“We may find ourselves emerging from our bunkers in the future, troglodytes blinking as we encounter daylight, strangers to those with whom we once spoke…”

Mercy University Hospital’s Dr. Adrian Brady, urging his fellow radiologists not to “become the recluses of medicine.”

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The Imaging Wire

The Vanishing Radiologist

A new European Radiology editorial warned radiologists to stay visible in spite of the (sometimes welcomed) factors that could move the specialty to the patient care sidelines. Here are some details:

• Radiology’s Rise – The development of new and improved diagnostic technologies and the emergence of interventional radiology has given radiologists an increasingly visible role at the center of patient care.

• How to Become Invisible – However, a combination of new technologies (PACS, dictation, AI, teleradiology), greater structured reporting adoption, increasing workloads, isolationist behavior, and the COVID pandemic could risk diminishing radiologists’ accessibility and visibility.

• Visibility Warning – Despite the productivity upsides that come with invisibility, the author argued that radiology’s future success depends on today’s radiologists maintaining their visibility across care teams and with patients.

• Vital Visibility – Otherwise, radiologists “will still produce reports, which will still be important, but we may find ourselves emerging from our bunkers in the future, troglodytes blinking as we encounter daylight, strangers to those with whom we once spoke, peripheral to any decisions about resources or planning, having lost our standing to others who have taken advantage of our invisibility.”

• The Takeaway – The editorial’s main point is quite straightforward (radiologists: don’t become the recluses of medicine), but it’s worth noting that this comes a few weeks after another editorial encouraged radiologists to make a similar patient / colleague-focused shift in order to maintain relevance as AI’s role evolves.
  

The Wire

• Butterfly on NYSE: Butterfly Network officially shed its startup cocoon, making its debut on the New York Stock Exchange (and on WallStreetBets) after completing its merger with “SPAC” Longview Acquisition Corp. The listing also provided the first glimpse into Butterfly’s financials, revealing that it generated $45m in 2020 revenue (+63% YoY), which is decent growth for a company selling $2k medical devices (plus subscriptions), but also shows how much of Butterfly’s $1.5b acquisition value was based on its long-term potential.

• PACS Mouse Miles: A pair of Swiss radiologists tracked a rad resident’s mouse movements, finding that the resident moved her/his mouse 1.37 miles and performed 10,778 keystrokes during an 8-hour shift. The paper suggested that the resident’s “complex and extensive mouse patterns” revealed a need for more advanced user interfaces and more AI automation for repetitive tasks (e.g. creating hanging protocols or synchronizing image stacks).

• Intelerad Acquires LUMEDX: Intelerad continued to add to its enterprise imaging portfolio, acquiring healthcare analytics and cardiovascular information systems (CVIS) company, LUMEDX (>650-hospital customer base). Intelerad has become arguably the most active enterprise imaging acquirer, buying Clario Medical in 2018 (zero-footprint worklist), Radius in mid-2020 (cloud tech), and Digisonics in late-2020 (CV & OB/GYN PACS), due in part to Intelerad itself gaining a new PE parent company in early 2020.

• No AI Education: A new European Radiology paper (n = review of 100 AI programs) found that although imaging AI education is becoming more common, most programs feature short and stand-alone sessions (80%), focus on basic concepts (85%), use a passive learning/teaching approach (93%), are provided by professional institutions and commercial companies (91%), and are not part of longer-term curriculum. The authors called for the opposite of this, suggesting that AI education should be integrated into general radiology curriculum, adopt hands-on and real-world training approaches, and focus on helping radiologists learn how to use AI in their day-to-day work.

• Fujifilm & Candelis: Fujifilm Medical Systems U.S.A. and Candelis announced a partnership that will make Candelis’ ImageGrid suite (ImageGrid, ImageGrid Mini, and ImageGrid Plus) and ASTRA cloud storage and image transfer services available with Fujifilm’s imaging technology. Fujifilm will offer Candelis’ ImageGrid suite with its ASPIRE Cristalle mammography system and provide both the ImageGrid suite and ASTRA services with its Persona CT system.

• Weight-Based CT Contrast Evidence: A new JMIRS study found that customized weight-based volume contrast CT protocols (WBV) can rival enhancements from fixed volume protocols (FV, the current standard), while reducing exam costs. The review of 220 patients’ WBV and FV chest/abdomen/pelvis CTs found that over 90% of images from both protocols were “excellent,” FV produced higher overall contrast enhancements, but the custom WBV protocols were more consistent across patients with different body weights and allowed for a 28% cost reduction.

• DIY Ultrasound from the COVID Ward: Tel Aviv’s Sheba Medical Center will provide pregnant women in its COVID ward with PulseNmore personal ultrasound systems, allowing the women to scan themselves and have the scans remotely reviewed by clinicians in the hospital’s maternity ward. The article didn’t reveal whether these hospitalized pregnant women would have any clinician support during their scans (ultrasound-focused readers are probably wondering about that), but the PulseNmore scanner is intended for home/remote ultrasound assessments and it appears that these COVID ward exams will also be DIY.

• GE MRI DLR Evidence: A new MD Anderson study supports GE Healthcare’s AIR Recon DL deep learning reconstruction technique’s effectiveness for prostate MRI assessments. Using 31 patients’ 1.5T / 3T multiparametric MRIs with endorectal coils (ERC), the researchers created four series of T2-weighted images (ERC + DLR, ERC + conventional reconstruction, Non-ERC + DLR, and Non-ERC + conventional reconstruction). Three radiologists found that Non-ERC + DLR was most frequently the “best series” and least frequently the “worst series” for image quality, artifact reduction, and anatomical landmarks and tumor visualization.

• Prestige’s East Coast Expansion: Major Northeast U.S. imaging system dealer Prestige Medical Imaging (PMI) acquired major Southeast dealer G.E. Walker, creating the largest independent radiology service and solutions provider in the Eastern United States.

• Incidental AI Pros and Cons: A Duke University study found that AI could help radiology teams catch more incidental pulmonary embolisms and support incidental PE quality improvement initiatives, while also highlighting AI’s false positive challenges. The researchers used an AI tool to review nearly 12k single-phase CTs that were originally performed for non-PE indications, finding 79 incidental PE cases that were correctly reported and 49 additional PE cases that the radiologists missed. However, 85% of the cases that the AI tool suggested might contain incidental PE proved to be negative.

• GE’s Turkish AI Accelerator: GE Healthcare launched an AI development alliance with Istanbul-based AI startup CUREA to accelerate Turkey’s healthcare AI development. CUREA’s R&D team will leverage GE Healthcare’s Edison Health Services to develop AI applications, starting with COVID-19 detection / assessment and breast MRI detection / classification solutions, and later expanding to other solutions and other Turkish AI startups. GE Healthcare’s new Turkey alliance comes several months after a similar initiative in France.

• COVID Postponements: New research from the Urban Institute and Robert Wood Johnson Foundation found that 36% of nonelderly adults and 29% of children in the U.S. delayed or cancelled their medical care because of COVID exposure concerns or because their healthcare providers limited services. Although much of this cancelled care was routine (25% dental, 21% check-ups), 16% of the cancelations were for screenings and medical tests. Delays and cancellations were also more common among Blacks and Latinos than White patients (40%, 36%, 34%).

• PCP Interpretation Challenges: A new study in BMC Family Practice revealed notable X-ray interpretation challenges among family medicine residents, suggesting that family doctors should receive more radiology education or outsource more reads to teleradiology partners. The researchers had 205 Saudi Arabia-based physicians from a variety of career levels and specialties interpret 10 chest X-ray cases, identifying the most likely diagnosis and their confidence level for each case. The surveyed family medicine residents were far less accurate than radiology residents (58% vs. 90.5%), provided far lower diagnostic confidence scores (64% vs. 87.9%), and not surprisingly were far less likely to have adequate CXR training (25.7% vs. 85.7%).

• Insightec OK’d in China & Brazil: It’s safe to say that Insightec is having a good February so far, after Chinese and Brazilian regulators approved its Exablate 4000 (Exablate Neuro) MR-guided focused ultrasound platform for Essential Tremor and Tremor-dominant Parkinson’s Disease treatment (it’s already approved in the U.S., Europe, Japan, Korea, and Russia). Insightec will support its Brazilian expansion through a partnership with local distributor Strattner and operate in China through its Shanghai-based subsidiary.
  

The Resource Wire

– This is sponsored content.

• In this Hitachi blog, VidiStar users share how they’ve benefitted from the cardiovascular information system’s flexible SaaS-based pricing model and leveraged its productivity advantages to increase reimbursements.

• Learn how Beirut’s emergency physicians used their point-of-care ultrasound systems to triage and treat patients injured in last year’s massive Port of Beirut explosion in this GE Healthcare profile.

• This NIH study details how Imaging Biometrics MR (available on the Arterys marketplace) supports brain tumor treatment management decisions.

• Learn how Novarad’s Nova RIS system helps radiology departments streamline front office workflows, ensuring they get all the reimbursements they’ve earned while also providing a great patient experience.

• Read about the 2021 CPT code changes impacting radiology practices in 2021 in this blog article from Healthcare Administrative Partners.

• Learn how Zebra-Med’s AI Coronary Calcium solution can provide an ‘early-warning’ system for patients with coronary artery disease using existing CT scans.

• These two independent Phase III trials provided new evidence supporting the accuracy and effectiveness of using Bayer’s Gadavist contrast agent for cardiac MRI.

• Learn how Yale New Haven Health improved its radiology efficiency, communications, and turnaround times when it adopted Nuance’s PowerScribe Workflow Orchestration and PowerConnect Communicator solutions.

• Check out Riverain Technologies’ on-demand webinar demonstrating how its AI solutions integrated into LucidHealth’s radiology workflow and sharing best practices on how to combine AI with radiologist expertise.

• Read Siemens Healthineers’ latest case study to see how one customer is pioneering MR-guided, non-invasive treatment for prostate cancer with MAGNETOM Skyra MRI.