Prostate MRgFUS | DeepCAC CV Risk | Visage AI

“If the medical team cannot clinically tell that this is a massive groin hernia then please consider retraining as medical professionals.”

One radiologist’s EHR note after an “essentially unconscious” COVID-positive patient was sent for what he/she views as an unnecessary testicular ultrasound.

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The Imaging Wire

DeepCAC CV Risk Predictor

The Mass General Brigham Artificial Intelligence in Medicine (AIM) team just unveiled a deep learning system that automatically produces coronary artery calcium (CAC) scores from chest CT scans, using that data to accurately predict cardiovascular events.

  • The Study – The AIM team tested their new DeepCAC system’s ability to predict cardiac events using chest CTs from 20,084 people (different health profiles, scanners, protocols) and then compared their results against 5,521 people’s manually-produced CAC scores.
  • The Results – The automated DeepCAC scores proved to be “a strong predictor of cardiovascular events,” while achieving similar accuracy (0.74 & 0.75 AUCs) and intra-class correlation (0.993 & 0.997 ICCs) as the manual risk scores.
  • The Takeaway – Considering that CAC scores are rarely quantified due to resource constraints (expertise, time, equipment), these results show that automated CAC scoring tools like DeepCAC (or Zebra’s Cardiac Solution) could make cardiovascular risk screening a realistic/efficient addition to population health initiatives (even if they aren’t reimbursed yet).

Prostate MRgFUS is Effective

A new study out of Toronto’s Joint Department of Medical Imaging found that MRI-guided focused ultrasound prostate cancer treatment is effective and could help men avoid the incontinence/sexual risks associated with current glandular approaches. Here are some details:

  • About MRgFUS – With MRI-guided high-intensity focused ultrasound treatment (MRgFUS), an ultrasound transducer focuses sound waves to generate heat at a single point and destroy targeted tissue. MRgFUS is used for a range of applications (bone metastasis, fibroids, osteoid osteoma, Essential Tremor), and as this study shows, it could eventually treat prostate cancer.
  • The Study – The researchers performed MRgFUS treatment on 44 men with intermediate-risk prostate cancer and measured their outcomes using MRI, biopsies, and surveys regarding erectile and urinary function.
  • The Results – The researchers successfully completed the 44 MRgFUS treatments with no major adverse events, finding that 93% of the participants were disease-free at their five-month biopsies and “preserving” each of the patients’ erectile and urinary functions.
  • The Takeaway – MRgFUS prostate cancer treatment still needs to gain regulatory and payor approvals, but 20% to 30% of prostate cancer patients could be candidates for this type of therapy and most of these candidates would likely “want their prostate cancer eradicated without diminishing their quality of life.”

The Wire

  • Visage’s Density AI: Visage Imaging parent company, Pro Medicus Limited, announced its new Breast Density Algorithm’s FDA approval and the start of its commercial rollout across the U.S., Europe, and Australia (it’s now cleared in all three regions). Developed through Pro Medicus’ AI Accelerator platform with the company’s academic partners, the Visage 7-native Breast Density algorithm analyzes DM and DBT images to provide radiologists with BI-RADS categorization. This launch makes Visage/Pro Medicus the first major PACS vendor to offer a self-developed, FDA-cleared AI algorithm directly into their PACS, representing a notable milestone in an increasingly AI-focused part of the industry.
  • Pay-for-Performance Works: When Brigham and Women’s Hospital launched a radiology pay-for-performance program (PFP; +5% salary incentive), their radiologists’ performance improved. A review of the year before / after BWH implemented the PFP program (n = 144 rads, 1.5m reports) showed improvements in scan to report signature times (90th percentile fell from 21.1 to 16.7hrs), timely closure of critical alerts (90% timely rate increased from 95% to 98.4% of rads), and peer-learning participation (all units exceeded goal of ≥90 annual peer-learning communications).
  • Imaging’s Mixed Q4: After last summer’s reopenings brought overall Q3 healthcare/imaging division revenue growth, the major OEMs’ Q4 2020 performances were mixed. The quarter featured year-over-year revenue growth from Siemens Healthineers’ imaging business ($2.67b to $2.8b), Canon Medical Systems ($1.05b to $1.17), and Konica Minolta’s healthcare business ($245m to $268m), but declines within GE Healthcare ($5.4b to $4.82b), Philips’ Diagnosis & Treatment division ($3.13b to $2.98b), and Hologic’s breast imaging division ($275m to $268m). Still, just about everyone had some reasons to feel positive about Q4 (e.g. solid margins, comp sales growth, strategic growth) and the major OEMs performed better in 2020 than many might have feared during the COVID shutdown.
  • COVID No-Shows: When New York City enacted social distancing policies last spring, Mount Sinai’s total outpatient imaging volumes fell by 85% and its no-show rates spiked by ~400% (radiography no-show rates increased by ~700%). Although the hospital system’s no-show rates returned to pre-pandemic levels within two months, its total imaging volumes were still down as of July 2020.
  • Volpara Acquires CRA Health: Volpara Health took another step in its expansion strategy, acquiring breast cancer risk assessment company CRA Health for $18m to $22m. Volpara plans to combine CRA Health’s software (analyzes patient info, makes imaging/genetic testing recommendations) with its own suite of breast imaging solutions to offer more personalized breast cancer risk assessments. This acquisition comes 1.5-years after Volpara bought breast imaging clinic management software company MRS Systems for $14.4m and its latest move reaffirms Volpara’s role as one of the more aggressive M&A forces in the breast imaging solutions arena.
  • The Benefits of CDS Integration: The University of Virginia Health System detailed the efficiency improvements they achieved by integrating their clinical decision support tool (CDS) into their advanced outpatient imaging prior authorization ordering process (MRI, CT, PET, nuclear medicine). During the 1.5-year pilot program with Aetna, the CDS tool deemed 69% of the orders it processed as “usually indicated” (997 of 1,453), circumventing the labor-intensive prior authorization request process for orders that were likely to be found appropriate anyway (eliminating ~266hrs of labor).
  • Micro-X Eyes U.S. Expansion: Lightweight X-ray manufacturer Micro-X raised $23.2m to fund its expansion to the U.S. market and support product development. Micro-X might not be a household name, but it produces Carestream’s Nano mobile X-ray (Micro-X has since made that distribution agreement non-exclusive) and it recently landed FDA clearance for a mobile X-ray system for military facilities.
  • Three Big Digital Health Predictions: After the COVID-19 pandemic drove 2020’s digital health boom, Healthcare Dive and a panel of industry analysts/consultants predicted this trend to continue through 2021. Specifically, the report forecasted that: 1) Healthcare will become more predictive with the help of connected devices, wearables, and AI; 2) Telehealth’s massive growth will continue (possibly accelerate), while evolving to more sophisticated use cases; 3) Increases in tech use and available patient data will make healthcare cybersecurity an even greater priority.
  • Stroke Ambulances Work: A new JAMA study confirmed that using mobile stroke ambulances (w/ CT, lab testing, and ability to perform thrombolysis) does indeed lead to better outcomes for patients with acute ischemic stroke versus performing thrombolysis at the hospital. A study involving 1,543 German stroke patients found that the 749 patients transported in the stroke ambulances had lower rates of severe disability (12.6% vs. 13.3%) and death (7.1% vs. 8.8%), and higher rates of no-to-moderate disability (80.3% vs. 78%) after three months.
  • Nanox’s FDA Disruption: Nanox’s stock tumbled early this week after the FDA asked the startup to address “deficiencies and questions” related to its single-source Nanox.ARC system’s intended use and predicate devices. This wouldn’t be a newsworthy event for most startups (“more info” is not an unusual 510(k) request; Nanox probably won’t take this version to market), but Nanox and its day-trader supporters have consistently emphasized how 2021 FDA approvals would set Nanox up for market disruption in future years.
  • RadTranslate Translates: Noting COVID-19’s disproportionate impact on communities with limited English proficiency (LEP) and the challenges that creates for translators / technologists / patients, MGH just rolled out its new RadTranslate web app to provide LEP patients with multilingual audio radiology exam instructions. During a 63-day test period, RadTranslate was used 1,267 times to support CXR-based COVID triage with Spanish-speaking patients, most commonly to explain exams (30%) or instruct patients to disrobe/remove jewelry (12%), without affecting exam length or standard-of-care.
  • HAP & New England Baptist Radiology Partner: New England Baptist Radiology selected Healthcare Administrative Partners to be its radiology revenue cycle management (RCM) provider, including billing, coding, carrier credentialing, and MIPS Measure Assurance Services. New England Baptist Radiology (~8 radiologists, MSK and neurorad-focus) practices at New England Baptist Hospital and supports patients across eastern Massachusetts and New Hampshire.
  • SpectraWAVE’s $13m: Cardiac imaging startup SpectraWAVE announced a $13.2m Series A-2 round (increasing total to ~$29m) that it will use to support its flagship intracoronary imaging product’s development and regulatory filing. SpectraWAVE’s medical imaging platform uses a multi-modality imaging catheter to give interventional cardiologists insight into patient plaque structure and coronary blood vessel content for coronary stenting assessments.

The Resource Wire

– This is sponsored content.

  • In this GE Healthcare Q&A, Oxford University Hospital Trust’s Dr. Alex Novak discusses imaging AI adoption and his experience with GE’s Critical Care Suite.
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