Hospitals’ Hot Seat | SNMMI 2021 | PET DLIR

“algorithms are the new drugs”

Hardian Health’s Hugh Harvey on how AI firms can learn from pharma companies’ R&D and regulatory practices.

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Arterys | Bayer Radiology | Canon Medical Systems | GE Healthcare
Healthcare Administrative Partners | Hitachi Healthcare Americas
Novarad | Nuance | Riverain Technologies | Siemens Healthineers
United Imaging | Zebra Medical Vision

The Imaging Wire

Hospitals on the Hot Seat

The last week brought four separate stories detailing hospitals’ high and mysterious costs and new evidence that payers and regulators might actually start doing something about it.

  • Non-Transparency – A new JAMA study revealed that most U.S. hospitals still weren’t complying with the 2021 federal healthcare cost transparency laws in March. The study found that 87 of 100 randomly-selected hospitals and 75 of the 100 largest hospitals were noncompliant with at least one of the rules (publishing… out-of-pocket rates, payer-negotiated rates, and rates for “shoppable services,” in an easy-to-understand and machine-readable format). The largest hospitals were also the most “selectively compliant,” with just 35 disclosing payer-negotiated rates.
  • Ultrasound’s Wide OoP Variations – A Hospital Pricing Specialists study took advantage of the same transparency laws, revealing wide regional out-of-pocket cost variations for abdominal ultrasound exams (n = 2,078 hospitals). The firm identified average statewide rates ranging between $319 in New Jersey and $2,295 in Florida — that’s 57% below and 308% above the $745 national average.
  • The States Know – A Georgetown University survey of 47 state employee health plan leaders revealed that these organizations view hospitals as their main driver of cost increases, but they almost never target hospitals with their cost containment initiatives (so far anyway).
  • UnitedHealth’s Offsite Commitment – States might not be ready to address hospital costs, but UnitedHealth reminded us that it definitely is. UnitedHealth committed that over 55% of the outpatient surgeries and radiology services that it covers will be delivered at ambulatory centers and stand-alone imaging centers by 2030 (up from 47% in 2019). UnitedHealth plans to achieve this offsite shift by providing physicians with tools to help guide patients to the “most appropriate” setting.
  • The Takeaway – A conversation in Earnest Hemingway’s The Sun Also Rises describes one character’s bankruptcy as happening “gradually and then suddenly,” and that’s a good way to describe how most big changes happen. It’s hard to say how close hospitals are to experiencing their big change, but the fact that their pricing policies are making the news and the biggest healthcare payers are starting to do something about it suggests that we could be beyond the “gradual” phase of that change.

ETMC and Bayer’s Contrast Reduction

See how East Texas Medical Center reduced its abdominal CT contrast volumes by 30% after adopting Bayer Radiology’s contrast dose management software.

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CVIS’ Cloud Advantages

This Diagnostic and Interventional Cardiology article details the unique advantages of cloud-based CVIS systems (off-property access, team collaboration), with insights from one Mississippi-based cardiologist on the benefits of Hitachi’s VidiStar CVIS.

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The Wire

  • Brain PET Super-Resolution: A study presented at SNMMI 2021 detailed a new “super-resolution” technique that produces more detailed brain PET scans and could detect neurological disorders “at their earliest stages.” The new technique combines FDG-PET scans with an external infrared camera that continuously measures patients’ head movements, compensating for the negative effects of head motion and achieving “noticeably” higher image resolution.
  • Vanishing UCC X-Rays: An AuntMinnie.com guest post detailed how US urgent care centers (UCCs) struggle to achieve ROI from their X-ray systems (high equipment/operational costs, low/no reimbursements, low scan volumes, staffing issues). This has led to more “limited scope” UCCs opening without onsite X-ray systems and conventional UCCs not staffing technologists during overnight shifts.
  • United Imaging’s All-In PET Additions: United Imaging expanded its PET solutions portfolio at SNMMI 2021, unveiling its uAI HYPER DPR (AI-based PET iterative reconstruction, improves small lesion detection and quantitative accuracy) and HYPER FOCUS (reduces respiratory motion artifacts and increases SNR). Both uAI HYPER DPR and HYPER FOCUS are automatically available with United Imaging’s PET/CT systems (including all installed devices) due to the company’s All-In Configurations policy.
  • GO2’s IPN Effort: The GO2 Foundation for Lung Cancer (GO2 Foundation) expanded its early lung cancer detection program to include incidental pulmonary nodule (IPN) management, citing the roughly 1m IPNs that aren’t followed-up on in the U.S. each year (2/3rds of all IPNs). The GO2 Foundation is working with its partner facilities to identify best practices, develop and distribute tools, and support IPN management adoption.
  • Canon AiCE’s MI Expansion: Canon Medical Systems expanded its Advanced intelligent Clear-IQ Engine (AiCE) deep learning image reconstruction technology to molecular imaging, announcing AiCE’s FDA approval for use with its Cartesion Prime Digital PET/CT system (AiCE previously available w/ CT & MR systems). Like with Canon’s other modalities, AiCE for PET/CT allows faster exams with lower dosage and better image quality for both PET and CT acquisitions.
  • Visualizing Cancer’s Master Switch: A Stanford study presented at SNMMI 2021 detailed the 18F-DASA-23 radiopharmaceutical’s ability to image the PKM2 “master switch” protein that controls cancer cell metabolism (the first agent to do so), suggesting that it could improve brain cancer treatment assessments. The study found that 18F-DASA-23 PET/MRI scans successfully visualized PKM2 in patients with glioblastoma brain tumors, while rapidly clearing from healthy volunteers.
  • Circle CVI Adds DiA: Circle Cardiovascular Imaging added DiA Imaging Analysis’ LVivo Toolbox cardiac ultrasound solutions to its cardiovascular imaging reading / reporting portfolio. The distribution alliance expands Circle CVI’s portfolio to cardiac ultrasound (previously cardiac MR and CT-focused), while expanding DiA’s channel beyond ultrasound and PACS vendors.
  • GBCA’s Linear Retention: A new Radiology Journal study found that Gadolinium retention was far higher with gadobenate dimeglumine (a linear agent) than gadoteridol (a macrocyclic agent). The study reviewed autopsies from 37 individuals exposed to the GBCAs (28 w/ gadoteridol, 9 gadobenate dimeglumine), finding that the gadobenate dimeglumine group had far higher median gadolinium retention levels in the brain (3-6.5x higher), bones (4.4x higher), and skin (2.9x higher).
  • Micro C Cleared for Pediatrics: OXOS Medical’s unique Micro C handheld dynamic digital radiography (DDR) system gained FDA approval for pediatric patients (it’s already approved for adults). The announcement focused on Micro C’s low radiation dosage, representing a different approach than OXOS’ adult FDA announcement that targeted the device at non-traditional healthcare settings (e.g. nursing homes, urgent care centers, patient homes, and sports medicine practices).
  • Scoliosis SSDR’s Low-Tech Improvement: Singapore-based researchers found that having severe scoliosis patients hold a walking stick, rest their head on a sponge attached to the wall, and rest their other arm on another wall during slot-scanning digital radiography (SSDR) exams could improve spinal fusion surgery planning. This three-point support technique helps patients achieve maximal side-bending flexibility and hold still, resulting in more accurate images that could help avoid unnecessarily aggressive spinal fusions.
  • GE StarGuide’s FDA: GE Healthcare announced the FDA approval of its new StarGuide SPECT/CT system (already cleared in the EU), highlighting its 12 CZT Digital Focus Detector, which performs 3D imaging and supports Theranostic procedures (for therapy delivery & disease monitoring). StarGuide also launches with improvements to its user workflow automation, gantry, image quality, and its ability to use multiple tracers at once.
  • A Kidney CT Dose Reduction Intervention: A new JACR study detailed an effective way to encourage the use of reduced-radiation dose CT (RDCT) for patients with kidney stones. The researchers identified 314 facilities with at least 40 kidney stone CT cases in 2015 and introduced a dosage reduction program at 155 of the facilities in 2016 (customized CME modules, personalized consultation, protocol recommendations for RDCT). Kidney stone CT dosage at these intervention facilities fell by 16% in 2017 to 110mGY (significantly lower than the control group), and they continued to achieve “significant and persistent reductions” in 2018 and 2019.

Imaging AI’s DLIR Future

Check out this talk from Eliot Siegel, MD on the “Hype, Myth, Reality and Next Steps” of imaging AI, including a profile on Canon’s AiCE Deep Learning Reconstruction solution at around the 4-minute mark.

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The Resource Wire

  • This Riverain Technologies case study details how Duke University Medical Center integrated ClearRead CT into its chest CT workflows, reducing read times by 26% and improving nodule detection by 29%.
  • See why the time is right for imaging AI-enabled population health in this Hardian Health profile featuring Zebra-Med’s CEO, Zohar Elhanani.
  • Easy access to patient records, reduced inefficiencies, improved collaboration and compliance, and enhanced security. These are just a few of the benefits of Novarad’s enterprise imaging solution detailed right here.
  • See how Arterys Lung AI improved radiologists’ lung nodule detection and reduced inter-reader variations in this study from two European hospitals.
  • United Imaging’s uAI PET artificial intelligence algorithms are trained on total-body data, which means they’re trained on the most robust data sets available in the world. And the more robust the data, the better the intelligence.
  • Discover how to make your next AI workflow integration a success in this upcoming webinar featuring AI leaders from DASA, Signify Research, and GE Healthcare.

Today’s issue was brought to you by Jake Fishman and Jason Barry.

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