Space X-Ray | No-Show Determinants | Breast Screening Debate

“Using stargazing technology to spot cancer is exactly the type of advanced innovation that could improve care for patients.”

NHS England’s national clinical director for innovation, Professor Tony Young, on the UK Space Agency and UK NHS’ decision to fund Adaptix’s space tech-based 3D X-ray.

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  • Medmo – Helping underinsured Americans save on medical scans by connecting them to imaging providers with unfilled schedule time.
  • Pocus Systems – A new Point of Care Ultrasound startup, combining a team of POCUS veterans with next-generation technology to disrupt the industry.

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Portable 3D X-Ray from Space
In honor of the UK NHS’ 70th birthday, the UK Space Agency awarded Oxford-based imaging startup, Adaptix, with a £1 million grant to fund the development of a portable 3D medical X-ray machine that’s based on technology once used in space travel.

This isn’t a common storyline, but it makes sense that Adaptix won this grant. The company got its start at the European Space Agency’s Business Incubation Centre and uses a range of technologies developed for space. For example, “field emitters etched onto silicon wafers used previously in ion thrusters and X-ray optics deployed on star mapping spacecraft.”

Adaptix plans to use this grant, along with additional funding from InnovateUK and the National Physical Laboratory, to “transform radiology” and “surpass $100m in revenue” by providing a more comprehensive view of suspected tumors with greater portability and connectivity than current X-ray and CT scanners. The tablet-sized 3D X-ray system is scheduled to launch within the next 18 months, targeting usage both in patient homes and hospital bedsides, while serving as a low-dose alternative to CT.

The American College Radiology took what appears to be a big step to democratize AI access and adoption with the ACR Data Science Institute’s launch of its new ACR AI-LAB platform. The free, open, and vendor-neutral platform is intended to “empower local radiologists to participate in the creation, validation and use of health care artificial intelligence” by providing the tools to develop AI algorithms in-house, with their own data, and behind their own firewalls. The ACR AI-LAB platform will integrate with NVIDIA’s Clara AI toolkit, Nuance’s AI Marketplace, and GE Healthcare’s Edison AI platform, providing a range of AI tools that are intended to simplify AI adoption and radiology workflow integration. There’s still plenty of advancement needed before radiology AI is truly democratized, but the neutral and collaborative ACR AI-LAB seems like a solid step towards this goal.

Income, Weather, Distance, and No-Shows
Wealthier patients who don’t have far to travel are more likely to make it to their outpatient imaging appointments, especially if the weather’s good. This is from research by a University of Washington team who looked at 3,379,947 outpatient radiology appointments between 2000 and 2015, and particularly the 270,574 (8.0%) cancellations and 87,407 (2.6%) no-shows that happened within that time frame. Here are the factors they found to be associated with cancellations and no-shows.

  • Income – Wealthier people were much more likely to make it to their appointments. People who earn $120,000 annually have lower cancellation rates (8%) and no-show rates (1%) than those making $20,000 per year (14% cancel, 6% no-show).
  • Weather – As you might expect, cold and snowy days are bad for attendance. The researchers found that the odds of no-shows decreased by 2% for every 10°F increase in daily high temperature, while no-show odds increased by 4.5% with every additional inch of daily snowfall.
  • Commute – Although not specified, longer commutes were associated with no-shows, especially among lower-income patients.

This research comes nearly a year after a similar study by the same team, who found that discomfort, long scheduling lead-times (>6mos), patient age (>60yrs), and day of the week (Mon & Sat) had the greatest association with no-shows. Combine those with weather, wealth, and distance factors and we’re getting closer to predicting which patients could use some help getting to their appointments.

Breast Screening Debate
The American College of Physicians (ACP) upset many in the breast health community, changing its breast cancer screening guidance to recommend that average-risk women should begin screening at 50 years old (previously 40), followed by screenings every other year until the age of 74. The ACP justified this shift with its claim that the harms of screening “outweigh the benefits” among 40-49yr old women without symptoms or risk factors, while essentially making the same argument for annual screening after the age of 50. The group shared a pretty long list of screening harms, too, including overdiagnosis, overtreatment, false positives, radiation exposure, radiation associated breast cancers and breast cancer deaths, and associated distress from unnecessary follow-up tests. The change also aligns the ACP’s guidance with the US Preventive Services Task Force’s recommendation.

However, critics of this move were quick to point out that it’s hard to “outweigh the benefits” of the early detection of a potentially deadly disease and it’s hard to argue against that. A joint statement from the American College of Radiology and Society of Breast Imaging suggested that this change “may result in up to 10,000 additional, and unnecessary, breast cancer deaths in the United States each year” and lead to “thousands more women enduring extensive surgery, mastectomies and chemotherapy.” The critics in this screening debate appear to have an advantage among the general public, which makes sense given the widespread impact of breast cancer, and the optics of what many see as debate between discomfort and life-saving screenings.

The Wire

  • An undersupply of the radiotracer choline in the UK has reportedly forced the UK NHS to cancel some PET-CT prostate cancer scans and extended some wait times beyond two months, causing some patients to pay as much as £1,500 for scans using PSMA tracers instead of choline. These delays have prostate cancer groups calling for the NHS to improve its choline supply situation and accelerating its work towards commissioning a more effective tracer.

  • An AIUM lecture delivered by U of Wisconsin ultrasound expert, James Zagzebski PhD, and covered by AuntMinnie.com touted quantitative ultrasound (QUS) as a promising new ultrasound technology. The lecture suggested that advances in QUS technology may result in improved sensitivity and specificity over conventional ultrasound, providing more data on tissue features, with less chance of operator variability.

  • Seventy two percent of interventional radiologists are burned out. That’s based on an online survey (n=339) performed by a University of Michigan School of Medicine resident, who found that women IRs and IRs who work over 80 hours weekly (logically) have even higher burnout rates. This is one of the reasons we try to keep Imaging Wire articles as brief as possible.

  • SuperSonic Imagine unveiled a new liver disease assessment solution for its Aixplorer MACH 30 ultrasound at this week’s International Liver Congress show. The new Aixplorer MACH 30 Hepato solution combines the system’s ShearWave PLUS electrography tech (measures tissue stiffness), B-Mode Ratio mode (screens intra-hepatic steatosis), Angio PL.U.S. (images micro-vascularization of lesions), and Doppler and contrast imaging for screening and characterization of liver nodules.

  • Canon Medical Systems Japan launched a Women’s Health configuration of its Aplio i800 ultrasound. In addition to its “pink pearl” accent color, the specialized version features iBeam Forming and iBeam Slicing image rendering (for breast and fetal ultrasound), supports Luminance and Shadow Glass (for 4D fetal ultrasound), includes 2D Wall Motion Tracking for Fetal Heart, and can be configured with SMI (Superb Micro-vascular Imaging, measures placental blood flow and vascularization of tumorous lesions) and elastography (measures lesion stiffness).

  • Carestream announced that its partner, Radiology Services, installed five Q-Rad X-ray systems at Lowell General Hospital in Lowell, Massachusetts, placing the systems in two outpatient facilities and three urgent care centers. The ceiling-mounted digital X-ray systems are part of Lowell General Hospital’s planned medical equipment upgrade, with the Carestream option beating out two other “major suppliers.”

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This is sponsored content.

  • This Medmo video details how its healthcare marketplace platform and network of participating radiologists help underinsured patients pay as little as possible for their imaging procedures.

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