#417 – The Wire

  • Digital Health, Bubble or No Bubble? A new report from Rock Health concluded that the digital health space “is not in an investment bubble, but it is frothy.” The digital health segment reportedly shares one of the six key attributes found in historical bubbles (high valuations), but it’s only “somewhat” associated with three other major bubble categories (high burn rates, funding from non-industry investors, unclear exit paths), and is innocent of two of the worst bubble indicators (hype outweighs business fundamentals, misuse of funds).
  • Pediatric BoneView: Skeletal Radiology published a rare pediatric AI study, finding that GLEAMER’s BoneView algorithm accurately detected acute pediatric appendicular fractures. Using an external dataset of 300 extremity X-rays (150 w/ fractures, 10.8yr avg age), BoneView achieved an 0.93 per-patient AUC (91.3% sensitivity & 90% specificity), with “consistently high” performance across all anatomical locations and types of fractures, except avulsion fractures (72.7% sensitivity). This study continues BoneView’s recent momentum, coming a few months after its FDA clearance and a similarly-positive study highlighting BoneView’s impact on clinician accuracy.
  • When the PHE Ends: Healthcare Administrative Partners shared a helpful breakdown on how and when radiology practices will be affected by the COVID-19 Public Health Emergency’s expiration (potentially in mid-July). Practices can expect increased Medicare enrollment labor as relaxed PHE policies are eliminated (would be effective immediately) and additional telehealth credentialing work as out-of-state “flexibilities” are discontinued (151 days after PHE ends). Meanwhile, practices in states that gained additional Medicaid coverage will see a shift in their payor mix (by the end of the quarter that PHE ends), and practices that received Provider Relief Funds will have new deadlines for using their PRF funds (June 2022 to June 2023) and reporting their funding usage (September 2022 to September 2023).
  • 68Ga-FAPI PET/CT for Metastatic Thyroid Cancer: A new study out of China detailed 68Ga-FAPI PET/CT imaging’s strong diagnostic performance with metastatic differentiated thyroid cancer (DTC), achieving far better results than 18F‐FDG PET/CT (the current standard). The prospective study of 35 patients with suspected or confirmed metastatic DTC found that 68Ga-FAPI PET/CT achieved higher tracer uptake than 18F-FDG PET/CT across all metastatic lesion areas (7.0 vs 4.2), and had higher sensitivity for depicting neck lesions (83% vs 65%) and distant metastases (79% vs 59%).
  • nference’s Imaging Entrance: Drug discovery/development AI company nference expanded into imaging, acquiring small India-based imaging AI startup Predible. nference has built an impressive business by using largely unstructured EHR data to support drug discovery/development, while Predible analyzes chest CT scans to generate visual/quantitative diagnostic reports. It appears that this was an acqui-hire, allowing nference to leverage Predible’s team of imaging AI experts to help it make “ALL biomedical data computable.”
  • GE & RaySearch’s RT Alliance: GE Healthcare and RaySearch will work together to develop a new radiation therapy simulation and treatment planning solution, combining RaySearch’s treatment planning systems with GE Healthcare’s multi-modality simulator systems (CT/MR/MI). The alliance comes just a month after GE announced a similar radiation therapy collaboration with Elekta.
  • deepc’s International Acceleration: deepc announced plans to expand globally (with an emphasis on the US), following its acceptance into the German Accelerator Life Sciences program, which helps its members expand to new global markets. Although the US already has plenty of AI marketplaces and platforms, deepc has been operating in Europe for a few years and already has a long list of FDA-cleared AI partners (e.g. Qure.ao, Lunit, Vuno, Avicenna.ai, others). 
  • X-Ray Age Uproar: The Australian Federal Police’s use of wrist X-rays to help decide whether to prosecute younger foreign-born defendants as adults came under scrutiny last week. An Australian court overturned convictions against six Indonesian men, who received adult prison sentences in 2010 (when they were as young as 13), even though experts had warned that the technique was unreliable. This is a unique story, but not a unique practice, as X-ray bone age is used for asylum and immigration decision-making across the world.
  • Compression Equivalence: A new study in European Radiology showed that mammography exams involving patient-assisted compression produce equivalent image quality as standard compression exams. In the randomized trial (n = 444 women, 60yr avg age) the two compression types produced the same “PGMI” image quality distributions (Perfect, Good, Moderate, Inadequate), including both CC and MLO exam views. 
  • Philips MR 7700 Cleared: Philips announced the FDA clearance of its high-performance MR 7700 3T MRI system, which is positioned for both clinical and research use, and boasts a number of unique capabilities to support its dual positioning. The MR 7700 features an enhanced XP gradient coil system, new multinuclear clinical capabilities (diffusion imaging, integrated multi-nuclei and spectroscopy imaging, neuroscience sequences), and interface and workflow features intended to support both clinicians and researchers.
  • AI’s External Validation Drop: A new Johns Hopkins study review added the latest evidence that deep learning algorithms often struggle when applied to external validation sets. Of the 86 algorithms included (83 academic studies from 2015-2021), 81% (70/86) performed worse with the external set, including 24% showing a substantial decrease and 49% showing at least a modest decrease (≥0.10 & ≥0.05). Although these results probably aren’t surprising to AI insiders, this was arguably the most-shared AI story across radiology social media this week, and it likely had an outsized influence on AI opinions.

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-- The Imaging Wire team