“These companies put a white coat on and cloak themselves in the goodwill we rightly have toward medical professionals, but in practice, they behave like almost any other private equity-backed firm: Their desire is to make profit.”

Yale professor Zack Cooper on the difference between what PE-backed physician firms say and what they do.

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Imaging Wire Sponsors

• Focused Ultrasound Foundation – Accelerating the development and adoption of focused ultrasound.
• GE Healthcare – Providing point of care ultrasound systems, from pocket-sized to portable consoles, designed to support your clinical needs and grow along with your practice.
• Healthcare Administrative Partners – Empowering radiology groups through expert revenue cycle management, clinical analytics, practice support, and specialized coding.
• Hitachi Healthcare Americas – Delivering best in class medical imaging technologies and value-based reporting.
• Nuance – AI and cloud-powered technology solutions to help radiologists stay focused, move quickly, and work smarter.
• Riverain Technologies – Offering artificial intelligence tools dedicated to the early, efficient detection of lung disease.

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The Imaging Wire

Summit Fights Back

Summit Imaging is fighting back against Philips’ allegations that Summit’s Adepto Software illegally hacks into Philips ultrasound machines in order to allow healthcare facilities to upgrade and service their own equipment.

• Philips’ Lawsuit – Back in October, Philips accused Summit of misappropriating trade secrets, false advertising, and modifying copyrighted materials, demanding that Summit return its trade secrets, pay damages, and stop using any tools to circumvent its hardware controls.

• Summit’s Counter – Summit Imaging is now asking a federal judge to dismiss Philips’ claims and accusing Philips of anti-competitive and exclusionary conduct, while positioning its software as a “repair” tool.

• Bigger than Summit – Summit is in for quite a legal fight (and it could be bigger if GE joins in), but this is just one part of a much larger battle over the “right to repair” healthcare devices. This battle seems to be heating up. Just last month, the DIY electronics repair website IFIXIT published a crowdsourced database of 13k medical device repair manuals to enable more in-house service and the US Public Interest Research Group launched a lobbying campaign to expand servicers’ “right to repair.”

Bad Science

Imaging Wire readers and just about anyone in the medical science would agree that there’s been a surge of COVID-19 related studies and papers. This makes sense given the urgency and attention that comes with a pandemic. However, this surge also revealed some major flaws in the medical journal publishing process…. and The New York Times just did an excellent job documenting these flaws.

• What Happened – Two of medicine’s most prestigious publications (NEJM and The Lancet) published incorrect papers about the safety and efficacy of potential COVID-19 treatments (neither directly imaging-related). The studies were quickly retracted after the public caught on, but this lapse revealed how the COVID-19 emergency even upended scientific journals.

• Peer Review Pressure – Although this story should start with the studies’ authors, the NYT largely focused on faults in the peer review process for letting these flawed (or fraudulent) stories through. The COVID-19 pandemic significantly increased the pressure on peer reviewers, who have a responsibility to quickly help in the CV19 fight, are faced with increasingly short review windows (as little as 48 hours), and were tasked with processing a surge in CV19 studies (overall submissions up 3x during COVID). The reviewers also didn’t realize that they should be on the lookout for “outright deceit.”

Mach7’s Viewer

Mach7 Technologies announced plans to acquire Client Outlook for roughly $27.5m ($40m AUD), combining the longtime collaborators’ enterprise imaging / viewing solutions as well as their respective customer bases and sales channels.

• Mach7’s Target – Client Outlook’s eUnity is the star of this acquisition, as the enterprise viewing platform would allow Mach7 to offer a modular PACS solution (combines VNA, workflos, worklist, viewer).

• Mach7’s Big Bet – Mach7 went all in with this acquisition, given that the company has about $2.5m in cash on hand, generated $6.4m in revenue last year, and therefore had to launch a $23.9m capital raising plan to afford Client Outlook (all USD figures).

• Mach7’s Payoff – Mach7’s justification for a bet this big is all about Client Outlook’s potential to create a more complete and modular portfolio, expand its addressable market (from $750m to $2.75b), increase its pipeline (+56%), grow its annual revenue (+70%), and increase its customer base (+150% to ~150 customers).

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The Wire

• Breast Ultrasound AI: A team of Chinese researchers developed a breast ultrasound CAD system that was able to identify breast cancer cases as well as trained sonographers, justifying its use as an efficiency and diagnostic aid (not a sonographer replacement). The team developed a number of AI models (trained on 2.5k benign & 2.5k malignant images), with the strongest model achieving a higher AUC than a team of sonographers (0.913 vs. 0.846) when tasked with interpreting 683 ultrasound exams.

• GE & Oxford’s CV19 AI: GE Healthcare is collaborating with the University of Oxford-led National Consortium of Intelligent Medical Imaging (NCIMI) to develop AI intended to diagnose and manage COVID-19 pneumonia. GE and NCIMI will develop the algorithms using medical imaging, lab, and clinical data from thousands of CV19 patients, particularly focusing on predicting which patients could develop severe respiratory distress and/or develop long-term complications.

• IR House Calls Work: Bringing interventional radiologists along on collaborative house calls helped reduce emergency department use by 77%, cut hospital readmissions by 50%, and improved patient satisfaction rates from 17% to 84%. That’s from new research presented at the Society of Interventional Radiology’s 2020 meeting, detailing the results from a new care model that brought IRs (along with other clinicians) into the homes of nearly 1,000 elderly homebound patients across rural Indiana to perform image-guided treatments.

• XR & Flouro Bounceback: Coming off a brutal three months, Signify Research forecasts that demand for general radiography and fluoroscopy systems will begin a “V shaped” rebound starting in H2 2020 and reach pre-COVID levels by 2022. Signify expects that this rebound will be driven by: 1) Pent up demand that was delayed during the COVID emergency; 2) The upcoming volume surge and its expected wear and tear on imaging systems; 3) Strong existing order books and the fact that previous orders were delayed and not cancelled; 4) Support from government stimulus; 5) Expected resilience if a second COVID peak does happen.

• Ultromics’ $10m: Cardiovascular imaging AI firm Ultromics closed a $10m Series A round (increasing its total to $26m) that it will use to support its expansion into the U.S. and to fund ongoing product development. Ultromics’ EchoGo Core AI electrocardiogram solution already has CE and FDA approval, while its more advanced EchoGo Pro solution gained CE marking this year.

• Nanox Goes to Russia: Nanox continued its global expansion, signing an exclusive three-year deal with unnamed distribution partners that will expand 600 Nanox.ARC systems across Russia and Belarus. Reportedly worth $48m in annual service fees, Nanox’s new Russia / Belarus agreement follows shortly after announced expansions into Italy (500 units) and South Korea and Vietnam (2,500 units).

• MRI Kaiser Score: A study in European Radiology found that a new “Kaiser score” breast MRI lesion classification system accurately identifies / excludes malignancies and could significantly reduce unnecessary breast biopsies among high-risk patients. In the study, three blinded readers performed Kaiser score evaluations using breast MRIs from 159 women with histologically proven BI-RADS lesions (183 lesions, 41 malignant), achieving relatively high AUCs (86.5 to 90.2) and sensitivity (95.1% and 97.6%) and excluding between 45% and 72.5% of the group’s 142 benign lesions.

• Canon’s SPEEDER MR: Canon Medical announced the FDA approval of its Compressed SPEEDER technology for use with its Vantage Orian 1.5T MRI system, three months after launching the solution with the Vantage Galan 3T system. Compressed SPEEDER reconstructs full resolution MR images from under-sampled data, allowing 4-times faster scans while maintaining resolution and signal to noise ratio.

• CTC Training Works: A new study in Clinical Radiology found that radiologists could significantly improve their CT colonography (CTC) reading performance by attending one-day training sessions. The study provided a one-day training session to random members of a group of 139 radiologists, who all had similar sensitivity when identifying >6mm polyps on 10 baseline CTC scans before the training session (49.7% training, 43.6% control). After completing the training, the training group’s sensitivity increased to 66.3% when they reviewed one-month follow up exams (vs. 44.5% control) and 66.1% when they reviewed six-month exams (vs. 49.6% control).

• Debunking Screening Anxiety: We’ve heard a lot about the role of patient anxiety in breast cancer screening, which a paper by Mount Sinai’s Shivani Chaudhry just dismissed as “benevolent sexism” that is bad for health outcomes if it’s used to justify discouraging screening before the age of 50. Chaudhry suggested that this concern is based on the premise that women are weak and need to be protected, and more importantly, she suggests screening anxiety isn’t as common as many believe.

• Muscle Mortality Predictor: A Wake Forest-led research team developed a machine learning-based muscle measurement method that uses chest CT scans to predict 6-year mortality risk, potentially serving as an alternative to DEXA measurements. The study used CTs from 6,803 men and 4,558 women (60-69 years, 635 men and 265 women died), finding that higher densities of paraspinous skeletal muscle area (SMA) and skeletal muscle density (SMD) are associated with lower risk of all-cause mortality among male participants (not female).

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The Resource Wire

– This is sponsored content.

• This GE Healthcare white paper details how its suite of point of care ultrasound AI tools simplify complex patient assessments, enable faster clinical decisions, and calculate precise results.

• Rural hospitals have unique needs and most know that bigger doesn’t always mean better when it comes to healthcare. This Hitachi blog details why its combination of the right features, ROI, service levels, and philosophy make it the right partner for rural hospitals.

• This Healthcare Administrative Partners blog post discusses workplace safety policies, changes to your office space, and workflow processes that you should consider as your radiology practice prepares to return to pre-COVID-19 imaging volume.

• This Riverain Technologies case study details how Einstein Medical Center adopted ClearRead CT enterprise-wide (all 13 CT scanners) and how the solution allowed Einstein radiologists to identify small nodules faster and more reliably.

• Watch this new Focused Ultrasound Foundation’s webinar on Liquid Biopsy for Brain Tumors, presented by Stephen J. Bagley, MD, MSCE of the University of Pennsylvania Perelman School of Medicine.

• This Nuance blog details how it helped Northwell Health quickly expand its use of PowerShare to support New York City radiologists in their response to COVID-19.

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