval of its AI-Rad Companion Brain MR for Morphometry Analysis (measures volumetric changes in brain) and AI-Rad Companion Prostate MR for Biopsy Support (segments prostate for MR+US targeted biopsy). The new Brain MR and Prostate MR solutions are the first MRI-focused solutions in the AI-Rad Companion portfolio, following chest CT and radiation therapy abdominal tools.

• Techs for PICC: A paper from Mount Sinai Toronto gave more evidence supporting using technologists to perform peripherally inserted central catheters (PICCs) in the IR suite at patient bedsides (vs. performed by IRs). Technologists performed 82% of their PICCs in 2017 and 89% of PICCs in 2018 without assistance. The efficiency / workflow-focused Toronto study comes about six months after an Australian study found that techs also perform PICCs with a high success rate.

• $100 Ultrasounds: North Carolina State University researchers unveiled a new ultrasound concept that could lead to simpler and lower-cost ultrasound systems (potentially “$100 or so”) by eliminating reliance on electrical signal processing to reconstruct scanned images. The new design features a receiver that incorporates piezoelectric crystal and an OLED screen. When ultrasonic waves hit the crystal, it produces voltage, which causes the 10×10 pixel OLED screen to light up. This is obviously still in its early stages (hard to see a 10×10 screen), but the team believes they could scale up to a 500×500 panel and significantly higher resolution.

• Doppler for Cervical Cancer: A team of Chinese researchers found that Doppler ultrasound could be used to diagnose and monitor cervical cancer. The researchers found that Adler grades (0-3 scores), produced using transvaginal color Doppler flow imaging (TV-CDFI), had a strong correlation with pathology results in 162 patients with cervical cancer.

• Triad Joins Strategic Radiology: Strategic Radiology added Triad Radiology Associates (46 radiologists, services 9 hospitals) to its consortium of radiology practices, which now includes 30 member practices and over 1,200 radiologists. Triad is SR’s fourth practice in North Carolina, all of which joined SR since the start of 2019.

• Off-Hour Errors: A Mayo Clinic study in RSNA Radiology found that radiologist interpretation errors are more common during overnight shifts (6pm-7am). The researchers reviewed 10,090 body CT studies, revealing a 2% error rate among the 2,195 daytime studies and a 3% error rate among the 7,895 night cases. Of the 32 radiologists involved in the study, 22 (69%) had higher error rates during nighttime shifts. Although there’s been studies attributing nighttime errors to the higher use of residents, this might be the first detailing how overnight shifts affect even seasoned radiologists’ performance.

• Carestream’s Long-Length Detector: Carestream joined the list of manufacturers with long-length DR detectors (Fujifilm, Del Medical), launching its new 17×51” DRX-L Detector. The new panel allows clinicians to capture long-length images with a single exposure (e.g. legs & spine imaging), allowing reduced dosage, shorter exam times, and fewer repeat scans.

• MICC Benefits: A new paper in JACR revealed how adopting a Medical Imaging Call Centre (MICC) helps build relationships between radiology departments and community-based primary care physicians, while improving operations. A review of a 3.5-year-old MICC program (n = 2,297 calls) found that average calls per month increased by 39% since its launch (44/mo. in first 6mo vs. 61/mo. in final 6mo), calls involving PCP-to-radiologist communication increased, and ED admission were avoided in 98% of calls that would have otherwise involved emergency imaging (215 of 220).

• SimonMed & CorTechs: Major imaging / radiology provider SimonMed announced the integration of CorTechs Labs’ RSI-MRI+ for Prostate software across many of its U.S. imaging center sites. The AI-based post-processing software leverages Restriction Spectrum Imaging (an advanced diffusion MRI technique) to enable faster and more accurate PI-RADS scoring. SimonMed is emerging as a leader in AI adoption, as it’s used CoreTechs Labs’ NeuroQuant for some time and also uses AI solutions from Riverain, iCAD, ProfoundAI, and Qview.

• UK’s Rebound Delays: NHS England revealed that its scan volumes are approaching pre-COVID levels, but the country is struggling to support its pent-up imaging demand. The report revealed that the number of patients waiting over six weeks for advanced imaging fell by about 12% in June to 127,897, but the >6-week waitlist is still 15-times higher than it was at the start of 2020. The Royal College of Radiologists attributes the UK’s imaging backlog to staffing shortages and a lack of modern imaging systems.

• Rad Residents US Scans: A new study from St. Paul’s Hospital in Vancouver found that radiology residents performed ultrasound scans for suspected appendicitis with similar accuracy as sonographers. The researchers reviewed 104 US scans performed by rad residents and 104 US scans performed by sonographers, finding that they had similar appendix visualization rates (27% vs. 30%), sensitivity (63% vs. 69%), and specificity (both 98%). However, scans performed by the rad residents were more likely to miss pelvic organs (35% vs. 1%), leading to increased downstream imaging.

• Affiliate Imaging Declines: A new paper from a Mass General Hospital team revealed that its affiliated imaging centers experienced much steeper volume declines at the start of the COVID-19 crisis than at its main hospital (-64% vs. -54%) and the affiliate centers experienced slower volume rebounds since then (+6.95 per day vs. +7.18). The study found the lowest volume declines for CT (-43% affiliate & -41% hospital), radiography (-61% & -49%), and ultrasound exams (-60% & -53%), while mammography absorbed the greatest volume declines (-92% at both).

---

The Resource Wire

– This is sponsored content.

• Radiology will see a significant cut in Medicare reimbursement in 2021 if the MPFS Proposed Rule is applied without a change to the budget neutrality requirement in the law. Get all the details in this Healthcare Administrative Partners blog post.

• Hear Regional Health CIO and CMIO, Stephanie Lahr, MD, explain how Nuance PowerShare enables Regional Health to share diagnostic images across a large geographical region quickly and efficiently.

• Learn how Riverain’s ClearRead CT Vessel Suppress provides a powerful and intuitive view for clinicians through the suppression of vascular structures.

• 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.

• Bayer’s new Gadavist Imaging Bulk Package multi-patient dosing system eliminates the waste associated with individual GBCA vials, benefitting rad techs (improved workflow, increased patient focus), administrators (reduced costs / waste, increased productivity), and patients (greater dosage consistency).

• Hitachi Healthcare Americas’ latest blog detailed COVID-19’s recent and future impact, warning cardiac practices and clinics of an upcoming wave of patients with cardiovascular issues that worsened due to delayed treatments, followed by a “third wave” of patients who developed heart complications from COVID-19 infections. Hitachi also shared some guidance on how to manage and minimize these waves.

---