#393 – The Wire

  • PET RA Predictions: A new study out of the Netherlands suggests that PET imaging might improve rheumatoid arthritis (RA) treatment response monitoring, identifying changes in RA-related immune cells earlier than current imaging methods (CT, MRI, US). The researchers performed whole-body macrophage PET/CT on 35 patients with early-stage RA who were beginning COBRA therapy, identifying notable PET uptake changes during week-two of the 13-week regiment (171 PET-positive joints at baseline, 100 joints at 2 weeks). Notably, they found that measuring PET uptake in the foot joints (highest uptake at baseline, greatest decreases at week 2) along with traditional DAS44 scoring might be sufficient for predicting treatment response, making whole-body exams unnecessary.
  • HeartFlow SPAC Canceled: HeartFlow and Longview Acquisition Corp terminated their plans to go public via a reverse SPAC merger. The companies announced their SPAC merger last summer, which would have given HeartFlow a $2.4B enterprise value and $400M in the bank, but it appears that SPAC and medtech stock headwinds might have dissuaded them. Longview has reason to be cautious, noting that Butterfly Network (it’s previous SPAC merger) has seen its stock tumble 77% in the last year (~$26 to ~$6).
  • More Transfer Learning Evidence: A new MGH and Ohio State study shared more evidence of transfer learning’s potential to improve AI generalizability and reduce image labeling work. The researchers trained an AI model to detect decreased ejection fraction and left ventricular hypertrophy using 4D cardiac CTA scans from “site 1,” and tested model performance using 45 CCTA scans from “site 2” before and after transfer learning. As you might expect, the transfer learning-based model had fewer errors measuring left ventricular ejection fraction (3.7 vs. 10 avg.), LV end-diastolic volume (5.9 vs. 8.4 ML avg.), and LV mass (7.7 vs. 12g avg.).
  • Sonosite LX: Fujifilm Sonosite launched its new flagship Sonosite LX “kiosk” ultrasound system, replacing the X-Porte and landing above the Sonosite PX. The Sonosite LX leads with its new 21.3” clinical display, which is the largest and highest-clarity display in its portfolio, adds adjustability features to accommodate more bedside settings (extends, rotates, tilts), and features an updated UI to support “heads-up” operation. Fujifilm Sonosite also launched the T8-3 transesophageal transducer and Cardiac Resuscitation exam (compatible w/ LX and PX systems) to support clinicians during ultrasound-informed resuscitation from cardiac arrest.
  • Photon-Counting Coronary CTA: Radiology Journal published the first in-human study of photon-counting CTs’ performance for coronary CT angiography exams, while adding to PCCT’s growing list of advantages over traditional CT technology. The researchers performed coronary PCCT and energy-integrating detector dual-layer CT angiography exams on 14 patients and had three blinded radiologists evaluate the exams. The radiologists’ assigned the PCCT images higher scores for overall quality and diagnostic confidence (5 vs. 4 median for both, 1-5 scale), while PCCT images achieved significant improvements for diagnostic quality of calcification, stents, and noncalcified plaque (+100%, +92%, and +45% improvements).
  • MIM Software & AMG Medtech’s British Isles Alliance: MIM Software and UK-based healthcare AI consultancy, AMG Medtech, announced that AMG Medtech will sell and market MIM Software’s medical imaging solutions in the UK and Ireland. MIM’s diverse list of imaging solutions (radiology, nuclear, cardiac, radiation oncology) seem to fit well with AMG’s portfolio, which includes both radiology (Arterys) and radiotherapy solutions (RADformation, IntraOp, Limbus AI, Proton, Sabr).
  • Understanding Missed HNCs: A new CAR Journal study suggests that a meaningful number of head and neck cancers might have been detectable in previous imaging studies. The researchers reviewed 1,196 HNC patient cases, finding that the cancers were “clearly evident” in 46 patients’ previous CT and MRI studies (4%) but were either missed (32, 70%) or misinterpreted (14, 30%). To address this issue, the authors proposed increasing awareness of commonly missed HCN cancer locations and encouraging radiologists to review potential blind spots (e.g. nasopharynx or salivary glands in plain head CTs).
  • NHS Breast Screening Shakeup: Mainstream media outlets in the UK recently ran stories suggesting that the NHS breast cancer screening program could be headed towards the “biggest shakeup” in its 30-year history. The articles detailed a range of ongoing breast cancer screening studies that could end up justifying younger screening ages (40yrs vs. 50yrs), new risk scoring tests (e.g., genetics, density), and risk-based screening plans (different exam frequency, modalities). However, the articles didn’t include any comments from the NHS and none of these studies are complete, so the “shakeup” that everyone is talking about could just be a more exciting way of covering ongoing screening studies. 
  • Probo’s New PE Parent: Private equity firm Avista Capital Partners acquired imaging parts/service/device company, Probo Medical, from its previous PE parent company (Varsity Healthcare) for an undisclosed sum. Probo joins Avista as a much different company than when Varsity acquired it in late 2018, following at least seven acquisitions that expanded Probo into new modalities, service lines, and geographies.
  • Viz.ai ISC Evidence: Viz.ai was well represented at the AHA International Stroke Conference where its modules were featured in four studies. Viz.ai’s Viz LVO module (for large vessel occlusion) was highlighted in a UCSD paper showing a notable reduction in LVO “door to groin times” (n = 82; 50 to 39min overall) and in a Mount Sinai paper highlighting its detection rates (n = 1,822 CTAs; 100% w/ ICA terminus occlusions, 93% w/ M1 occlusions, 49% w/ M2 occlusions). Viz.ai’s Viz ICH module (for intracranial hemorrhage) was featured in an Ohio State study detailing its accuracy and ICH notification speeds (n = 611; 87.9% sensitivity, 98.3% specificity, 2.03min avg) and in a similar Mount Sinai accuracy study (n = 682, 89.3% sensitivity, 99.4% specificity, 99.5% NPV).
  • Transparency Non-Compliance: A new survey of over 1k hospitals from PatientRightsAdvocate.org found that only 14% of hospitals currently comply with the federal cost of care transparency rule that took effect at the beginning of 2021. The most common act of noncompliance was lacking or incomplete posting of negotiated rates for service items from accepted health plans (including imaging), but it’s hard to predict that the situation will improve quickly given that the cost of compliance with the rule is $12k per hospital.

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-- The Imaging Wire team