Integrated X-Ray | LD-CT Review | Reliable RTs

“Booking a mammogram is now as easy as ordering an Uber.”

Ezra CEO Emi Gal, on the direct-to-consumer cancer screening company’s new convenience-focused mammography service.

Imaging Wire Sponsors

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

Qure.ai and Fujifilm’s X-Ray Integration

Qure.ai will integrate its qXR chest X-ray AI application with Fujifilm’s FDR Xair portable X-ray, creating a uniquely mobile AI solution.

  • QXR + FDR Xair – qXR analyzes chest X-rays and displays flagged abnormalities on the FDR Xair’s interface within 20 seconds, with the help of Fujifilm’s new Expansion Unit EX-Mobile image processing box.
  • An X-Ray AI Milestone – We’ve seen decent momentum with AI-integrated portable X-rays, but none that combine the FDR Xair’s small size (~7 lb. vs. ~200-800 lb.) with qXR’s diagnostic capabilities (TB, lung cancer, COVID, etc. vs. mainly single-function AI).
  • The Case for Handheld AI – Handheld imaging AI (both X-ray and ultrasound) could be a really big deal, especially if you consider that: 1) The majority of the world doesn’t have sufficient access to imaging systems and radiologists; 2) One of the biggest trends in first-world medicine is a shift to at-home care; and 3) Handheld ultrasound AI systems are already showing strong momentum.

Hitachi VidiStar Benefits

See how Hitachi VidiStar users have benefitted from the cardiovascular information system’s flexible SaaS-based model and leveraged its productivity advantages to increase reimbursements.

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LD-CT Reimbursements in Review

The U.S. CMS just opened a review of Medicare’s lung cancer screening reimbursement policies, which if approved, could significantly expand the country’s low-dose CT screening population.

  • Background – CMS’ lung cancer screening coverage review comes a few months after the USPSTF’s decision to expand its recommended screening population (age from 55 to 50yrs, smoking from 30 to 20 pack-years), prompting increased industry pressure on CMS to similarly expand Medicare reimbursements.
  • Impact – CMS’ potential decision to adopt the USPSTF’s new eligibility criteria would increase the screening population by over 80%, bringing massive LD-CT scan volume increases and everything that comes with that (more diagnoses, more incidentals, workflow constraints, new hardware and software demand).

Reconstructing AI’s Next Steps

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 Wire

  • Low Risk RT: A new study out of Denmark supports the country’s growing reliance on radiographers to interpret emergency X-rays. The study compared 100 skeletal X-ray reports from four radiographers against reports from six radiology and orthopaedic trainees, finding that the radiographers had significantly lower Consequence of clinical Outcome scores, wrong result risks, and severe error risks.
  • LVivo EF + Vscan for LVEF: Mount Sinai researchers found that GE’s VScan handheld ultrasound combined with DiA Analysis’ LVivo EF solution can help medical residents identify patients with reduced left heart function (LVEF). Two residents examined 30 ICU patients with and without LVivo EF support, finding that the AI-aided scans most consistently identified patients with LVEF compared to the patients’ formal echocardiograms (r= 0.88 w/ AI vs. 0.79 without).
  • Improving Patient Handoffs: A new JACR paper detailed how radiology departments can reduce errors that happen during departmental patient “handoffs” (for radiology, that’s during communication and transitioning decision-making). The paper proposed targeting: 1) Individual behaviors (e.g. training on error sources & communications); 2) Team behaviors (e.g. create routines, standardize checklists and schedules); and 3) The organization (e.g. automate processes, create culture of safety).
  • GE’s Xeleris V: GE Healthcare unveiled its new Xeleris V nuclear imaging processing and review solution, allowing clinicians to access data from multiple locations (beyond their NM workstations) and adding support for a range of new AI tools. Xeleris’ new AI suite includes Q.Volumetrix AI (SPECT/CT and PET/CT segmentation & quantitation), Q.Lung AI (segments lung lobes or lungs/trachea), EXINI Bone (segments and highlights whole-body bone scans), and Q.Thera (segments organs for quantitation and dosimetry calculations).
  • Radiologist Comp Down: A new Medscape survey revealed that 46% of radiologists made less in 2020 (largely due to COVID), with average pay falling 3% to $413k. Interestingly, 35% of the rads didn’t expect their income to return to pre-COVID levels for several years and 11% don’t ever expect their pay to rebound. In case these radiologists need a reason to be optimistic, a separate AuntMinnie survey showed that radiologists’ comp increased by 3.4% in 2020.
  • Riverain & Imbio’s Lung AI Alliance: Riverain Technologies and Imbio announced a partnership that will combine Imbio’s AI tools for chronic lung and cardiothoracic disease with Riverain’s lung nodule detection software. The companies will jointly offer their FDA cleared AI tools as part of a comprehensive lung imaging solution.
  • BUS AI Slashes False Positives: NYU researchers developed a breast ultrasound AI system (trained & validated w/ 289k exams) that achieved impressive accuracy and helped radiologists overcome breast ultrasound’s false-positive challenges. The AI system scored high accuracy in a test with 44,755 exams (0.976 AUROC), in a reader test (0.962 AI vs. 0.924 ten radiologists), and against an external set (0.911). It also helped radiologists significantly reduce false positives (-37.4%) and biopsy requests (-27.8%).
  • The Ezra Mammogram: Direct-to-consumer cancer screening company, Ezra, added mammography to its suite of screening services (starting in NY and CA). Ezra positions its new mammography service as a more convenient way for women to book mammograms (“as easy as ordering an Uber”) as well as an expansion to its members-only proactive screening service.
  • Behold.ai’s Triage Evidence: A new Clinical Radiology study detailed a CXR AI triage pathway that could reduce missed lung cancers, while improving accuracy and consistency. The researchers had three radiologists and the Behold.ai-based solution review 400 CXRs (including 200 difficult cases), finding that the algorithm matched the radiologists’ average tumor detection rate (87%), while reducing missed cancers by 60% when combined with the radiologists (90.67% accuracy).
  • Keeping Competence: Physicians have historically cared for patients through a combination of “competence” (medical knowledge and ability) and “warmth” (empathy and relationship-building), but they might increasingly share “competence” responsibilities with AI. In light of that potential shift, a new NPJ Digital Medicine editorial warned physicians to maintain control over new technologies “to keep the ‘competence’ dimension on their side,” rather than just increasing their level of “warmth” at the expense of their role in medicine.
  • Philips Spectral CT 7500: Philips announced its new Spectral CT 7500, touting its ability to perform spectral CT scans on all patients (cardiac, pediatric, bariatric, etc.), in a single scan, with no special protocols, and with the same dosage as conventional scans. Philips also highlighted the new CT’s ease-of-operation (integrated spectral workflow, 1-2 second scans) and its “first-time-right diagnosis” value prop (faster diagnosis, fewer repeat & follow-up scans).

Bayer’s Dose Management Benefits

With radiation dose management now largely considered best practice, this Bayer white paper details the top five benefits of adopting contrast dose management.

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The Resource Wire

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  • Because of United Imaging’s Software Upgrades for Life program, every time United Imaging launches a new solution it can automatically be installed in every compatible system at no cost.
  • This AI economics overview from Healthcare Administrative Partners details the various AI ROI scenarios and ways that AI can contribute to radiology practices until reimbursements become more of a reality.
  • A new study in European Radiology highlighted Riverain Technologies’ ClearRead Xray – Detect as one of just two imaging AI products to achieve the FDA’s most stringent premarket approval level. See how they measured up against the other 99 AI tools here.
  • With the gap between AI interest and AI adoption becoming increasingly clear, this GE Healthcare post details how AI startups can bridge that gap.
  • The Saint Joseph Mercy Health System doubled its follow-up recommendation identification/tracking when it adopted Nuance PowerScribe Follow-up Manager, achieving ROI within the first year. Find out how in this Nuance case study.

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