“Machine Learning has changed much less than, say, the Honda Accord since 1982.”
AI pioneer, Doug Lenat, suggesting that ML algorithms have barely changed in the last 40 years. It’s CPUs, data storage, internet, and the availability of big data that’s changed.
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- Carestream – Focused on delivering innovation that is life changing – for patients, customers, employees, communities and other stakeholders.
- Focused Ultrasound Foundation – Accelerating the development and adoption of focused ultrasound.
- Medmo – Helping underinsured Americans save on medical scans by connecting them to imaging providers with unfilled schedule time.
- Pocus Systems – A new Point of Care Ultrasound startup, combining a team of POCUS veterans with next-generation technology to disrupt the industry.
The Imaging Wire
Healcerion and South Korea’s Gachon University Gil Medical Center announced the co-development of the Healcerion Sonon 400S, calling it the world’s first 3-in-1 wireless ultrasound (musculoskeletal, abdominal, and cardiovascular). Healcerion and Gachon/Gill just completed the Sonon 400S’ clinical trials and plan to collaborate throughout the pocket-size system’s global rollout, with the new handheld eventually joining or replacing the existing Sonon 300C (abdominal) and Sonon 300L (musculoskeletal) in Healcerion’s portfolio. Healcerion and Gachon are quite bullish about the Sonon 400S, suggesting that its 3-in-1 capabilities make it better positioned to achieve the “stethoscope of the future” role that many in the POCUS industry envision, especially compared to the single-function handheld systems currently on the market. However, many ultrasound purists would argue that single-function ultrasounds exist for a reason (e.g. curved probes are best for deep applications, linear best for superficial), suggesting that unless the Sonon 400S is able to rival the different single-function systems, it may be better off targeting the growing number of ultrasound newcomers (EMTs, developing regions).
GE Sells Biopharma, Shelves IPO
GE’s Healthcare spinoff took an unexpected turn this week with the sale of its biopharmaceutical business to Danaher Corporation for $21.4 billion and subsequent revelation from CEO Larry Culp that “an IPO [for GE Healthcare] in 2019 looks unlikely at this point.” It’s widely understood that General Electric confidentially filed for GE Healthcare’s IPO in mid-December, targeting sometime between Spring and mid-2019 for the public offering. Although a future healthcare IPO (or other spinoff method) is still very possible, the biopharma sale helps GE achieve the main goals of the planned IPO (streamline its businesses, generate cash) and gives the company more time to explore options for GE Healthcare, which is suddenly very imaging-focused. It’s also worth noting that GE will retain its pharmaceutical diagnostics imaging supplies division, which was previously part of its biopharma business but was excluded from the Danaher sale.
The OR of The Future
The convergence of radiology and augmented reality (AR) took another step forward at MWC this week, as Philips and Microsoft showcased an “operating room of the future” concept that combines Philips’ Azurion image-guided therapy system with Microsoft’s HoloLens 2 mixed reality system. The new AR concept would allow physicians to view live imaging (e.g. low-dose X-ray, ultrasound) and other data sources via the HoloLens 2 headset while they perform minimally-invasive, image-guided procedures. The companies plan to use the concept to support the development of future AR-based image-guided solutions, and although trade show concept products are historically slow to materialize, the promise of AR-based image-guided applications combined with the strengths of Philips and Microsoft suggest that the “operating room of the future” may come sooner that some believe.
Thermography’s Bad Week
Less than a week after Good Morning America broadcast a pretty scary segment on the dangers of relying on (just) thermography for breast cancer screening, the FDA jumped to action, issuing a warning against the imaging center featured in the segment and making a public “safety communication” that thermography is not an FDA-cleared mammography alternative. The FDA’s announcement was primarily targeted at the San Diego-area imaging center, Total Thermal Imaging, “for illegally marketing and distributing an unapproved thermography device as a sole screening device for breast cancer,” adding that “there is no valid scientific data to show that thermographic devices, when used on their own or with another diagnostic test, are an effective screening tool for any medical condition.” Reactions across breast health community were almost unanimously in agreement with the FDA, and against thermography-only screening, although Total Thermal Imaging is far from the first to be warned for misrepresenting thermography as a mammography-alternative and it probably won’t be the last.
A DIY CT
A few months after building his own X-ray machine (w/ a dental X-ray tube, homemade 65kV power supply, and an intensifying screen), a Spanish technology “hacker” converted his new X-ray system to a CT scanner. This very homemade (and pretty impressive) CT was made possible by installing a motor that he “(probably) took from a microwave oven” to rotate scanned objects and developing software to reconstruct the CT’s 3D images. The industry’s big CT manufacturers certainly don’t have another competitor to worry about, as this new CT system has only been used to scan household items (LED bulbs, a lighter, LED panel indicator so far), but those who aren’t concerned about the system’s radiation exposure or using a 65k power supply may find this hack pretty cool.
- Research from the West Virginia School of Osteopathic Medicine revealed that ultrasound may be an effective way to screen for osteoporosis, finding that ultrasound measures bone mineral density (BMD) roughly as well as dual–energy x-ray absorptiometry (DXA), which is viewed as the “gold standard” for osteoporosis screening. The study suggested that ultrasound’s sufficient diagnostic performance, combined with its mobility, radiation-free operation, and cost advantages could allow far wider adoption of osteoporosis screening and lead to improve early detection rates.
- Philips announced the launch of its IntelliSpace Portal 11 visualization software at ECR 2019. The latest IntelliSpace Portal version is highlighted by improvements to support secure data sharing between systems within hospital networks, the integration of Mirada Medical’s Nuclear Medicine Viewer, and the addition of new zero-footprint viewer capabilities.
- A team of Icahn/Mount Sinai researchers set out to prove whether clinical decision support (CDS) is particularly effective at curbing unnecessary imaging orders from house staff physicians (generally prone to overuse), confirming that CDS implementation indeed led to more appropriate overall usage, but CDS-driven improvements were similar between house staff and non–house staff physicians. The researchers reviewed CT and MRI scans before CDS adoption, after implementing the first CDS phase, and after the second CDS phase, finding respective mean ACR appropriateness scores of 6.2, 6.2, and 6.7 for the three phases (range= 1-9, higher scores represent more-appropriate orders).
- InSightec announced that its MRI-guided focused ultrasound system, Exablate Neuro, gained Medicare coverage for the treatment of essential tremor across 13 new states (Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, North Dakota, Oregon, South Dakota, Utah, Washington and Wyoming), following an agreement with Medicare contractor, Noridian Healthcare Solutions. The announcement gives InSightec coverage in 38 states, after adding 25 states in 2018.
- Volpara Solutions unveiled a new version of its VolparaLive! mammography decision-support software at ECR 2019. VolparaLive! gives mammography technologists information on patient positioning and breast compression to support mammogram consistency and reduce patient recalls for technical reasons. The company didn’t specify any additions or upgrades to the new VolparaLive! version, but given that the software just launched at RSNA 2018, the new version is believed to be pretty similar.
- If it feels like nearly every Imaging Wire issue has a pro-DBT story, it’s because DBT is on a roll. The latest pro-DBT story comes from a team of UC Davis-led researchers who found that there is “no evidence of a [DBT] learning curve” regardless of DBT volume, radiologist subspecialty, or breast density. The study (n= 104 radiologists, 106,126 DBT exams, 221,248 DM exams) found that the radiologists had a 10.4% recall rate and 4.0/1k screening cancer detection rate using DM a year before DBT adoption and during the two years after DBT adoption the radiologists’ recall rate fell to 9.4% and their cancer detection rate increased to 4.6/1k screenings.
- Indian AI solutions developer, Niramai Health Analytix, completed a $6 million series A funding round that it will use to expand the company’s domestic operations and work towards gaining international regulatory approval for its Thermalytix breast cancer screening CAD system. Thermalytix specializes in analyzing thermography images, which suffered a nearly-simultaneous setback in the U.S. (see FDA story above), suggesting that Niramai would be wise to use its regulatory investments outside of the US for a while.
- New research from Altarum found that travel and wait times for healthcare services are at least two-times higher than any other service category (followed by veterinary services). Healthcare consumers travel an average of 34 minutes and wait an average of 11 minutes for healthcare services, representing an $89 billion annual opportunity cost.
- A new study (n = 2,000 hospitals) from Navigant Healthcare reveals that 21% of hospital in the US are at risk of closing, despite the fact that 64% these hospitals are essential to the health and economic success of their communities. This trend has been going on for quite some time (100 have closed in the last 10 years), but Navigant suggested that new telehealth reimbursement laws and increased partnerships between rural hospitals and academic and regional systems would help slow rural hospital closures.
- Medscape kept its steady stream of pretty unhappy “physician happiness” surveys going with a new survey focused exclusively on radiologists (here’s some previous reports about burnout and happiness). The new report reveals that only 25% of radiologists are “very or extremely happy” at work (20th out of 29 specialties), but rads do better outside of work with 53% reporting to be unhappy (16 of 29), even though 45% are burned out, 14% are colloquially depressed, and 3% are clinically depressed.
The Resource Wire
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- Focused ultrasound researchers are making unprecedented progress towards developing life-extending treatments for patients with deadly glioblastoma multiforme (GBM) brain tumors, with key blood-brain barrier (BBB)-related breakthroughs at a range of global companies, academic institutions, and research centers.
- Carestream’s DRX-Transportable System/Lite X-ray, featuring the company’s DRX Core 3543 detector, will be used for physical evaluations at the 2019 NFL Scouting Combine, marking the 8th straight year that a Carestream DRX detector was used at pre-draft scouting event.
- The POCUS Systems founding team has over 80 years of combined experience in the ultrasound industry.
- Siemens Healthineers’ MAGNETOM Sola 1.5T MRI landed its first installation at South Texas Radiology Imaging Centers in San Antonio, roughly four months after the 70-cm, BioMatrix-equipped system gained FDA clearance.
- Did you know that imaging patients are most likely to no-show for their procedures on Mondays and Saturdays? By partnering with Medmo, imaging centers can keep their schedules full, despite the inevitable Monday no-shows.