Nanox’s Big Short | BC Risks | NP Warning

“This $3 billion company is nothing more than a science project with a simple rendering, minimal R&D, fake customers, no FDA approval, and fraudulent claims that are beyond the realm of possibility.”

Citron Research, doing its best to burst Nanox’s bubble.

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The Imaging Wire

Nanox’s Big Short

Just two days after we detailed Nanox’s massive buzz, a report from Citron Research called the would-be imaging disruptor a “complete farce,” “Theranos 2.0,” and “the most blatant stock promotion in years.” As one might expect, the report coincided with Nanox’s stock falling by about 40%. Here are the details:

  • Citron’s Argument – The famous shorting fund shared plenty of reasons why Nanox isn’t the real deal. Here are a few: 1) Nanox still hasn’t shown a real product and only a few scans; 2) It has a 13 person R&D team and spent $7.5m on R&D in its history (a bit less than GE & Siemens); 3) Nanox sold for just $13.3m last year (significantly below its $1.6b market cap); 4) Its partners seem fake.
  • About the Fake Partners… – Much of Nanox’s recent news has focused on its $164m in credit-backed service agreements, using the announcements to build credibility and show early demand. However, Citron revealed that Nanox’s largest partner doesn’t even mention medical imaging on its site and some other partners can barely be found on the internet.
  • Fast Action – Within hours of the Citron paper, class action specialty firm Bronstein, Gewirtz & Grossman already started recruiting unhappy Nanox investors to join its lawsuit, while specifically citing the Citron paper.
  • Nanox Loyalists – Nanox supporters quickly emerged on social threads and message boards, listing Nanox’s various reputable backers (Fujifilm, Bill & Melinda Gates Foundation, Foxconn) as evidence that the company has real potential. They also reminded everyone that Citron itself could even be viewed as a scam, suggesting that it uses papers like this to help make its “short” bets come true.

The Wire

  • BC Risk Models: Swedish researchers developed a breast cancer risk model combining iCAD’s ProFound AI Risk solution (age, density, subtle mammographic features) with a pair of models based on lifestyle and genetics to identify women with a high risk of developing breast cancer within two years. In the study (n = 974 women with incident cancers, 9,376 healthy), the ProFound AI Risk model identified high risk women with an AUC of 0.73 on its own (higher than existing models) improving to 0.74 with the inclusion of lifestyle data and 0.77 with the addition of genetic data.
  • AMA’s NP Warning: The AMA urged California Governor Gavin Newsom to veto state bill AB-890, which would expand nurse practitioners’ ability to provide care without physician supervision (including ordering, performing, and interpreting images). The AMA warned that the bill wouldn’t benefit rural and underserved areas, but it would increase overall health care costs (because they over-prescribe meds and imaging) and threaten patient health and safety (because they don’t have sufficient training).
  • COVID CXR AI: A Princeton team developed an AI system that can use chest X-rays to distinguish COVID-19 pneumonia from viral pneumonia and normal lungs with 95% accuracy. In a test using 2,300 CXRs (1,018 normal, 1,011 w/ pneumonia, 271 w/ COVID-19), the algorithm was able to accurately categorize scans from each group, even spotting CV19-positive patients using scans that appeared normal without the AI system.
  • Aidoc’s $20m: Aidoc announced that it raised an additional $20m through its Series B funding extension round, increasing the round to $47m and growing its fundraising total to $60m. In a unique move compared to most funding announcements, the press release emphasized how Aidoc’s accomplishments justify this funding round (3x revenue since start of 2020, 6 FDA-cleared solutions, in use at 400 health centers), rather than detailing how it plans to use the money.
  • Value-Based Radiology: A new JAMA Network paper detailed how radiology is increasingly positioned on the wrong side of value-based care equations, while sharing five ways that the specialty can reinforce its value. The paper suggested that radiologists should: 1) Clarify radiology’s “breadth of contributions” to medicine; 2) Quantify how radiology improves patient outcomes and quality of life; 3) Hold referring physicians accountable for the costs of their referred studies; 4) Help hospitals understand the consequences of understaffing radiology (bottlenecks, delayed care and discharges); 5) Ensure that their studies are indeed appropriate.
  • Florida Stark Fight: An orthopedic surgeon continued his legal battle against Orlando Health after the system allegedly fired him for performing surgeries at outside facilities and making referrals to outside imaging centers. After his initial federal Stark Law whistleblower lawsuit failed to get state and federal support, the surgeon just filed a similar $800k lawsuit in the Orange County circuit court.
  • COVID Guidelines Work: New research in Radiology: Cardiothoracic Imaging found that the RSNA guidelines for reporting COVID-related CT findings achieved relatively high accuracy and consistency. The interobserver study had 9 readers (6 specialists, 3 residents) evaluate 89 consecutive CT scans from patients with COVID-19 using the RSNA guidelines. The readers identified “typical appearance” COVID-19 pneumonia with 86% sensitivity (range 72%-94%) and 80.2% specificity (range 75-93%), with 60%-86% agreement levels across the attendings and trainees (163 disagreements out of 801).
  • Riverain’s New Sr. Scientist: Riverain Technologies welcomed Seyed Sadegh Mohseni Salehi as its new senior research scientist, responsible for the research and implementation of advanced image analysis and machine learning systems. Salehi joins Riverain after years of developing deep learning based medical imaging systems at Hyperfine and in academia.
  • Compressed SENSE is Fast: The Compressed SENSE MRI acquisition method can significantly decrease knee imaging scan times without affecting diagnostic certainty or image quality. That’s from a new German study that scanned 22 patients’ healthy knees using a variety of MRI methods, finding that Compressed SENSE scans can reduce scan times by 34% for 2D scans and 54% for 3D images.
  • Inflammation Imaging: Washington University School of Medicine researchers developed a PET imaging agent that illuminates the location and the intensity of inflammation. To create the agent, researchers created Galuminox, a chemical compound that detects reactive oxygen species (a sign of inflammation), and then linked it to gallium-68 to allow visualization in PET imaging. In their initial study, PET scans revealed that the Galuminox-based agent was concentrated in the lungs of mice injected with lipopolysaccharide to simulate acute respiratory distress syndrome.
  • CV19 CXR Reads Improve with Experience: Italian researchers found that radiologists’ ability to diagnose COVID-19 in chest X-rays depends on their CXR experience and improves over time. The retrospective study reviewed CXR reads from two groups of radiologists (Group 1: >10yrs CXR experience; Group 2: <10yrs), finding that the groups had the same sensitivity (89% & 89%), but the more experienced group had higher specificity (66% vs. 40.7%) and accuracy (83.7% vs. 76%). When comparing reads from the first and second half of the study period, sensitivity (80.8% vs. 92.8 %) and accuracy (76.4% vs. 85.6 %) both improved over time but specificity declined (67.7% vs. 53.2%).
  • GE & Candelis: GE Healthcare will offer Candelis’ ImageGrid software suite (ImageGrid, ImageGrid Mini, and ImageGrid Plus) with its Senographe Pristina mammography system as an enhanced breast imaging workflow solution. The combined solution is intended to simplify mammography image transfer and storage workflows, with the ImageGrid suite providing pre-fetching, routing, interface, and archiving functionality.
  • The Case for CEUS Liver Cancer Imaging: A University of Calgary report highlighted contrast-enhanced ultrasound’s (CEUS) advantages over CT and MRI for diagnosing some liver cancers, specifically citing its safety (no radiation), lower cost, bedside use, real time results, and in some cases its better imaging results. The paper suggested that CEUS might have the greatest value during the portal venous phase, more accurately showing washout in malignant tumors than CT and MRI.
  • World’s Smallest Ultrasound Detector: German researchers developed the world’s smallest ultrasound detector (100x smaller than a human hair, 10,000x smaller than current detectors), leveraging its small size to visualize features that are much smaller than previously possible (<1mm). Based on miniaturized photonic circuits on top of a silicon chip, the mini ultrasound detector monitors changes in light intensity, rather than recording voltage from piezoelectric crystals like typical detectors.
  • CMRI for COVID Myocarditis: Ohio State researchers found that cardiac MRI (CMRI) can identify myocarditis, a heart condition often linked to COVID-19 infections, suggesting that the imaging technique could help confirm whether athletes recovering from COVID-19 are safe to return to the playing field. The study examined 26 male and female college athletes who tested positive for COVID-19, using clinical exams, ultrasound, EKG, blood tests, and CMRI, finding that only CMRI identified the 15% of participants with signs of myocarditis.

The Resource Wire

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  • Radiology will see a significant cut in Medicare reimbursement in 2021 if the MPFS Proposed Rule is applied without a change to the budget neutrality requirement in the law. Get all the details in this Healthcare Administrative Partners blog post.
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  • Learn how Riverain’s ClearRead CT Vessel Suppress provides a powerful and intuitive view for clinicians through the suppression of vascular structures.
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