“It’s like we can see the tumor breathing.”
Cancer Research UK Cambridge Institute professor, Kevin Brindle, on the images produced by his team’s new carbon-13 hyperpolarized imaging technique.
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The Imaging Wire
Magnetized Imaging Breakthrough
A team of UK-based researchers unveiled the results of their new carbon-13 hyperpolarized imaging technique, which may be able to provide real-time insights into breast cancer tumors’ status and risk. Here are some details:
The Technique – As its name suggests, carbon-13 hyperpolarized imaging relies on hyperpolarizing (magnetizing) carbon-13 pyruvate by cooling it to about one degree above absolute zero (-272°C) and exposing it to extremely strong magnetic fields and microwave radiation (making pyruvate 10k-times more magnetic). This frozen material is then thawed and dissolved into a solution that is injected into patients before a breast MRI.
The Study – The technique was tested on seven patients with various types and grades of breast cancer before they had received any treatment. The team used the scans to measure how fast the patients’ tumors metabolized the pyruvate (converting it to lactate), to detect differences in tumor size/type/grade/aggressiveness, and to understand tumor topography.
The Takeaway – The team called the results among “the most detailed pictures of the metabolism of a patient’s breast cancer that we’ve ever been able to achieve.” They also suggested that when combined with genetic testing, the new technique could lead to more individualized cancer treatments.
CT Contrasts’ Overstated Kidney Risk
A joint statement from RSNA and the National Kidney Foundation (NKF) argued that the risks of using iodinated contrast CT agents on patients with impaired kidney function “has been overstated” because previous studies incorrectly combined “contrast-induced injury” and “contrast-associated injury.” Here’s some details on that statement and their new guidance for CT contrast.
Historical Fears – The groups suggested that due to incorrect previous studies (combining associated vs. induced injury), iodinated contrast media has been “denied or delayed in patients with reduced kidney function” due to perceived risk. However, this practice often created a greater risk of delayed or inaccurate diagnosis.
Modern Data – Fighting fear with data, RSNA and NKF based their new guidelines on a study that found pediatric patients who underwent CT imaging with intravenous contrast material had a similar 10-year rate of acute kidney injury as those who were not exposed to the iodinated contrast. This comes less than a year after a Columbia University researcher found that CT agents are somewhere between “nearly harmless and totally harmless.”
Guidance – The groups stated that CT contrast is appropriate for patients with acute kidney injury or estimated glomerular filtration rate (eGFR) below 30 mL/min per 1.73 m2 as long as they don’t have heart failure, aren’t undergoing dialysis, and don’t have other contraindications. Just to be sure, they also called for new research to better understand the link between CT contrast and kidney injury.
- Fujifilm revealed plans to launch its new Systems Integration (SI) business, intended to support image and data integration in the operating room (OR) and interventional suites, while serving as a connector between Fujifilm’s medical image capture products and Synapse Enterprise Imaging portfolio. Fujifilm highlighted its role as the only vendor with endoscopic imaging, modality solutions, and enterprise imaging, suggesting that the new SI business will better serve OR/interventional clients and solidify Fujifilm within its accounts.
- Strategic Radiology added North Carolina-based Gaston Radiology (18 radiologists) to its consortium of independent radiology practices, which now includes 26 private practices and over 1,100 radiologists. Gaston Radiology joins Asheville Radiology Associates and Mecklenburg Radiology Associates as the third North Carolina-based practice to align with Strategic Radiology in the last year.
- A new (and very detailed) white paper from ASRT provided insights into radiologic technologists’ perspectives on AI, finding that they have generally optimistic views on the potential impact of imaging AI. Although the respondents had a “mixed” level of familiarity with AI technology and were concerned about AI’s impact on the “human” part of their profession (31% believe it will reduce the profession), more respondents didn’t expect AI to reduce RT staffing levels (46%) and most trust the technology (83%).
- The family of a 64-year-old South Florida man who died from a brain hemorrhage received a $2 million settlement after it was revealed that a radiologist read the man’s 691 emergency CT images in six minutes and 26 seconds (that’s 2 images per second) before he reported that there were no signs of hemorrhage. The patient was quickly discharged after this report, but was soon rushed to another hospital when his symptoms worsened and he died the following day.
- An editorial on thehill.com proposed a relaunched “fight against medical errors,” suggesting that improvements in medical science are being undermined by the “plague” of medical errors by doctors and hospitals. The piece specifically highlighted diagnostic errors, including those by radiologists who are “burdened” by continuously increasing reading volumes, while calling on the FDA to prioritize solutions that address this “epidemic.” All that said, this op-ed was penned by the CEO of imaging diagnostic error-focused company, Ferrum Health.
- Mindray Medical announced the release of its new TE7 ACE point-of-care ultrasound system, intended for use in anesthesia, critical care, and emergency environments (ACE). Likely related to the already-available Mindray TE7, the TE7 ACE is highlighted by its touchscreen interface, AI-based fluid management tools, safe needling toolkit, data connectivity, and disinfection solution.
- IHS Markit researched 363 diagnostic AI solutions from 288 different vendors, finding that 28% of these solutions have achieved regulatory approval (FDA, CE, MFDS, CFDA; up from 15% last year). The firm found that Neurology was home to the highest number of regulatory-cleared AI solutions (26), followed by Chest and Lung (19) and Cardiology (15).
- A 17-year-old San Ramon, California high school student developed an AI model that uses MRI scans to help determine whether a patient is responding to neoadjuvant chemotherapy. Through her work at the Simons Summer Research Program at Stony Brook University, Janice Yang developed the model using MRI scans from women who did and did not respond to neoadjuvant chemo, earning her a spot among the national Regeneron Science Talent Search finalists.
- Medscape’s 2020 physician burnout survey found that 42% of surveyed physicians reported feeling some level of burnout (n = 15,181 physicians, 29 specialties), including 46% of radiologists (6th most). The physicians attributed administrative tasks (55%), long hours (33%), and lack of respect at work (32%) as the main burnout drivers, while about 50% of respondents said they would take a lower salary (~$50k) if it meant less burnout.
- Healthcare Administrative Partners’ latest blog revealed that changes to the 2020 Current Procedural Terminology (CPT) coding are bringing relatively few changes to diagnostic radiology (primarily: abdominal/gastrointestinal plain films, nuclear medicine for tumor localization, and myocardial PET imaging) and interventional radiology (pericardial and spinal puncture procedures). The firm provided complete details on each change and encouraged practices to evaluate the fee schedule changes based on their mix of modalities and procedures.
- New research in JACR found that when an urban hospital adopted standardized structured reporting for chest radiographs, it saved radiologists time and led to economic gains for the hospital. When the hospital’s use of a standardized CXR template increased from 46% adoption to 96.2% adoption, it saved an estimated 8.5 hours of radiologist time per month, while driving correct-to-bill rate increases of 8% for radiography and 12% for all modalities. Not to mention the fact that these structured reports will pave the way for much more straightforward data mining.
- Hitachi Healthcare Americas announced the creation of its new Medical Imaging Innovation Center, a 40-person R&D center focused on imaging AI and machine learning located within its Cleveland area headquarters. The new R&D center will collaborate across the imaging industry as well as with local healthcare leaders, particularly relying on a partnership with local incubator BioEnterprise.
- A new editorial in healthnewsreview.org called for the press to get over their “machine-versus-doctors fixation,” arguing that this worn-out storyline undermines the more important questions: whether AI will help patients and/or reduce healthcare costs. The editorial tracked through a number of AI vs. MDs examples and detailed the recent pushback against this angle, while calling on journalists to improve their healthcare AI coverage, even if it comes at the expense of flashy headlines.
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