#410 – The Wire

  • Breast MRI Cascade: Breast MRI produces more diagnoses than mammography, but it also leads to far more follow-ups and patient costs. That’s from a new JAMA study of 9,208 women screened with breast MRI and 9,208 screened with mammography (w/ matched propensity scores), finding that the breast MRI cohort had far more follow-up imaging tests (18 vs. 13 per 100 women), procedures (22 vs. 5), physician visits (89 vs. 76), and new diagnoses (3.9 vs. 0.9) during the six months after their exams. That additional care also led to more overall ($869 vs. $305 per woman) and out-of-pocket ($573 vs. $542) breast-related costs.
  • Remote Neurointerventions: MIT engineers developed a telerobotic neurointerventional platform that might allow neurovascular surgeons to remotely treat stroke or aneurysm patients at smaller/rural hospitals that typically lack on-site neurosurgeons. The remote surgeons would use a modified joystick and real-time fluoroscopy to control a robotic arm that performs the on-site procedure. Although this platform is in its early stages, remote neurosurgeons were able to remotely guide an interventional wire to a targeted location in a phantom after just an hour of training.
  • AI Research Reckoning: A European Radiology review of 535 imaging AI academic studies (2015-2019) showed that even though many papers highlighted AI’s “expert-level results,” the studies were narrow in focus (mainly neuro and cancer) and lacking in methodological quality (only 2% prospective, just 14% externally validated). Noting the negative impact this has had on AI’s reputation and adoption, the authors urged AI researchers to diversify their clinical targets (more pathologies, modalities, use cases) and embrace best practices for AI training and study design. AI research methodology has surely improved since 2019, but the authors’ recommendations still seem relevant.
  • Intermountain and SCL’s Model Merger: Intermountain Healthcare and SCL Health officially completed their merger, growing Intermountain into a $12B nonprofit health system with 33 hospitals and 385 clinics across seven Mountain West states. The merger will bring Intermountain deeper into Colorado, Montana, and Kansas, while advancing the former SCL Health sites’ digital transformation, and allowing them to tap into Intermountain’s patient value advantages.
  • POCUS AR: Point-of-care vascular ultrasound company Dolphin Medical Imaging and augmented reality smart glasses company NuEyes announced a partnership to combine their respective products. When the NuEyes glasses and a Dolphin probe are connected via a Samsung smartphone or tablet, clinicians would be able to perform ultrasound-guided vascular access procedures without looking away from the patient. Dolphin appears to be more focused on smart glasses integration than most POCUS vendors, previously launching a partnership with mixed reality glasses company ThirdEye.
  • Self-Scheduling Barriers: A new JACR study revealed that the use of online self-scheduling portals for mammography screening appointments is extremely low, and it’s even lower among traditionally disadvantaged patients. Analysis of 46k patients who received screening mammograms at an urban academic medical center in 2019 revealed that only 302 patients used the self-scheduling system (0.7%), and those patients were much more likely to be English speakers (OR: 21.3), White (OR: 1.7), have commercial coverage (OR: 1.5), and younger.
  • Promaxo Adds Funding: Point-of-care MRI company Promaxo closed a $1.4M funding round (total now >$30M) that it will presumably use to support its product development and commercialization efforts. Leading with its small-size and low-cost, the Promaxo MRI is intended for use in physician offices and other clinical locations where MRI-based diagnostics and interventions traditionally haven’t been possible.
  • Well Paid, Pretty Satisfied, and Largely Male: Medscape’s new Physician Compensation Report (n = 13k physicians, 29 specialties) showed that the average US radiologist earned $437k in 2021, representing a 5.6% increase from a COVID-impacted 2020. Radiology fell from the 6th to 8th top-earning specialty, but many radiologists still believed they were fairly compensated (63%, the 5th highest specialty), would pick the same specialty again (92%, 7th highest), and reported relatively low weekly paperwork labor (13.7hrs, 8th lowest). Radiology also remained one of the most male-dominated specialties (23% female, 7th lowest).
  • Ultrasound for Bone Stress: A Journal of Ultrasound in Medicine study suggests that ultrasound might help sports medicine providers diagnose bone stress injury (BSI), when added to their standard clinical evaluation process. The study performed ultrasound and MRI exams on 37 athletes with suspected lower-extremity BSI (30 later confirmed), finding that ultrasound detected BSI with 0.80 sensitivity, 0.71 specificity, a 0.92 positive predictive value, and a 0.45 negative predictive value.
  • Reinforcing Radiation Ethics: A new WHO policy brief called on healthcare providers to evolve their approach to ethical imaging, suggesting that its two foundational principles (procedure justification, optimized radiation protection) need reinforcements after 25+ years of rising imaging volumes. The WHO proposed new approaches focused on improving awareness (training, cultural changes) and formal efforts to create imaging ethics regulations and governance structures.
  • CAD Voice Biomarker: Mayo Clinic researchers showed that a commercial voice biomarker can predict coronary artery disease events, suggesting that voice tests could eventually be used for CAD screening (and potentially affect CAD imaging use). The researchers had 108 patients referred for coronary angiography create three 30-second voice recordings, finding that patients with high baseline voice biomarkers had significantly higher risks of CAD events (hazard ratio: 2.61) and positive stress tests or coronary angiography results (hazard ratio: 3.13) during a 24-month median follow-up period.

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-- The Imaging Wire team