“It’s the brave new world of unimagined consequences of new technologies,”
University of Miami law professor, Anita Cava, in response to Amazon’s move to allow UK-based users of Britain’s National Health Service to ask Alexa for medical advice.
Imaging Wire Sponsors
- Carestream – Focused on delivering innovation that is life changing – for patients, customers, employees, communities and other stakeholders
- Focused Ultrasound Foundation – Accelerating the development and adoption of focused ultrasound
- Medmo – Helping underinsured Americans save on medical scans by connecting them to imaging providers with unfilled schedule time
- Nuance – AI and cloud-powered technology solutions to help radiologists stay focused, move quickly, and work smarter
- Pocus Systems – A new Point of Care Ultrasound startup, combining a team of POCUS veterans with next-generation genuine AI technology to disrupt the industry
- Qure.ai – Making healthcare more accessible by applying deep learning to radiology imaging
The Imaging Wire
Ultrasound-Assisted Optical Imaging Breakthrough
For those of you who enjoy a good “new modality may replace existing modality” story, Carnegie Mellon researchers developed an ultrasound-assisted optical imaging technique that they say could replace endoscopy. The researchers are suggesting that “this method can revolutionize the field of biomedical imaging,” and here’s how they back that big statement up:
- The Technique – The new technique may allow noninvasive endoscopic imaging of deep organs and tissue by using ultrasound to guide light through the body and then “create a virtual lens within the body, rather than implanting a physical lens.” The technique can focus light within the tissue, allowing them to capture images that were historically only available through invasive procedures.
- The Benefits – Replacing endoscopy is easier said than done, but the benefits would be significant, as this would mean “scopes may no longer need to be inserted into the body, such as down the throat or under the skin, to reach the stomach, brain, or any other organs.”
- The Future – This new approach could be applied with handheld devices or wearable patches, initially focusing on imaging brain tissue and imaging under the skin, but potentially expanding to other organs and even non-medical applications (e.g. machine vision and metrology).
Gartner’s AI Governance
A new Gartner paper called for healthcare system CIOs to establish AI governance to make sure the solutions they use are trustworthy, safe, and transparent, in addition to effective. The firm predicted that 75% of healthcare delivery organizations (HDOs) will have invested in operational or clinical AI by 2021, but noted that most HDOs have not developed a strategy for AI and called for healthcare CIOs to address this issue. Gartner suggests that the best way to do this is to establish an AI Governance Council that encompasses:
- Legal, regulatory, and compliance review to decide what happens if AI causes harm.
- Clinical and scientific verification to confirm AI is tested on a valid data set.
- Ethical guidelines defining how patients are informed about AI’s role in their diagnosis and treatment.
- Organizational deployment and change management for training staff on AI expectations and actions.
Gartner also calls for providers to develop a common definition of AI, come to an agreement on the strategic value of AI, and scrutinize their current data governance practices and acquisition methods.
Analysis from McKinsey & Company suggests that the U.S. healthcare industry will be far more resilient during the next economic downturn compared to the 2008-2009 recession due in large part to coverage protections created by the ACA and the greater healthcare provider scale brought by ongoing consolidation.
However, healthcare certainly won’t be immune to the next downturn. A recession would still increase the number of uninsured patients and create a 3 to 10 percentage point increase in state Medicaid spending, potentially causing states to cut reimbursement rates. This combination would result in earnings decreases among payers (down 5% – 20%), providers (5% – 30%), pharmacy benefit managers (5% – 20%), and pharmacies (5% – 15%).
- A study in Academic Radiology (n = 22,445 radiologists) found that female radiologists read fewer studies from advanced imaging modalities (CT & MRI) than their male counterparts, including female generalist radiologists with MRI studies (10.2% vs. 13.2%), female abdominal radiologists with CT (53.7%. vs. 56%) and MRI (8.1%. vs. 9.4%), and female musculoskeletal radiologists with MRI (44.8% vs. 49.6%). However, female abdominal radiologists read more ultrasound studies (27.1% vs. 21.9%) and female musculoskeletal radiologists significantly outpaced their male counterparts with radiography studies (41.6% vs. 34.8%).
- The Chinese government created an “association for brain imaging” combining over 50 research institutes, universities, hospitals, and brain imaging equipment manufacturers, who will support five national laboratories focused on brain science and ten clinical medical research centers focused on neurology and dementia. The association will establish standards for brain imaging data collection and analysis, promote the open sharing of brain imaging equipment among members, organize conferences and training activities, and promote cooperation with international brain imaging research organizations.
- Intel rolled out its Pohoiki Beach neuromorphic computing system across 60 research partners this week, marking a key milestone for the computing system that is reportedly 1,000 times faster and 10,000 times more efficient than traditional processors.Pohoiki Beach’s design is based on the neural structure of the brain (can apply principles like common sense and context), making it a promising technology for scaling-up AI.
- Johns Hopkins research into 55,000 malpractice claims finds that 34% of malpractice cases that result in death or permanent disability were due to an inaccurate or delayed diagnosis, making them the “most common, most catastrophic and most costly of medical errors.” Diagnostic errors that caused the greatest harm were related to cancer (37.8%), vascular events (22.8%), and infection (13.5%), which combined for $1.8 billion in malpractice payouts over 10 years.
- Bracco Diagnostics highlighted the safety of its Lumason ultrasound enhancing agent for transthoracic echocardiography, releasing results from a prospective clinical study that found “extremely low” adverse events (AEs) with the agent. The Oregon Health & Science University study (n = 5,013 patients, 5,521 UEA administrations) found that overall incidence of AEs was low (14 AEs, all non-serious) although Lantheus Medical Imaging’s Definity agent (13 AEs out of 3,306 administrations) had far more AEs than Bracco’s Lumason agent (1 AE out of 2,137 administrations).
- nView medical announced the FDA clearance of its nView s1 surgical imaging system, which combines low-dose x-ray with imaging algorithms to produce reconstructed fluoroscopic and multiplanar 3D views, that surgeons can use to assess the anatomy and placement of implants during spinal and orthopedic procedures.
- A Kaiser Permanente Colorado team found that using evidence-based Clinical decision support (CDS) tools drives a “modest but significant improvement” in advanced imaging (MRI & CT) order appropriateness. The study compared appropriateness scores before and after adding best practice CDS alerts (n = 22,297 studies), finding that 77% of orders were appropriate before the alerts and 80.1% were appropriate after implementation, although the rate of orders per month didn’t change. Order change requests from the radiology department decreased from 5.7% before CDS implementation to 5.3% after.
- Lithuanian medical imaging solutions company, Oxipit, completed a $1.7 million seed round that it will use to bring its AI-based ChestEye chest x-ray computer aided diagnosis platform to market after gaining CE clearance in February 2019. ChestEye produces preliminary radiology reports for 75 common radiological findings (at 93% AUC), localizing the findings on a radiograph as a heatmap and producing a standardized text report that they found cuts time per patient by 30% and reduces errors by up to 50%.
- Bayer’s Gadavist MRI agent became the first contrast agent approved by the FDA for cardiac MRI, landing approval for myocardial perfusion assessments and late gadolinium enhancement in adult patients with known or suspected coronary artery disease (the most common heart disease in the world). The approval is significant both for cardiac imaging and for Bayer’s Gadavist agent, which has now gained approval for four unique MRI applications.
- In a case of physician supply following patient demand, Doximity found that physician interest in telemedicine doubled between 2015 and 2018 (growing 20% annually), supported by a 261% annual increase in telemedicine patient visits between 2015 and 2017. As expected, radiology led all specialties for telemedicine job post engagement and was in the top three specialties for locum tenens positions.
- Research from a Brigham and Women’s Hospital team (n = 224 exams) found that 78% of screen-detected breast cancers were equally or more conspicuous using 2D synthetic mammography (SM) versus full field digital mammography (FFDM), although calcifications and asymmetries smaller than 2cm were less conspicuous with SM than DBT. The study suggested that clinicians should take this into account when using SM + DBT instead of DM + DBT.
- Philips continued its acquisition spree, scooping up patient communication startup, Medumo. The Boston-based Y Combinator alum helps hospitals remotely connect with their patients via text and email to guide them through the scheduling, referral, and follow-up process and encourage them to follow pre- and post-exam exam tasks (e.g. fasting, reporting pain).
The Resource Wire
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- Nuance’s Woojin Kim, MD will take the stage at AHRA next Sunday at 1PM to discuss the Fear, Hope, and Hype of Artificial Intelligence in Medical Imaging and examine how AI can benefit both medical imaging professionals and patients.
- This Focused Ultrasound Foundation post highlights how the opioid crisis may create opportunities for non-opioid pain treatments like focused ultrasound.
- Here’s some impressive numbers for you. In the past year, Qure.ai’s two CE Marked radiology solutions have touched over 150,000 lives in over 50 sites across 14 countries.
- Carestream’s AHRA 2019 booth will spotlight its ImageView software and mobile imaging portfolio, including its CARESTREAM DRX-Revolution Nano Mobile X-ray System, CARESTREAM DRX-Transportable System/Lite, and new CARESTREAM DRX Plus 2530C Detector.
- This POCUS Systems video details how its forthcoming ultrasound helps patients and providers, and reduces reliance on MSK MRI use.
- By partnering with Medmo, imaging centers can keep their schedules full and their equipment busy. Here’s where to learn more and get started.