North Carolina attorney, Ellis Boyle, questioning a WakeMed radiographer who accidentally hit a man with a portable X-ray.

Imaging Wire Sponsors

Arterys  •  Bayer Radiology  •  Blackford Analysis  •  Canon Medical Systems  •  Fujifilm Healthcare  •  GE Healthcare  •  Nanox.AI  •  Novarad  •  Nuance  •  Riverain Technologies  •  Siemens Healthineers  •  United Imaging

Prostate Cancer Imaging

The PSMA PET/CT + mpMRI PCa Effect

There’s been a growing number of studies comparing 68Ga-PSMA PET/CT and mpMRI’s effectiveness along the prostate cancer pathway, but new research suggests that the modalities might be particularly effective if used together early in the diagnostic process.

The Study – A team of Australian researchers reviewed pre-operative mpMRI and 68Ga-PSMA PET/CT exams from 1,123 men (median PSA = 6), comparing their imaging results and histology findings. Here’s what they discovered:

• mpMRI identified tumors in 93 men (8%) that were missed by 68Ga-PSMA PET/CT
• 68Ga-PSMA PET/CT spotted tumors in 117 men (10%) that mpMRI missed
• The combined modalities identified index tumors with Gleason Scores of ≥3+4 in 92% of men (vs. 80% w/ only mpMRI & 82% w/ only PSMA PET/CT)
• 68Ga-PSMA PET/CT and mpMRI performed similarly for lesion/tumor detection and localization

Better Assessments and Decisions – In addition to identifying more tumors, mpMRI and 68Ga-PSMA PET/CT’s combined localization accuracy might improve biopsy targeting, leading to more accurate tumor grading and better management decisions.

More Necessary Biopsies – Meanwhile, patients with negative mpMRI and 68Ga-PSMA PET/CT findings would likely have a low risk of clinically significant prostate cancer, making them solid candidates for active PSA monitoring and allowing them to avoid unnecessary biopsies.

The Takeaway – This approach needs a lot more research and PSMA tracers currently only have FDA approval for patients with metastatic prostate cancer or biochemical recurrence, so 68Ga-PSMA PET/CT won’t be combined with mpMRI in early diagnostic exams very soon. That said, this study suggests that we’ll see more future efforts to combine and evaluate mpMRI + 68Ga-PSMA PET/CT as an early diagnostic step.

Pivoting to Population Health AI

Check out this Imaging Wire Show featuring Nanox AI strategy leader, Dr. Orit Wimpfheimer, where we discuss building an international telerad practice, what’s wrong with triage AI, and pivoting to population health AI.

Why X-Ray Will Remain a Mainstay Modality

There might be more “advanced” imaging modalities, but X-ray keeps growing and will be a mainstay modality for the foreseeable future. See the factors driving X-ray’s growth in this GE Healthcare report.

The Wire

• Breast Imaging AI Growth: Signify Research expects the breast imaging AI market to maintain a 22% CAGR through 2025 when it will reach $205m (vs. $60m in 2020), driven by efforts to overcome screening backlogs, ongoing DBT system adoption, and increasing interest in breast ultrasound AI. The U.S. will likely maintain its dominant share of the global breast imaging AI market (80% in 2020) until European countries grow more comfortable with using AI as a second reader and major Asian countries launch national breast cancer screening programs.

• Low-Field MRI Warning: A new JACR editorial from Yale radiologist, Jeffrey Weinreb, MD, warned that if radiologists don’t proactively embrace low-field MRI technology the specialty “will be in trouble.” The MRI expert argued that low-field MRI is here to stay and could disrupt key exam workflows and physician relationships, making radiologists’ early-stage influence even more important.

• Feedback’s Funding: UK-based imaging workflow company Feedback PLC issued $14.6m worth of shares, revealing plans to use its new funds to support commercialization efforts and further develop its CareLocker product (cloud storage) and Bleepa platform (image sharing/communication).

• Radiation Oncology’s Significant Incidentals: A new study out of Creighton University warned of “significant” incidental findings in radiation treatment planning CT scans, encouraging radiation oncology teams to formalize how they spot and follow-up on these findings (including referring them to radiology). The researchers had a radiation oncologist review treatment planning CTs from 115 patients, identifying four abnormal findings that were unrelated to the patients’ primary cancers (3 neoplasms, 1 benign) and could have been missed during the treatment planning process.

• Ricoh Brings 3D On-Site: Ricoh USA and Stratasys announced a new alliance that will allow healthcare providers to print anatomical 3D models on-site. Hospitals and clinics would use the RICOH 3D for Healthcare solution (integrated with IBM iConnect Access) to design patient-specific anatomic models that would be produced on-site by Ricoh’s managed service staff using Stratasys’ 3D printers. Ricoh announced a related 3D model ordering/delivery service in late August.

• POCUS’ DDH Advantages: A new study out of NYU Langone showed that using point-of-care ultrasound to assess infants with developmental hip dysplasia (DDH) significantly reduces patients’ visit duration and costs compared to formal sonographic evaluations. Their analysis of 532 DDH visits at a specialty orthopedic hospital (326 w/ POCUS, 206 w/ ultrasound) found that POCUS-based encounters lasted an average of 42 minutes (vs. 92min) and cost an average of $121 (vs. $339).

• A Portable X-Ray Accident: A 72-year-old North Carolina man was awarded $175k from WakeMed Health after he was struck and injured by a portable X-ray system as it was wheeled down an ED hallway. The plaintiff’s lawyers argued that WakeMed was negligent because the 5’2” technologist couldn’t see around the 6’ X-ray system and the device didn’t feature any warnings (e.g. flashing lights). This seems like a rare accident, and the settlement was far lower than the plaintiff originally sought, but it’s easy to see how hospitals and RTs might appreciate being able to see around their portable X-rays.

• A Case for Online Scheduling: A new study out of Denmark found that the majority of cancer patients and their relatives (n = 555 & 115) want to use online scheduling systems to book their outpatient CT imaging exams (54% & 65%), while fewer were interested in reserving specific radiographers (37% & 56%). This is far from the first study supporting online scheduling, which is a patient-friendly option that’s already widely adopted in many regions, but not in Danish oncology pathways.

• CMS Hikes LDCT Rates: CMS revealed plans to increase Medicare reimbursements for outpatient low-dose CT lung cancer screening by 37% in 2022 ($81 to $111), drawing praise from the ACR after several years of lobbying efforts. This is especially good news for imaging centers considering that the USPSTF’s new guidelines doubled the US’ eligible lung cancer screening population, although the impact of both moves will still depend on getting more eligible people to participate in screening.

• More DBT+SM Evidence: A new study review in European Radiology added to the growing field of evidence supporting DBT plus synthetic mammography (DBT+SM), finding that DBT+SM is more effective than digital mammography (DM), in addition to exposing women to less radiation than DBT+DM (SM doesn’t require additional DM scan). Their analysis of 12 papers comparing DBT+SM with DM screenings (414k women, 10 populations) found that DBT+SM produced a higher cancer detection rate (1.35 risk ratio) and a lower recall rate (0.79 risk ratio), although their biopsy rates were similar.

• MRI Diabetes AI: A team of Swiss and German researchers developed a DL model that was able to identify patients with type 2 diabetes (T2D) using only whole-body MRI exams. The researchers used the DL model to analyze 2,371 whole-body T1 MRI exams, achieving an 87% AUC for distinguishing T2D and an 68% AUC for prediabetes, both of which were more accurate than conventional detection models.

BRG’s PowerScribe One Improvements

When Birmingham Radiological Group-GV adopted Nuance PowerScribe One, the practice eliminated 60-75 minutes in daily reporting time and reduced calls to the radiology reading room by 80%. See how in this Nuance Case Study.

The Resource Wire

• This Riverain Technologies case study details how Duke University Medical Center integrated ClearRead CT into its chest CT workflows, reducing read times by 26% and improving nodule detection by 29%.

• When the demand for your PET/CT imaging services outpaces available appointments, what are your options? Learn how Hackensack University Medical Center optimized its clinical operations by upgrading its Biograph Horizon to TrueV technology in this new case study from Siemens Healthineers.

• Here’s a quick introduction to Blackford Analysis’ dedicated AI platform and its service for the selection, deployment, orchestration, and use of imaging applications and AI.

• With radiation dose management now largely considered best practice, this Bayer white paper details the top five benefits of adopting contrast dose management.

• Can Cloud Security keep healthcare data secure? Read this whitepaper to find out how Arterys utilizes the cloud to keep this data private and protected.

• In this Novarad video, interventional oncologist Gary M. Onik, MD shares how Novarad’s AR surgical navigation system, OpenSight, helps his team accurately assess and treat tumors.

• Trying to grow your imaging practice? See the strategies Desert Radiology used to manage its growth in this on-demand webinar from Aunt Minnie and United Imaging.

• See how VidiStar users have benefitted from the Fujifilm Healthcare’s cardiovascular information system’s flexible SaaS-based model and leveraged its productivity advantages to drive reimbursements.

• Check out this talk from Eliot Siegel, MD on the “Hype, Myth, Reality and Next Steps” of imaging AI, including a profile on Canon’s AiCE Deep Learning Reconstruction solution at around the 4-minute mark.