Vinod Stops Being Polite | Electrast US | CDs’ Impressive Resilience

“Any radiologist who plans to practice in 10 years will be killing patients every day.”

Famous Silicon Valley investor and Sun Microsystems founder, Vinod Khosla, condemned the radiology profession during a hyperbole-laden speech last week.

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The Imaging Wire

Vinod Khosla Stops Being Polite

Famous Silicon Valley investor and Sun Microsystems founder, Vinod Khosla, condemned the radiology profession during a speech last week, suggesting that AI-based solutions will become so superior to humans that “any radiologist who plans to practice in 10 years will be killing patients every day.” Here are some of his other gems:

  • The time for being polite is over, since human radiologists will be more dangerous than machine intelligence in 10 years.
  • “Radiologists are toast” and “shouldn’t be a job.”
  • Oncologists have a bit longer before AI makes them obsolete (15 years), but oncology is still “much easier to automate” than a factory worker job, which has “has much more dimensionality.”
  • General practitioner doctors will become more valuable than specialists, using AI solutions the way they currently consult with skilled specialists.

Unsurprisingly, the radiology community attacked these forecasts, pointing out the usual reasons that radiologists will be needed for years to come, as well as Khosla’s lack of medical understanding and the fact that he’s an early investor in Zebra Medical Vision and therefore prone to bias. Still, even if you think these arguments are ridiculous, the fact that they came from someone who many view as a visionary certainly doesn’t help bring sanity to the AI impact debate.

For context, during the same speech Khosla forecast that humans won’t listen to music in ten years.

Electrast Enhanced Ultrasound

Drexel University researchers are developing a heart-activated ultrasound contrast agent that they believe might support earlier heart disease diagnosis. The still in development Electrast ultrasound agent is activated by the heart’s electrical activity, producing higher resolution images of blood flow in the heart muscle, which has historically been challenging using standard imaging tech. Here’s how Electrast works:

  • Targeted Illumination – Unlike current contrast dyes that illuminate patients from the moment of injection, often leading to overly-illuminated images, Electrast only activates when it reaches the heart’s electric field and therefore doesn’t illuminate surrounding areas.
  • Perfluorocarbon in Lipid Design – The researchers inserted perfluorocarbon (a common ultrasound compound) into a lipid molecule, which is injected into any vein (no catheter required) and then travels through the bloodstream until reaching the heart’s electric field, and releases the perfluorocarbon tracer.

Electrast is in its early stages, but the Drexel team has high hopes for this new design, noting that currently “at least 30-40 percent of ultrasound images of the heart are inadequate” and suggesting that this contrast enhancement approach may mark a “significant inflection point” for cardiac imaging.

CDs’ Impressive Resilience

While the decline of music CDs is paving the way to some neat DIY décor projects, a new study from Yale University School of Medicine finds that CDs remain extremely relevant for medical image sharing. The survey of 80 U.S. hospitals was intended to assess compliance with patient imaging access regulations, and found that hospitals were generally compliant, but patient access processes are complicated and still very reliant on CDs.

  • CDs Dominate – Of the 80 hospitals, 100% were able to provide imaging studies on CDs, while 8% (6) provided studies via email and 4% (3) provided images through an online patient portal.
  • But Slower and Costlier – The hospitals charged between $0 and $75 to release a single CD (vs. $6 for email, no charge for patient portal), and although CD copies were available within 24 hours at 74% of hospitals, wait times could be much longer (2-5 days: 13%, 5–10 days: 10%, 10–30 days: 4%).
  • And complicated – The patient request process is further complicated by the common practice of fulfilling requests outside of the diagnostic radiology department (47 of the 80 hospitals).

Although these results are not surprising, the study brings up an important point about whether many hospitals’ patient access practices are living up to their patient-centric intentions, understanding the declining role of CDs in patients’ media consumption behavior and available technology. Realistically, CDs will likely remain in use at 80 out of these 80 hospitals for quite some time (they are still relevant for sharing with other docs and remain HIPAA compliant), but patients are surely ready for more modern options from these same hospitals.

The Wire

  • Canon and Toshiba were each hit with $2.5 million in fines from the U.S. Justice Department after they reportedly executed a scheme to avoid the HSR Act (requires companies to file premerger notifications with the FTC and DoJ) prior to Canon’s 2016 acquisition of Toshiba Medical Systems. The scheme was allegedly intended to allow Toshiba (then struggling financially) to recognize proceeds from the deal during its 2015 fiscal year, rather than waiting until FY2016. The settlement will also require that the companies create a program for complying with the notification law going forward.
  • A study from Johns Hopkins Medicine found that the Mammography Quality Standards Act’s new requirement to make mammography recall letters easier to read will be effective. After simplifying its notification letter from a 12th grade level to a 4th grade level (smaller words, shorter sentences), a 599-patient survey found that patients’ understanding that they should return to the hospital’s breast center within a month improved from 49.6% to 95.2%, with the greatest impact among patients without a college degree. The Imaging Wire fully endorses making things easy to read.
  • A team from Penn State and the University of Chicago revealed the development of a new CT and histology-based 3D tissue imaging technique, called X-ray histotomography, that allows scientists to noninvasively study cells. The new approach avoids the drawbacks of traditional histology (tissue loss and image distortion), suggesting that it may be able to distinguish between cancer subtypes and other diseases by analyzing cellular features.
  • MITA just published a trio of reports highlighting the massive financial impact that the medical imaging industry has on state economies as part of its call to permanently repeal the medical device tax. The reports found that Washington, Massachusetts, and Pennsylvania’s medical imaging industries create thousands of jobs (WA: 12k, MA: 26k, PA: 36k), billions in wages (WA: $1.03b, MA: $2.31b, PA: $2.5b), and even more billions in total contribution to economic activity (WA: $3.4b, MA: $7b, PA: $10b).
  • Signify Research outlined the five trends that are shaping the future of the global ultrasound market. Here they are: 1) the continued expansion to new users (particularly in developing markets and acute and primary care settings), 2) the emergence of new US use cases, often as a low-cost/no-radiation alternative or supplement to CT/MRI/mammography etc., 3) the growing demand for ultrasound in emerging markets (fastest in Southeast Asia, Brazil, China and India), 4) the rapid growth of the handheld ultrasound market (expected to grow 50% in 2019, reach $400m globally by 2023), and 5) AI’s ability to address some of ultrasound’s limitations (sonographer training/shortages, image quality).
  • Signify Research detailed some key takeaways from Philips’ recent Analyst Forum including the company’s notable shift to becoming a pure-play healthcare vendor, Philips’ ongoing efforts to expand its informatics reach across a wider range of diagnostic departments and shift to an Imaging IT managed service model, and its growing focus on imaging AI and a platform-based AI strategy. Outside of imaging, Signify also reported a major focus on Philips’ TeleICU business and Population Health Management (PHM) platform.

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