#451 – The Wire

  • Referrer Feedback Works: A new JAMA study showed that giving referring physicians individualized feedback about their high imaging volumes reduces their future imaging orders. The researchers randomized 3,660 Australian general practitioners (all among the top-20% of referrers for 11 different MSK imaging exams) into either an interventional group or a control group (n = 2,933 & 727). The interventional group’s imaging orders were significantly lower 12 months after they received the data-based feedback (27.7 vs. 30.4 per 1k patient consultations), resulting in an estimated 47,318 fewer exams.
  • Scan.com’s Series A: UK-based “diagnostics-as-a-service” startup, Scan.com, completed a £2.2M Series A round (total funding now £4.2M) that it will use to fund its expansion to the US and Germany, and to support the development of new B2B products. Scan.com provides an API-connected portal that clinicians and patients can use to schedule imaging exams and view results. It previously targeted the UK’s private healthcare providers and patients, while serving as an NHS alternative.
  • Google’s TB AI: A Google Health-led team developed a deep learning system that detected tuberculosis in chest X-rays as accurately as radiologists, and could help address TB-stricken countries’ radiologist access and cost barriers. The researchers trained the AI model using 165k CXRs from 22k people across 10 countries, and tested it against CXRs from 1,236 patients from four countries (17% with active TB). Compared to radiologists, the DL system detected TB with a higher AUC (0.89), greater sensitivity (88% vs. 75%), and noninferior specificity (79% vs. 84%). They estimated that it could reduce the cost of TB detection by 40% to 80% per patient.
  • Osteoporosis DL Progress: University of Wisconsin researchers developed a DL system that accurately detected osteoporosis in abdominal CT scans, showing solid progress from a previous feature-based bone mineral density (BMD) algorithm. The researchers used the DL and BMD algorithms to analyze 11k CTs (automated level selection & L1 trabecular ROIs), using manual measurements as the reference standard. The DL model achieved a far higher success rate compared to the older BMD algorithm (99.3% vs. 89.4%), while allowing optimization for either specificity or sensitivity depending on ROI slice selection (single-slice = 39.4%/98.3%; seven-slice = 71.3%/94.6%). 
  • Samsung’s V7 Ultrasound: Samsung’s US-based ultrasound and radiography subsidiary, Boston Imaging, announced the FDA clearance of its new V7 general ultrasound, highlighting its clinical versatility, image quality, clinical apps, and ease-of-operation. The V7 system is positioned just below Samsung’s V8 ultrasound that launched last fall, and shares many of the same core features.
  • PSMA PET/CT’s Management Impact: A new study in JNM showed that 18F-DCFPyL PET/CT (Lantheus’ Pylarify PSMA tracer) has a significant impact on the management of prostate cancer patients who are being considered for salvage radiotherapy after radical prostatectomy and PSA recurrence. Among 98 participants, PSMA PET/CT detected disease in far more patients than diagnostic CT (46.9% vs. 15.5%), and prompted more “major” and “moderate” changes in treatment recommendations (12.5% vs. 3.2% & 31.3% vs. 13.7%). This comes a few months after another study found that Pylarify similarly improves prostate cancer treatment staging.
  • Unnecessary X-Ray Sentencing: California orthopedic surgeon, Dr. Gary Wisner, was sentenced to 7 years in prison for performing unnecessary X-rays on his patients and fraudulently billing for those exams. Government investigators reviewed a random sample of Dr. Wisner’s patients, finding that at least 10 patients received “hundreds of unnecessary X-rays,” including scans of multiple body parts that weren’t associated with the patients’ condition.
  • EchoNous’s AS Evidence: A paper published in JASE found that EchoNous’s Kosmos handheld ultrasound with CW Doppler (CWD) capabilities can reliably detect and grade aortic stenosis (AS). Of 118 patients with known or suspected AS, Kosmos with CWD achieved “excellent” agreement with a high-end cart-based echo system (intraclass correlation: 0.97). The handheld device detected at least moderate AS with 93% sensitivity, 98% specificity, and 96% total diagnostic accuracy.
  • xWave’s Seed Round: Ireland-base imaging referral software startup, xWave Technologies, completed a €1.3M Seed round to fund its commercial expansion across Ireland, the UK, and Northern Europe. xWave’s xRefer platform uses evidence guidelines to help clinicians make appropriate referrals, reportedly reducing the time to create/send a referral and have a radiologist review it by 99.6%. xWave estimates that it would reduce the Irish healthcare system’s duplicate and unnecessary radiology referrals by more than 60% if adopted nationwide.
  • Dismal U.S. Life Expectancy: Although this probably won’t come as a shock to many readers, a new report from the Commonwealth Fund found that the U.S.’ 78.8-year average life expectancy trails far behind other developed nations such as Japan (84.4 years), Spain (84), and Switzerland (84). Deaths from avoidable causes (including some imaging-screened diseases) and a weak commitment to community-based primary care were singled out as reasons for the poor performance, which looks even worse when considering that healthcare accounts for 20% of U.S. GDP, the highest among any country.
  • Fixed C-Arm Demand: A IMV Medical survey revealed that the broad use of fixed C-arms is driving procedure and unit demand. Fixed C-arm units were spread across hospitals’ cardiology (42%), radiology (35%), and surgery departments (23%) during 2022, especially in larger >200 bed hospitals (73%-85% have C-arms in multiple departments). IMV forecasts that fixed C-arm procedure volumes will increase by 16% year-over-year, prompting 62% of hospitals to consider buying new fixed C-arm systems through 2025.

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