“Healthcare is different. When patients receive care, they pay for the services rendered, either directly or through private insurance. So, if someone were to benefit financially from their medical information, shouldn’t they get a cut?”
Robert Pearl, M.D. on why Google and other tech giants won’t create the healthcare disruption that some expect, at least not without changing how they use personal data.
Imaging Wire Sponsors
- 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
- Nuance – AI and cloud-powered technology solutions to help radiologists stay focused, move quickly, and work smarter
- POCUS Systems – A new Point of Care Ultrasound startup, combining a team of POCUS veterans with next-generation genuine AI technology to disrupt the industry
- Qure.ai – Making healthcare more accessible by applying deep learning to radiology imaging
The Imaging Wire
Fujifilm to Buy Hitachi Imaging Business
Reports from Japan reveal that Fujifilm Holdings plans to buy Hitachi’s medical imaging business for roughly $1.55 billion in a move that would immediately give Fujifilm a top-tier portfolio and represent a major industry consolidation milestone.
Merger Motivations – The expected merger shouldn’t come as a surprise to industry watchers given Fujifilm and Hitachi’s market positions and strategic directions. The companies have almost no overlap in their imaging portfolios (Fujifilm = X-ray/PACS/POCUS/endoscope; Hitachi = MRI/CT/cart-based ultrasound), Fujifilm has clearly been targeting healthcare leadership (including a previous bid for Toshiba’s imaging business), and Hitachi has increasingly appeared to prioritize other parts of its massive organization.
Fujifilm + Hitachi – From a portfolio breadth standpoint, this acquisition would position Fujifilm/Hitachi among the top-four imaging OEMs. However, the companies’ combined ~8.4% market share (Fujifilm’s 5.5% + Hitachi’s 2.9%) would place them just behind Canon (~9.5%) and well behind GE, Philips, and Siemens (~65% combined). Still, the ability to support hospitals’ entire medical imaging operations should help Fujifilm/Hitachi grow its market share in the future as hospital consolidation continues.
AI Breast Cancer Prediction Breakthrough
A team of Swedish researchers developed an AI model that can predict future breast cancer risk more accurately than standard density/questionnaire-based methods, while achieving lower false-negative rates for more aggressive cancers.
The Model – The team trained a deep neural network on mammogram scans and breast cancer outcomes from all 40–74yr women within Sweden’s Karolinska University Hospital uptake area who were diagnosed with breast cancer between 2008 and 2012.
The Study – The researchers then tested the model on 40-74yr women from the same area in 2013 and 2014 (n = 2,283 women, 278 who developed breast cancer) to create a deep learning risk score based on a combination of age and density metrics.
The Results – The model found that women with a higher risk of cancer had a higher average age at the time of mammography (55.7 vs 54.6yrs), more dense area (38.2 vs. 34.2 cm), and higher percentage density (25.6% vs. 24%). More notably, the model achieved a higher breast cancer risk score (odds ratio: 1.6 and 1.3, respectively) and a lower false-negative rate (31% vs 36%) than the “best mammographic density model.”
Next Steps – The team is bullish on this new approach, given the imperfections associated with density-based scores, and is working on an update before starting clinical trials next year.
The Wire
- The 2.3% medical device tax is on its way to being repealed by the end of the year, before its latest 2-year suspension expires (previously suspended 2016-17, 2018-19). This repeal would be applauded across the medical device industry, as previous research suggests the tax dragged down manufacturer revenue (-$188M), gross margins (-$375M), and earnings (-$68M), and resulted in significant R&D funding cuts (-$34M).
- Dutch researchers found that the country’s referring clinicians comply with a 53.1% majority of second opinion radiology report recommendations. The study found that referring clinicians followed 53.1% (163 of 307) of 2nd opinion report recommendations, with 30 of the applicable “followed” cases (20.4%) leading to malignant diagnoses compared to just four of the 128 recommendations that were not followed (3.1%) leading to a malignant diagnosis.
- Jubilant DraxImage announced a favorable decision from the U.S. ITC in its defense against Bracco, allowing Jubilant to continue to import its RUBY-FILL rubidium-82 PET agent generators into the United States. Bracco filed a patent infringement case against Jubilant in early 2018, initially alleging that Jubilant’s strontium-rubidium radioisotope infusion systems infringed on its patents.
- New GE-funded research from MIT Technology Review Insights (n= >900 U.S. and UK healthcare professionals) came out heavily in favor of healthcare AI, finding that 78% of healthcare leaders have deployed AI, leading to reduced burnout (80%), more time with patients and for surgeries (45%), less report writing time (up to 66% with “robust” AI deployments), and more focus on preventative medicine (nearly 50%). The study includes even more findings that you can find here.
- A NEJM Perspective article by a pair of U of Texas and Brigham and Women health policy researchers argued that AI will help manage image interpretation volumes and improve accuracy, but current approaches won’t support early diagnosis or identify which tumors are dangerous (requires more complex histopathological analysis). Noting that pathologists can’t even agree on histopathological diagnosis, the authors suggest that developers should train models according to pathologists’ cancer disagreement types (total agreement on its presence, total agreement on its absence, and disagreement with cancer’s presence) to catch more lesions and reduce overdiagnosis.
- Fujifilm Japan officially launched the iViz air, a new wireless abdominal ultrasound system intended for in-home, emergency, and hospital use. The iViz air is a smaller and specialized extension of Fujifilm/Sonosite’s iViz family, shipping with a 7-inch wireless convex abdominal probe (vs. four 7” probe options) and a smaller smartphone-style 5.5-inch viewing screen (vs. 7”). The the iViz air also features a new automatic urine volume application, boasts a faster 20 second startup time (vs. 35 sec.), and has just a 0.76 lb. total weight (vs. 1.25 lb.).
- NEMA voiced its approval of The White House’s decision to delay its planned December 15th China tariff increases (originally scheduled to increase by 15%) and reduction to the September 1st tariffs (from 15% to 7.5%), although the original 25% tariffs on $250 billion of Chinese goods (including many imaging products) will remain intact for now.
- There’s been a lot of talk about Google and Apple disrupting the healthcare industry, but a recent Forbes article from Robert Pearl, M.D (previous Permanente Medical CEO) contends that even if they “make a lot of money on health-related products and services” they won’t transform healthcare because they aren’t targeting healthcare’s biggest problems: quality and cost. Dr. Pearl backs this up arguing that: 1) consumer preferences don’t equal medical needs, 2) Major tech companies won’t accept medical liability, and 3) Tech companies will face major data ownership/privacy issues.
- 24x7mag.com published a roundtable discussion on the evolution of the ultrasound segment, addressing major trends, challenges, and storylines. The panelists highlighted a range of topics including ultrasound’s expansion to new users and new uses (specialties, POC, treatment), improvements to US technology (image processing, transducers, workflow, operation), the growing role of AI, the importance/challenges of operator education, and ongoing improvements to ultrasound costs, portability, and ease of use.
- In imaging-adjacent news, new research in JAMA Internal Medicine reveals that the number of U.S. patients under 80yrs with a primary care provider fell from 77% in 2002 to 75% in 2015, which may not seem like much but amounts to “millions and millions of people who no longer have a primary care provider.” Declines were most evident among younger people, with 30-39yr patients with PCPs falling from 71% to 64%.
- Scottish ultrasound sensor startup, Novosound, landed €3.9 million in funding (adding to a £1m development grant in July and a £1.5m seed round in April 2018) that it will use to expand its technology into new global markets. Novosound aims to “revolutionize” industrial and medical ultrasound technology by replacing conventional sensor materials with a flexible ‘thin film deposition’ technology, although this announcement placed more emphasis on industrial applications than medical.
- Sectra announced a pretty major 5-year deal with St. Louis’ BJC HealthCare (14 hospitals, one of the largest non-profit HDNs) that will include Sectra’s enterprise imaging solution as well as its Sectra Breast Imaging PACS, and is highlighted by its integration with BJC’s Epic Radiant system.
- Butterfly Network had a busy week, quietly adding 3D bladder scanning, Power Doppler with 14 presets, support for Android phones (initially 10 devices), and the ability to finance its Butterfly IQ system ($58/mo. and up).
- Carestream highlighted how Georgia’s Piedmont Rockdale Hospital has benefitted from its DRX-Revolution Nano Mobile X-ray System, particularly for its contributions to NICU workflows, its portability, and its ability to serve as a backup for other X-ray systems.
- The Focused Ultrasound Foundation recently awarded a University of Virginia team a grant for research on MRI-guided focused ultrasound as a new, incision-free, radiation-free treatment option for lung cancer.
- This case study details how University of Rochester Medical Center reduced its delayed diagnoses risk by 80% after adopting Nuance PowerScribe Follow-Up Manager.
- Qure.ai was highlighted in this Hardian Health blog for the significant research supporting its AI algorithms.
- The POCUS Systems founding team has over 80 years of combined experience in the ultrasound industry.
- By partnering with Medmo, imaging centers can keep their schedules full and their equipment busy. Here’s where to learn more and get started.
