Prostate MR AI’s Experience Boost

A new European Radiology study showed that Siemens Healthineers’ AI-RAD Companion Prostate MR solution can improve radiologists’ lesion assessment accuracy (especially less-experienced rads), while reducing reading times and lesion grading variability. 

The researchers had four radiologists (two experienced, two inexperienced) assess lesions in 172 prostate MRI exams, with and without AI support, finding that AI-RAD Companion Prostate MR improved:

  • The less-experienced radiologists’ performance, significantly (AUCs: 0.66 to 0.80 & 0.68 to 0.80)
  • The experienced rads’ performance, modestly (AUCs: 0.81 to 0.86 & 0.81 to 0.84)
  • Overall PI-RADS category and Gleason score correlations (r = 0.45 to 0.57)
  • Median reading times (157 to 150 seconds)

The study also highlights Siemens Healthineers’ emergence as an AI research leader, leveraging its relationship / funding advantages over AI-only vendors and its (potentially) greater focus on AI research than its OEM peers to become one of imaging AI’s most-published vendors (here are some of its other recent studies).

The Takeaway

Given the role that experience plays in radiologists’ prostate MRI accuracy, and noting prostate MRI’s historical challenges with variability, this study makes a solid case for AI-RAD Companion Prostate MR’s ability to improve rads’ diagnostic performance (without slowing them down). It’s also a reminder that Siemens Healthineers is serious about supporting its homegrown AI portfolio through academic research.

Chest CT AI Efficiency

A new AJR study out of the Medical University of South Carolina showed that Siemens Healthineers’ AI-RAD Companion Chest CT solution significantly reduced radiologists’ interpretation times. Considering that radiologist efficiency is often sacrificed in order to achieve AI’s accuracy and prioritization benefits, this study is worth a deeper look.

MUSC integrated Siemens’ AI-RAD Companion Chest CT into their PACS workflow, providing its radiologists with automated image analysis, quantification, visualization, and results for several key chest CT exams.

Three cardiothoracic radiologists were randomly assigned chest CT exams from 390 patients (195 w/ AI support), finding that the average AI-supported interpretations were significantly faster. . .

  • For the combined readers – 328 vs. 421 seconds 
  • For each individual radiologist – 289 vs. 344; 449 vs. 649; 281 vs. 348 seconds
  • For contrast-enhanced scans – 20% faster
  • For non-contrast scans – 24.2% faster
  • For negative scans – 26.4% faster
  • For positive scans without significant new findings – 25.7% faster
  • For positive scans with significant new findings – 20.4% faster

Overall, the solution allowed a 22.1% average reduction in radiologist interpretation times, or an hour per typical workday.

The authors didn’t explore the solution’s impact on radiologist accuracy, noting that AI accuracy has already been covered in plenty of previous studies. In fact, members of this same MUSC research team previously showed that AI-RAD Companion Chest CT identified abnormalities more accurately than many of its radiologists.

The Takeaway

Out of the hundreds of AI studies we see each year, very few have tried to measure efficiency gains and even fewer have shown that AI actually reduces radiologist interpretation times.
Given the massive exam volumes that radiologists are facing and the crucial role efficiency plays in AI ROI calculations, these results are particularly encouraging, and suggest that AI can indeed improve both accuracy and efficiency.

Siemens’ Big SPECT/CT Launch

Siemens Healthineers kicked off SNMMI 2022 with the launch of its Symbia Pro.specta SPECT/CT, marking one of the biggest SPECT/CT rollouts we’ve seen in years.

The FDA and CE-cleared Symbia Pro.specta succeeds Siemens’ longstanding Symbia Intevo SPECT/CT (first launched in 2013) and is built to encourage nuclear medicine departments to finally replace their SPECT-only cameras and first-generation SPECT/CTs. That’s a big goal given SPECT/CT’s history of slow clinical adoption, and the Symbia Pro.specta will rely on a range of new and improved features to try to make it happen:

  • Integrated SPECT/CT The Symbia Pro.specta boasts a fully integrated SPECT/CT, including an integrated user interface, while allowing providers to also use the system for SPECT or CT-only imaging.
  • myExam Companion – The Symbia Pro.specta adopts Siemens’ high-priority myExam Companion solution, which combines a new UI and automated guidance tools to make SPECT/CT operation far less manual, user dependent, and inconsistent (before and after image acquisition).
  • Diagnostic-Quality CT – Siemens’ new SPECT/CT is now available with 32 or 64-slice CTs (vs. Symbia Intevo’s 32-slice max) and a 70cm bore, while also offering standard Tin Filter and SAFIRE iterative CT reconstruction for low-dose CT imaging.
  • Advanced SPECT – The Symbia Pro.specta ships with standard automatic patient motion correction during SPECT exams (and optional cardiac exam motion correction), while its advanced quantification and energy level versatility allow it to support treatment response evaluations and theranostics usage.
  • Accessibility & Flexibility – Siemens leaned-in on the Symbia Pro.specta’s accessibility strengths, noting that it is sleek enough to fit into most existing SPECT rooms, and can support a range of clinical uses (cardiology, neurology, oncology, orthopedics) and patient types (pediatric, obese, and physically challenged).

The Takeaway

SPECT/CT’s slow path towards becoming a mainstream modality arguably has more to do with its adoption barriers and providers’ acceptance of the status quo than any doubts about its clinical benefits. Even though not all adoption barriers are hardware-dependent, the Symbia Pro.specta lowers enough of them to give nuclear imaging departments a good reason to consider moving up to a modern SPECT/CT.

Siemens’ Healthineers Hardware Evolution

Siemens Healthineers’ Shape 22 pre-RSNA event featured a pair of ambitious hardware announcements that stand to expand what can be done with CT exams and where MRIs can be performed.

NAEOTOM Alpha PCCT – Siemens Healthineers confirmed its pole position in the Photon-Counting CT race, officially launching its NAEOTOM Alpha scanner. Although the NAEOTOM Alpha already received a rare marketing head-start from the FDA, this week’s launch begins its official 2022 rollout, and provides new details about this milestone product:

  • Far higher image quality than CT
  • Provides much more imaging data and new levels of CT-based insights
  • Expands CT to new cardiac, oncology, and pulmonology use cases
  • Allows 50% lower radiation dosage, could shift exams to non-contrast
  • Supports Siemens’ core solutions, including operability and AI-based diagnosis
  • Cleared in US and Europe, 20 systems already installed, 8k patients scanned
  • PCCT expected to become the main CT technology within 10 years
  • Siemens is holding another NAEOTOM Alpha event today (Nov. 18)
  • Siemens might be first, but we’re seeing more PCCT activity from GE Healthcare, and Canon and Philips aren’t far behind

MAGNETOM Free.Star MRI – One year after introducing the MRI-expanding MAGNETOM Free.Max, Siemens continued its MRI accessibility push, revealing the “disruptively simple” MAGNETOM Free.Star. The new Free.Star MRI will inherit much of the MAGNETOM Free.Max’s accessibility-friendly qualities (0.55T, small/light, low helium & installation requirements), and will have the ambitious goal of supporting the half of the world’s population that doesn’t have MRI access. The MAGNETOM Free.Star is still early-stage (it hasn’t begun the FDA process), but it’s massive healthcare ambitions make it worth keeping an eye on.

The Takeaway – The NAEOTOM Alpha is expected to be the start of a major shift towards Photon-Counting CT, while the new MAGNETOM Free.Max and Free.Star could expand where MRIs are used. That makes these extremely significant products.

Siemens’ First Photon-Counting CT

The FDA announced the 510(k) clearance of Siemens Healthineers’ NAEOTOM Alpha photon-counting CT scanner, calling it “the first new major technological improvement for Computed Tomography (CT) imaging in nearly a decade.” Those are some big words from a federal agency not known for hyperbole, and it doesn’t appear they are exaggerating.

About Photon-Counting CTs – Photon-counting CTs (PCCTs) produce far higher quality images than traditional CTs, with lower radiation and contrast dosage. Unlike standard CTs that simultaneously measure the total energy from many X-rays (at the expense of image info, clarity, and contrast), photon-counting CT detectors directly convert each individual X-ray photon into digital electrical signals that are then “counted.”

The NAEOTOM Alpha – The NAEOTOM Alpha might be the first PCCT scanner, but the star of this announcement is its detector. The new photon-counting detector leverages a CdTe active detection layer to achieve PCCT’s targeted image/dosage/contrast advantages, and it could be the foundation of Siemens’ PCCT portfolio for years to come. 

The PCCT Race – The other major OEMs seem to be doing everything they can to earn a spot among the PCCT leaders. GE Healthcare and Canon both acquired PCCT detector makers within the last year and are planning their own PCCT launches, while Philips appears to have ramped up its PCCT R&D.

The Takeaway – PCCT has been viewed as the “future” of CT technology for quite a while, and that future just became a lot closer with last week’s announcement. We’re going to see similar PCCT launches from the other major OEMs, but Siemens Healthineers will enjoy its role as the only player with an FDA-approved PCCT scanner until then.

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-- The Imaging Wire team