Ace New York Mets pitcher, Jacob deGrom, suggesting that a long and awkward MRI exam turned his mild forearm strain into a season-ending elbow injury.

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Imaging Policy & Legislation

The MARCA Divide

The American College of Radiology might have a neutral stance on the Medicare Access to Radiology Care Act (MARCA), but a new survey confirmed that most ACR members are far from neutral about non-physicians’ role in radiology. 

MARCA Madness – MARCA would require Medicare to reimburse supervising radiologists for imaging services performed by radiologist assistants, as long as RAs work within physician-led teams. The ACR revealed its neutral position on MARCA in August, enraging some members who are concerned that MARCA will undermine radiologists’ role, and accused the ACR of selling out to PE. 

The Opinion Divide – The ACR survey (n = 4,207, or 16% of members) revealed overwhelming opposition to MARCA, but more balanced views on working with non-physician radiology providers (NPRPs). By NPRPs, they mean radiology assistants, advanced practice registered nurses, and physician assistants.

• 60% are against MARCA (vs. 19% in favor, 21% neutral)
• 86% are concerned about NPRP scope creep
• 55% view NPRPs as a threat to patient care
• However, just 43% are against using NPRPs in their practice
• And 62% believe it’s up to practices whether they employ NPRPs

Behind the Divide – A deeper look into the ACR’s (very detailed) survey results revealed that members’ MARCA and NPRP opinions seem largely influenced by their professional situation. 

Career Stage

• 80% of residents/fellows and 65% of early-career rads view NPRPs as a threat to patient care 
• 51% of mid-career rads and 41% of late-career rads view NPRPs as a threat to patient care

Practice Type

• 61% of respondents from academic settings view NPRPs as a threat to patient care
• 69% of respondents from national and private practices think NPRP use is a practice decision 

Practice Role

• 61% of non-leaders view NPRPs as a threat to patient care
• 65% of practices leaders view NPRPs use as a practice decision

NPRP Experience

• 69% of respondents who do not work with NPRPs view them as a threat to patient care
• 57% of respondents who work with NPRPs believe they play an important role
• 84% of respondents who support MARCA currently work with NPRPs

The Takeaway – We now have data confirming what most of you already knew: the majority of radiologists are firmly against MARCA and a small minority support it. However, the data also shows that plenty of radiologists see value in NPRPs, especially if they already work with non-physicians and if their careers are less threatened by them. What’s still unclear is what it will take for the ACR to break its neutrality on MARCA (in either direction).

Arterys and the Cloud AI Convergence

Check out this Imaging Wire Show featuring Arterys’ Director of Product, Stephen Harrold, for a great conversation about the evolution of PACS and informatics, imaging’s AI and cloud convergence, and much more.

Canon AiCE’s Cardiovascular Imaging Evolution

See how Canon AiCE DLR is achieving new levels of cardiovascular imaging in this presentation from Jeannie Yu MD, FACC, FSCCT.

The Wire

• HiP-CT Revolution: UCL scientists unveiled the first hierarchical phase-contrast tomography (HiP-CT) images of intact human organs, showing that HiP-CT scans can produce a diverse range of clinical views (whole-organ, functional, blood vessels, cellular). HiP-CT is getting headlines for its impressive technology (its 100b-times brighter than current X-rays), but the UCL team seems more excited by HiP-CT’s ability to zoom-in on the smallest organ features, suggesting that it might “revolutionize” diagnostic processes and even our understanding of human anatomy.

• PowerShare Image Aware: Nuance and Collective Medical joined forces to launch PowerShare Image Aware, a new solution that provides ED physicians with their patients’ prior radiology studies in real time and within existing clinical workflows. Nuance PowerShare Image Aware also shows if images and associated metadata are available in PowerShare for viewing, while allowing radiologists to integrate a patient’s prior imaging into radiology reporting tools such as Nuance PowerScribe.

• COVID Burnout: A survey of 3,176 Sutter Health clinicians found that 29% experienced burnout during the COVID-19 pandemic (as of mid-2020), revealing higher likelihoods of burnout for women (odds ratio = 2.19), clinicians with childcare/caregiving responsibilities (OR = 2.19), and clinicians in emergency medicine and radiology settings (ORs = 1.58 & 1.87). Surprisingly, the report called radiology’s high burnout rates “surprising” and theorized that it might be because the pandemic reduced their “work or income,” showing that many healthcare experts aren’t aware of radiology’s long history of burnout (that’s definitely not due to reduced work).

• Hyperfine’s Gates Grant: Hyperfine received a $3.3m grant from the Bill & Melinda Gates Foundation (following a previous $1.6m grant) that will fund the deployment of 25 Hyperfine Swoop portable MRIs in developing countries. The Swoop systems will be used to study the neurological effects of malnourishment on young children, while also assessing the Swoop’s feasibility for pediatric neuroimaging in low-resource settings. 

• Self-Aware AI: Google researchers developed a dermatology classifier AI tool that “knows what it doesn’t know” when it’s used to diagnose a condition that wasn’t included in its training data. This paper is pretty complex if you don’t have an AI background, and it isn’t about our type of medical imaging, but it’s worth a look for readers trying to understand how to handle outlier conditions.

• A Case for Community Multispecialists: A new AJR study provided more evidence in favor of staffing multispecialty radiologists in acute community settings. The researchers analyzed 5.9m acute exams from community hospitals that featured preliminary interpretations from specialist telerads and final interpretations from on-site radiologists. Interpretation discrepancy rates didn’t increase when the telerads read exams from outside of their subspeciality, but did increase when telerads interpreted “advanced” exams from within their subspeciality (0.26% vs. 0.18% major discrepancy rates; 0.34% vs. 0.29% minor discrepancy rates).

• PaxeraHealth’s DIY AI: PaxeraHealth introduced its forthcoming “Ark” zero-coding AI authoring platform, which healthcare systems and academic centers could use to “DIY their own AI algorithms.” Providers will be able to utilize collaborative learning to train AI models leveraging data from other Ark members, expediting imaging AI production.

• deGrom’s MRI Injury: Ace New York Mets pitcher, Jacob deGrom, blames the elbow injury that ended his 2021 season on a long and awkwardly positioned MRI exam. The exam required deGrom to lie on his stomach with his elbow raised above him for nearly an hour, and revealed only a mild forearm strain. However, deGrom’s discomfort spread to his elbow during the next few days, and he wasn’t cleared to play again until the season was nearly over. Given deGrom’s $33.5m annual salary, this might be the most expensive MRI exam ever.

• ED Errors and Adverse Outcomes: When emergency imaging diagnostic errors cause patients to return to the ED for more imaging, it often results in adverse medical outcomes. That’s from a South Korea-based study that analyzed 1,054 patients who received emergency MRIs and CTs and returned to the ED for additional imaging within 7 days (231 due to diagnostic errors), finding that patients who had diagnostic errors experienced far higher rates of adverse outcomes within the next 30 days (33.3% vs. 14.8%).

• Covera & HealthHelp: Covera Health revealed plans to integrate its national Centers of Excellence program (CoE) into HealthHelp’s Diagnostic Imaging program. This seems like a logical combination, as providers use HealthHelp’s Diagnostic Imaging program to ensure appropriate imaging referrals and providers/plans use Covera Health’s CoE program to ensure that their patients are referred to quality imaging practices. It also significantly expands Covera’s potential CoE user base.

• Brain CT DL, With and Without Contrast: Japanese researchers developed a deep learning model that used a combination of contrast-enhanced and non-contrast CT head images (CE+NECT) to improve brain metastases detection. The team developed the CECT+NECT model using scans from 116 patients with brain metastases (428 metastases for training/validation, 231 for testing), which outperformed a contrast-enhanced CT model for sensitivity (88.7% vs. 87.6%), PPV (44% vs. 37.2%), and false positives per patient (9.9 vs. 13.6). 

• CyncHealth Selects PowerShare: CyncHealth selected Nuance PowerShare as the Iowa and Nebraska health information exchange’s patient imaging sharing platform, including Nuance’s new PowerShare Image Aware solution that provides ED physicians with patients’ prior imaging.

CVIS’ Cloud Advantages

This Diagnostic and Interventional Cardiology article details the unique advantages of cloud-based CVIS systems (off-property access, team collaboration), with insights from one Mississippi-based cardiologist on the benefits of Fujifilm Healthcare’s VidiStar CVIS.

The Resource Wire

• Do your patients text more than they use CDs? Find out how Novarad’s CryptoChart simplifies image access, combining secure QR codes and text and email communications to help providers and patients ditch the disk.

• This Bayer case study details how radiation benchmarking programs can help push CT dose exposure reduction initiatives from achieving compliance to driving quality.

• Attainable Intelligence. Simply Masterful. See how United Imaging’s forthcoming uCT Atlas combines breakthrough technology and design to allow you to conduct your masterpiece.

• Check out this Imaging Wire Show featuring GE Healthcare’s US & Canada MRI leader, Brian Murphy, discussing MRI’s evolution and how AIR Recon DL is eliminating MRI’s signal, speed, and resolution compromise. 

• The Saint Joseph Mercy Health System doubled its follow-up recommendation identification/tracking when it adopted Nuance PowerScribe Follow-up Manager, achieving ROI within the first year. Find out how in this Nuance case study.

• See why the time is right for imaging AI-enabled population health in this Hardian Health profile featuring Nanox AI’s Zohar Elhanani.

• 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.

• Thinking about AI ROI? Check out this AIMed conversation featuring Blackford CEO, Ben Panter and Lahey Hospital & Medical Center’s radiology Chairman, Dr. Christoph Wald discussing how to demonstrate the value of healthcare AI.

• The USPSTF guidelines for lung cancer screening were updated in May 2021, and driving compliance to such guidelines is a long, slow, repetitive process. Because of that, the Riverain team put together a kit to help hospitals and imaging centers educate either referring physicians or patients on the new guidelines either via branded tools or through the media.