Radiology Partners’ Nina Kottler, MD, MS, on why radiologists should be in the AI evolution driver’s seat, and not sitting as passengers (or pedestrians).

I’m excited to share the latest Imaging Wire Show, featuring Aidoc’s Elad Walach and Radiology Partners’ Nina Kottler, MD, MS. We explore Aidoc and RP’s efforts to integrate AI on a national scale, the upcoming AI evolution, and radiologists’ central role in the future of healthcare AI. This is a must-watch episode whether you’re an AI expert or still figuring out your AI strategy.

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

CT Scanners

Siemens’ Healthineers Hardware Evolution

Siemens Healthineers’ Shape 22 pre-RSNA event featured a pair of ambitious hardware announcements that stand to expand what can be done with CT exams and where MRIs can be performed.

NAEOTOM Alpha PCCT – Siemens Healthineers confirmed its pole position in the Photon-Counting CT race, officially launching its NAEOTOM Alpha scanner. Although the NAEOTOM Alpha already received a rare marketing head-start from the FDA, this week’s launch begins its official 2022 rollout, and provides new details about this milestone product:

• Far higher image quality than CT
• Provides much more imaging data and new levels of CT-based insights
• Expands CT to new cardiac, oncology, and pulmonology use cases
• Allows 50% lower radiation dosage, could shift exams to non-contrast
• Supports Siemens’ core solutions, including operability and AI-based diagnosis
• Cleared in US and Europe, 20 systems already installed, 8k patients scanned
• PCCT expected to become the main CT technology within 10 years
• Siemens is holding another NAEOTOM Alpha event today (Nov. 18)
• Siemens might be first, but we’re seeing more PCCT activity from GE Healthcare, and Canon and Philips aren’t far behind

MAGNETOM Free.Star MRI – One year after introducing the MRI-expanding MAGNETOM Free.Max, Siemens continued its MRI accessibility push, revealing the “disruptively simple” MAGNETOM Free.Star. The new Free.Star MRI will inherit much of the MAGNETOM Free.Max’s accessibility-friendly qualities (0.55T, small/light, low helium & installation requirements), and will have the ambitious goal of supporting the half of the world’s population that doesn’t have MRI access. The MAGNETOM Free.Star is still early-stage (it hasn’t begun the FDA process), but it’s massive healthcare ambitions make it worth keeping an eye on.

The Takeaway – The NAEOTOM Alpha is expected to be the start of a major shift towards Photon-Counting CT, while the new MAGNETOM Free.Max and Free.Star could expand where MRIs are used. That makes these extremely significant products.

GE’s Radiology Reporting Turnaround Playbook

The need for faster radiology report turnaround is increasingly clear, but the ways to improve turnaround time aren’t always. See how smarter prioritization, streamlined communication, and true integration are driving faster turnarounds in this new GE Healthcare report.

OLGH’s PowerScribe One Improvements

See how the Ochsner Lafayette General health system improved its radiology report quality and efficiency when it migrated to PowerScribe One.

The Wire

• The NTAP Effect: A new report from Vizient revealed that US hospitals significantly increased their use of ischemic stroke triage AI tools after CMS began awarding Medicare New Technology Add-On Payments in late 2020 (NTAPs – up to $1,040 w/ certain scenarios). The number of Vizient member hospitals using LVO AI triage tools doubled from Q4 2020 to Q2 2021 (63 to 130) and LVO AI procedures grew even faster (1,797 to 4,811), with 38% of these AI procedures resulting in mechanical thrombectomy.

• GE’s Endotracheal Tube AI FDA: GE Healthcare announced the FDA 510(k) clearance of its AI tool used to assess Endotracheal Tube (ETT) placements in intubated patients, which automatically detects ETTs in chest X-rays and provides clinicians with positioning measurements. The ETT tool is one of five algorithms in GE’s Critical Care Suite 2.0, all of which come embedded on its AMX mobile X-ray systems. Given that ETT assessments are common and relatively mundane, this is an AI use case that many radiologists might welcome.

• Telemedicine Leads to Fewer Treatments & Tests: When patients meet with their primary care providers via phone or video, they receive far fewer prescriptions and diagnostic tests. That’s from a pre-pandemic Kaiser Permanente study (n = 1.1m patients, 2.2 appointments) that found video and telephone visits were far less likely than clinic visits to result in prescriptions (38.6% & 34.7% vs. 51.9% of visits) or lab tests and imaging orders (29.2% & 27.3% vs. 59.3%). Although telemedicine visits were slightly more likely to require office follow-ups within 7 days (25.4% & 26% vs. 24.5%), they did not lead to more ED visits or hospitalizations.

• Lunit’s CXR Triage FDA: Lunit announced the FDA 510(k) clearance of its INSIGHT CXR Triage tool, marking the South Korean startup’s first FDA approval and a major step in its US commercial rollout. As its name suggests, Lunit INSIGHT CXR Triage triages and prioritizes emergency chest X-rays and notifies physicians of urgent cases. Lunit now plans to accelerate its commercial activity in the US, leveraging its partnerships with Philips and Fujifilm.

• Radiologist-Supervised Transfer Learning: A new UCSD study showed how AI algorithms can be improved through radiologist-supervised transfer learning. The researchers created 1,466 radiologist-annotated CXRs and used transfer learning to fine-tune an existing pneumonia localization CNN, and then tested it with CXRs from 203 COVID patients. This added transfer learning step improved the CNN’s performance for pneumonia detection (internal data AUCs: 0.756 to 0.841; external data AUCs: 0.864 to 0.876) and severity quantification, suggesting that closed-loop AI systems could be continuously improved by incorporating radiologist interpretations.

• Medtech OS Vulnerabilities: Cybersecurity firms, Forescout Technologies and Medigate, uncovered 13 vulnerabilities affecting Siemens’ Nucleus Real-time Operating System that hackers could use to cause millions of medical devices to crash or expose data (including imaging devices from multiple brands). There’s no evidence that hackers have exploited these vulnerabilities and Siemens has already released several updates.

• Mirai’s Broad Validation: A new study in the Journal of Clinical Oncology showed that MIT CSAIL’s Mirai mammography-based AI risk model was able to maintain its accuracy across an incredibly diverse test dataset (seven hospitals, five countries, 129k mammograms, 62k patients, 3,815 diagnosed with w/ cancer within 5yrs). Mirai predicted patient outcomes with 0.75 to 0.84 concordance indices across the seven hospitals, making this the broadest mammography AI validation ever, and suggesting that Mirai could allow broad and equitable improvements in care. This is the latest in a series of milestones that continue to show that Mirai is both accurate and generalizable.

• MPFS 2022 Breakdown: Healthcare Administrative Partners provided a complete overview of how CMS’ final 2022 Medicare Physician Fee Schedule (MPFS) impacts radiology. Big picture: the conversion factor will fall by 3.71% to $34.89, bringing smaller-than-anticipated cuts to diagnostic radiology (-1%), IR (-8%), nuclear medicine (-1%), and radiation oncology/therapy (-5%). Practices will also see an additional 2% payment reduction when sequestration resumes on January 1, 2022. HAP did a deep dive on all of the 2022 MPFS changes, so check out their report to learn more.

• Synthetic CT for FUS: A team of South Korean scientists developed an AI algorithm that can generate synthetic CT images from brain MRIs, finding that sCT could be effective for image-guided transcranial focused ultrasound treatments without exposing patients to CT radiation. There’s been quite a bit of synthetic CT research efforts in recent years, but they’ve mainly focused on sCT for radiation therapy planning.

• Radiologist-Involved Concordance Reviews: A new Beth Israel Deaconess Medical Center study revealed that CT-guided biopsy results are often discordant with diagnostic imaging findings, and highlighted the benefits of involving radiologists in imaging/biopsy concordance reviews. Their analysis of 926 consecutive CT-guided biopsies (453 reviewed w/ radiologists) revealed that 11% of pathology results were discordant with diagnostic imaging (57% proving to be malignant). When reviewed by radiologists, discordant cases were far more likely to be evaluated via repeat biopsies (50% vs. 13% via repeat imaging), leading to faster diagnosis times (median: 41 days w/ rad review vs. 56 without rads).

• Concussion App: A new NIH study suggests that pupillary light reflex measurements performed with smartphone apps might be able to identify concussed patients, improving diagnosis and treatment (and potentially reducing concussion/TBI imaging). The researchers analyzed data from patients who used the BrightLamp Reflex iPhone app, finding that patients with and without concussions had significantly different pupillary light reflex metrics (e.g. max & min pupil diameter, recovery time). BrightLamp Reflex joins a growing list of non-imaging approaches for concussion/TBI triage, although other options have generally focused on blood testing.

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.

The Resource Wire

• It’s clear that structured reporting is a must for CVIS platforms, but they aren’t all created equal. This Fujifilm Healthcare article reveals what physicians and sonographers view as the “non-negotiable” CVIS structured reporting features.

• After more than 15 years of development, the world’s first photon-counting system is here to redefine CT. Register now and join Siemens Healthineers at the launch event on November 18 to be part of this quantum leap forward in technology.

• 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.

• 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.

• Are you at RSNA 2021? Meet with Riverain at booth (#4129) to learn how you can optimize your lung disease detection using your existing acquisition and workflow. 

• Take the AiCE challenge and see why half the radiologists in a recent study “had difficulty differentiating” images from Canon Medical Systems’ Vantage Orian 1.5T MR using its AiCE reconstruction technology compared to standard 3T MRI images.

• See how Arterys LungAI matched (and actually exceeded) radiologists’ accuracy measuring lung nodule volumes in CT scans.

• Learn how Salem Regional Medical Center improved its radiology workflows and cut service and syringe expenses after adopting Bayer’s MEDRAD Stellant FLEX system.

• Working out your AI business case? Check out this helpful Blackford Analysis report on how to calculate AI’s clinical, IT, administrative, and financial value to your organization.