Philips & Elekta | PA Pushback | No-Show Risks

“Hey, this is the thing growing inside of you. This is pretty creepy.”

Tiktok physician influencer, MadMedicine, describing how babies look in fetal MRIs. This post ended up with 245k likes.

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The Imaging Wire

Philips & Elekta Go Deep

Philips and Elekta “deepened” their strategic partnership, revealing plans to further integrate their portfolios across the cancer care pathway.

  • Deeper Integration – This portfolio integration will expand beyond Philips and Elekta’s current MR-guided radiation therapy systems, combining Philips’ imaging and informatics tech with Elekta’s cancer treatment products to support the entire cancer care pathway (diagnosis, planning, treatment, monitoring, follow-up).
  • Integrated History – Philips and Elekta already had a pretty “deep” relationship, highlighted by Elekta’s 1997 acquisition of Philips’ RT division and their decade-old MR-guided RT alliance. However, even after this announcement, their partnership remains non-exclusive.
  • Integrating Industry – Portfolio integration makes clinical sense, but it may make even more business sense considering that Philps and Elekta’s top competitors (Siemens & Varian) are merging into a truly-integrated cancer imaging/therapy company. It also wouldn’t be surprising if these integrations from Philips/ Elekta and Siemens/Varian led to similar alliances or even acquisitions among the other major cancer imaging and treatment players.

Riverain ClearRead Xray’s Elite Status

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.

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Novarad’s Storyboard View

Check out how Novarad’s enterprise imaging patient storyboard view gives specialists more and better information from across a hospital system to better care for their patients.

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The Wire

  • PA Pushback: The ACR and other physician groups voiced their opposition to the American Academy of Physician Assistants’ decision to change PAs’ official title to “physician associates,” arguing that “physician assistant” is still accurate and the change would create confusion. This might seem like semantics, but physician groups are very concerned about PAs encroaching into their territory, and generally fight any move that could support that encroachment.
  • Predicting No-Shows: A SIIM 2021 presentation detailed a University of Maryland ML model that could help identify patients who are more likely to miss their radiology appointments (fast forward to minute 37). The model (trained w/ 39 EMR features from 4.5m CT/MR appts) predicted no-shows with 0.93 and 0.73 AUCs (retrospective & prospective tests), finding that patients with the highest risk scores were 7x more likely to no-show (21% vs. 3% likelihood).
  • Wales’ Double Shortage: The Welsh NHS is poised to spend £25m on new imaging equipment to help overcome a 568k-patient diagnostic backlog (18% of its population, +24% in the last year). However, the Royal College of Radiologists warned that the Welsh NHS would also have to hire and train far more radiographers, radiologists, and doctors in order to scan, diagnose, and treat all these patients.
  • Imaging Placental Bulge for PAS: MRI and ultrasound could be used to detect placental bulge (the focal area of myometrial-placental bulging beyond the normal uterine contour), helping to diagnose women with severe placenta accreta spectrum (PAS) disorder. The AJR study performed MRI and ultrasound exams on 62 pregnant women with suspected PAS (36 w/ severe PAS), discovering that placental bulge was the most accurate prenatal imaging finding for predicting severe PAS (US = 85.5%, MRI = 90.3%).
  • iCAD & Sectra Go Global: iCAD announced a global distribution agreement with Sectra, making its ProFound AI and ProFound AI Risk mammography analysis tools available through the Sectra Amplifier Marketplace. iCAD was previously a Sectra “Amplifier Integrator” (handling its own integration w/ Sectra clients) and also has PACS / marketplace distribution alliances with Change Healthcare and Nuance.
  • Unnecessary PICU CXRs: A Journal of Pediatric Nursing study review (n = 18 adult & ped studies) found no justification for performing routine daily chest X-rays on ventilated patients in pediatric ICUs, instead recommending on-demand CXRs. The studies showed no difference in outcomes between daily and on-demand CXR ordering (mortality, complications, length of stay, ventilator days), but did find that on-demand protocols reduced CXRs per patient (reducing: radiation, labor, false positives).
  • Probo Acquires Tenvision: Probo Medical continued its acquisition spree, acquiring Tennessee-based ultrasound equipment / service / training company Tenvision. Probo has acquired two straight U.S.-based and ultrasound-focused companies since April (Tenevision & SonoDepot), following a streak of acquisitions that focused on expansion into new modalities (MRI, CT, etc.) and regions (Europe).
  • Safety Officer Impact: Children’s Healthcare of Atlanta detailed how appointing an MRI safety officer and creating new safety procedures significantly reduced its MRI-related adverse events (from >25 events in 2017 to <10 in 2019). The hospital appointed/trained a technologist as its MRI safety officer, who then developed a 100pg MRI safety manual, educated more staff on MRI safety, assigned staff to safety screening roles, and launched weekly safety meetings.
  • Banning Scalar Energy: A team of Malaysian physicists called for a ban on ‘scalar energy’ pendants after finding that these metallic/glass pendants can expose wearers to 3 mSv of radiation annually (1 mSv/yr is the recommended max), while noting the lack of scientific/medical justification for wearing them.
  • CCTA Debate: A debate over Coronary CTA exams and coronary artery calcium scoring (CCTA & CAC) sprung up on JAMA Internal Medicine. It all started with a University of Utah physician’s advisory against routine CCTAs and CAC scoring because neither can estimate heart attack risk or identify ways to prevent heart attacks. A rebuttal from a Northwestern team argued that combining CAC scores with other risk models can indeed help detect/classify CVD risk, followed by a counter from the U of Utah physician that CAC scoring isn’t as accurate as traditional risk models but it does increase radiation exposure.
  • Quebec Techs on Strike: Quebec’s medical technicians (including imaging techs) launched a two-day strike this week to protest stalled contract negotiations that, among other things, ask for floating holidays and COVID bonuses. Another walk-off is scheduled for June 21-22 if an agreement isn’t reached.
  • Thyroid Screening Alternative: A team of European researchers showed that their developmental device combining near-infrared spectroscopy and ultrasound (code named “LUCA”), could be able to detect malignant thyroid nodules more accurately than current ultrasound / biopsy workflows. LUCA classified 13 benign and 4 malignant nodules with 100% sensitivity and 77% specificity, which is promising given the accuracy challenges with current ultrasound-based techniques (sensitivity = 10%-87%, specificity = 58%-96% depending on malignancy type).
  • MARCA Milestone: The updated Medicare Access to Radiology Care Act (MARCA) made its way to the U.S. Congress, drawing praise from radiologist and technologist societies. If made into a law, MARCA would require Medicare to reimburse imaging services performed with radiologist assistants at any facility (hospital, ambulatory center, etc.), as long as RAs are working within physician-led teams (not independently).

Siemens’ Dual Source Cardiac CT

Explore untapped potential in dual source CT for cardiac imaging. This new Siemens Healthineers whitepaper showcases the clinical benefits of fast native temporal resolution.

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The Resource Wire

  • 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.
  • Kick off SNMMI2021 with United Imaging’s opening day panel discussing the clinical and research impacts of ultra-high-resolution digital PET (June 11, 5pm ET), including the impact of PET AI reconstruction in routine PET imaging.
  • In this quick video, Sharp Memorial Hospital interventional radiologist, Jim Lyon, MD, describes the image quality and dose advantages of Canon Medical Systems’ Alphenix Sky+ system.
  • This MDPI study details how imaging represents the most powerful tool for identifying patients at risk of arrhythmic mitral valve prolapse, noting that 4D-flow CMR techniques (like Arterys’) show “great promise ” for assessing mitral regurgitation.
  • Independent and staying that way? Healthcare Administrative Partners just released a helpful set of guidelines that radiology practices can follow to stay private despite ongoing consolidation pressures.
  • This Bayer Radiology case study details how its Certegra P3T Software automates contrast enhanced abdominal CT injection protocols based on patient characteristics and contrast concentration.

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