When to Stop Screening | Coronavirus Imaging Update

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The Imaging Wire

When to Stop Screening

A new study revealed that healthy women over 75yrs-old might not benefit from annual breast cancer screening, even though 52% of them are still getting screened (in the U.S. anyway). Here are some details:

  • Study – The Harvard and MGH study (n = 1.06M women, 2000-2008) found that annual screening does not substantially reduce 8-year breast cancer mortality among healthy women over 75yrs. Women between 70 and 74yrs who attended annual screenings had one fewer death per 1k patients compared to women who discontinued screenings, but screening’s benefits reversed among 75-80yr-old women who had 0.7 more deaths per 1k patients than women who stopped screening.
  • Reactions – Not everyone is comfortable with these findings. A follow up editorial from Johns Hopkins’ Dr. Otis Brawley suggested that the 2000-2008 study period (early-digital, pre-DBT) isn’t representative of today’s screening tech and argued that screening would be more effective for older women if treatments were better. Meanwhile, the folks on the Aunt Minnie message boards took a more compassionate tone than usual, generally sharing the opinion that we discontinue screening too early and that this study undermines the importance of reducing the harm of breast cancer (not just reducing mortality).

This Week’s Coronavirus Imaging Update

Coronavirus continued to spread last week and it became a lot more real in the West, as the U.S. saw its second COVID-19 death and more COVID-19 cases without a direct connection to the disease’s Chinese epicenter began to emerge. Imaging’s role in diagnosing COVID-19 continued to increase as well:

  • CT for COVID-19A Chinese study published in the Radiology journal suggests that chest CT should be considered a “primary tool” for COVID-19 detection in epidemic areas due to its high sensitivity. The study of 1,014 patients (601 w/ positive RT-PCR results, 888 w/ positive chest CT) found that chest CT detects COVID-19 with 97% sensitivity (580 of the 601 positive RT-PCR results), while 88% of the patients with positive chest CT scans and negative RT-PCR tests were later found to be either “highly likely” or “probable” to have COVID-19.
  • More COVID-19 AIPing An joined the growing group of companies to release a coronavirus detection imaging AI algorithm (now at least three companies). Ping An Smart Healthcare’s COVID-19 Smart Image-Reading System analyzes CT scans for signs of COVID-19 in about 15 minutes with over-90% accuracy, and has already analyzed scans from 5,000 patients and more than 1,500 institutions.

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  • Qure.ai Funded: Qure.ai landed $16m from Sequoia India and Mass Mutual Ventures South East Asia, revealing plans to use the new funding to drive geographical and portfolio expansion and support its regulatory efforts. Sequoia’s role in this funding round is quite a testament to Qure.ai’s performance and potential, as the VC heavyweight highlighted Qure.ai’s unique “ability to deploy commercially at scale across multiple countries.”
  • KA Upgrades: KA Imaging announced plans to launch its Reveal x-ray detector that “upgrades any x-ray system to Dual-Energy” due to its ability to fit any ISO standard size tray. The KA Imaging Reveal leads with a low-cost value prop (~$125k vs. $500k for other dual energy detectors), while also highlighting its ability to “improve dual-energy x-ray images” by separating different energy levels with a single exposure (delivering traditional DR, soft tissue, and bone images). Reveal will be submitted to the FDA this year.
  • GE Cybersecurity: GE Healthcare launched its new Skeye healthcare cybersecurity service, a vendor-agnostic solution that combines GE teams and tools to help hospitals monitor and address security threats. Skeye provides a medical device security assessment to identify risks / vulnerabilities and guides follow-up actions, supports ongoing monitoring through its remote security operations center (SOC), and uses AI tools to automate connected device inventory and equipment risk profiling.
  • CTA’s AI Standard: The Consumer Technology Association (CTA) along with 52 major tech organizations (including: Amazon, AMA, Duke, Google, Humana, IBM, Intel, Microsoft, Philips) developed the first ANSI-accredited standard for using AI in healthcare: 11 definitions and characteristics to improve understanding of AI technologies and terminology. The new standard is the first in a series of healthcare AI standards from the CTA.
  • New PET/CT Tracer: The new radiopharmaceutical, 55Co-dotatate, outperformed other common PET/CT imaging agents at diagnosing neuroendocrine tumors in a recent Danish study. In the study, ten mice with 5mm neuroendocrine tumors underwent PET/CT imaging using 55Co-dotatate (3 mice), 68Ga-dotatate (4mice), 64Cu-dotatate (3 mice), finding that 55Co-dotatate had significantly higher tumor-to-liver and tumor-to-kidney uptake ratios than the other tracers, noting that the liver is a major site of neuroendocrine tumor metastasis.
  • EOS Acquired: Alphatec Holdings (ATEC) acquired EOS imaging for $122M (nearly 6x its 2019 revenue), adding EOS’ orthopedic portfolio to ATEC’s spinal surgery lineup. ATEC suggested that the acquisition will allow it to provide a more complete solution (spine imaging + planning) and create cross-selling opportunities.
  • Stretchable Coils: A Purdue University team developed new formable/stretchable RF MRI coils that could improve the patient experience and image quality, while reducing signal-to-noise ratio versus PCB coils by 13-30%. Rather than current methods that form rigid coil arrays based on a generalized shape of a body part, the Purdue team developed “adaptable, wearable and stretchable fabric embroidered with conductive threads” that wrap around the patient, improving comfort and potentially resulting in increased sensitivity and fewer false positives.
  • Agiliti Acquires: Nationwide medical device service company Agiliti (formerly Universal Hospital Services), announced its acquisition of Mobile Instrument Service & Repair, the third largest provider of surgical equipment repair services in the U.S. Although this particular acquisition focuses on other types of imaging (e.g. rigid endoscopes, laparoscopes, video cameras), Agiliti has also been active acquiring imaging servicers, including Zetta Medical Technologies in 2019 and Radiographic Equipment Services in 2016.
  • CADa/o: The FDA’s authorization of Caption Health’s Caption Guidance software last month also marked the creation of a new CAD regulatory classification: computer-aided acquisition/optimization (CADa/o). As its name suggests, CADa/o systems support the acquisition/optimization of images and/or diagnostic signals by providing guidance/feedback to the operator to help improve image or signal quality.
  • Screening Fails: Many states aren’t even coming close to achieving lung cancer screening targets. That’s from a new CDC report after a survey (n = 85,514 respondents, 10-states) found that just 12.5% of citizens who qualify for regular low-dose CT scans are actually being screened, even though it can reduce their risk of dying from lung cancer by 25%.
  • AI Hypebuster: A recent Forbes article from Robert Pearl, M.D (previous Permanente Medical CEO) described how healthcare AI can live up to its hype. Dr. Pearl’s main argument is that AI firms need to focus on solving the most significant problems in healthcare, while also reminding folks that AI should be ethical/secure, AI solutions should feel creative and personalized, and AI companies should balance their commercial and patient care priorities.
  • Navigating MPFS: Healthcare Administrative Partners detailed the 2020 Medicare Physician Fee Schedule’s (MPFS) impact on radiology, revealing that although there were more fee increases than decreases, many increases were by less than 1% and many decreases were by more than 1% (PC codes: 128 decreased by >1% and 76 increased by >1%; Global codes: 246 decreased by >1% and 430 increased by >1%). HAP provided details on changes to each code, although its general takeaway is many practices can expect a 0.46% decrease in professional component reimbursements and a 0.49% increase in global reimbursements.
  • Visage & Duke Go-Live: Just ten months after launching their partnership, Visage Imaging announced that Visage 7 is now live across Duke Health. Visage 7 is now implemented across all of Duke’s radiology departments, eliminating all legacy GE Centricity PACS systems, while enabling Epic-driven workflow and integrating with Duke’s existing VNA.
  • SR Adds OR Practice: Strategic Radiology added Oregon-based Diagnostic Imaging Northwest (12 radiologists, operating nearly 100yrs) to its consortium of independent radiology practices, which now includes 27 private practices and over 1,100 radiologists. Diagnostic Imaging Northwest is the first Strategic Radiology-affiliated practice in Oregon and just the second in the Pacific Northwest.

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– This is sponsored content

  • ClearRead Xray from Riverain Technologies includes the first FDA-cleared software solution to transform a chest x-ray into a soft-tissue image, providing unprecedented clarity for efficient, accurate, early detection of lung disease. Learn more.
  • The Focused Ultrasound Foundation’s latest newsletter details how Medicare patients in some Southeastern states will now have coverage for focused ultrasound treatment of tremor-dominant Parkinson’s disease.
  • Qure.ai is recognizing organizations that are working to eliminate tuberculosis and is seeking nominees, one of which will receive its qXR software and hardware worth $50k.
  • The GE Healthcare Venue Go features a uniquely adaptable design, a simple interface, and streamlined probe layout so you can go through your day quickly, efficiently, confidently.
  • This Healthcare Administrative Partners blog post details how independent radiology practices can build upon their relationships with hospitals, referring physicians, and even neighboring radiology practices to remain strong and independent in the face of ongoing consolidation.

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