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One-Stop Cardiac CT | Canon’s RSNA Rollout
December 9, 2021
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Together with
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“Scannie Lennox, Scandra Bullock and Princess Scan.”
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A few of the suggestions that Swindon Animal Hospital received during their recent MRI scanner naming social media campaign. They wisely selected “MRIah Carey.”
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We’re very happy to announce this year’s Imaging Wire Award honorees, who did amazing work to elevate radiology.
- COVID Hero: Lt Col Giovanni Lorenz, DO; San Antonio Military Health System (SAMHS)
- Diagnostic Humanitarian: Arlene Richardson, MD; Jackson Park Hospital
- AI Activator: Greg Zaharchuk, MD, PhD; Stanford University and Subtle Medical
- Insights to Action: Richard Duszak, MD; Emory University
- Burnout Fighter: Chris Mattern, MD; Greensboro Radiology
- Cornerstone: Elad Walach; Aidoc Medical
- Tech Trailblazer: Sheela Agarwal, MBA, MD; Nuance Communications
Congratulations to this year’s Imaging Wire Award winners and nominees, and many thanks to our judges and everyone who submitted nominations.
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A new Radiology Journal study found that combining Triple-rule-out CT (TRO CT) with Late Contrast Enhancement CT (LCE CT) significantly improves acute chest pain diagnosis.
Background – It’s traditionally been challenging to diagnose patients with acute chest pain and mild troponin rise, as TRO CT is effective for several key diagnoses (coronary artery disease, acute aortic syndrome, pulmonary embolism) but can’t identify nonvascular causes of myocardial injury.
The Study – The researchers examined 84 troponin-positive patients with acute chest pain using TRO CT, and then performed LCE CT exams on the 42 patients who had negative/inconclusive results.
The Results – The added LCE CT exams revealed positive/conclusive findings in 34 of the 42 previously-negative/inconclusive patients (including 22 w/ myocarditis), improving overall diagnostic rates from 50% to 90% (from 42/84 to 76/84).
The Takeaway – This new TRO CT + LCE CT protocol could make cardiac CT a “one-stop shop” for diagnosing acute chest pain, eliminating the need for follow-up MRI exams and allowing faster diagnoses. That’s especially notable considering that CT is already recommended for patients with low-risk acute chest pain (to exclude CAD) and was recently proposed as a gatekeeper for invasive coronary angiography.
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Canon and UC Davis’ Ultra High Resolution CT Experience
See Dr. Brian Goldner of UC Davis Sacramento detail his experience with Canon’s Ultra High Resolution CT and how it can be applied to cardiothoracic interpretations.
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Canon Medical was among the first companies to decide to virtually exhibit at RSNA 2021, but the OEM still had quite a presence, prominently placing Canon signage throughout the convention center and announcing a range of new products and technologies.
Vantage Fortian – Canon expanded its open bore MRI lineup, launching the Vantage Fortian 1.5T system. The FDA-cleared MRI debuts with a range of productivity enhancements, including new patient monitoring and positioning tools and planning tools for liver, prostate, and whole spine imaging. The Vantage Fortian also adopts Canon’s prioritized AiCE deep learning image reconstruction technology.
MRI Solution Expansion – The Vantage Fortian’s new automation tools will soon expand to Canon’s Vantage Orian 1.5T MR and later go into the Vantage Galan 3T system (pending regulatory approval). Canon will also make Resoundant Inc.’s advanced Magnetic Resonance Elastography (MRE) technology available with its latest MRIs.
Premium Ultrasound Overhaul – Canon Medical introduced the Aplio i-series / Prism Edition, completely redesigning its premium ultrasound family. The Aplio i-series / Prism Edition ultrasounds launch with a new interface and ergonomics, higher processing power, added image enhancement applications (microvascular, ultra wide view), and new AI-based workflow automations.
Aquilion ONE / PRISM CT Enhancements – Canon continued to enhance its Aquilion ONE / PRISM Edition CT scanner, adding its new Precise IQ Engine (PIQE, a new DLIR solution for cardiac CT image enhancement) and SilverBeam X-ray filter (reduces lung cancer CT radiation dosage close to CXRs). These FDA-pending enhancements come one year after the Aquilion ONE / PRISM Edition added Deep Learning Spectral CT scanning (allowing one-beat cardiac scans).
Hi-Def Interventional Detector – Canon also launched a new 12×16 Hi-Def detector for its range of Alphenix interventional systems (Sky +, 4D CT with Sky +, Biplane, and Core+), joining its existing 12×12 detector. The hybrid detector has the highest resolution on the market (76 micron resolution, up to 6.6 lp/mm), while achieving 2-times greater spatial resolution than conventional flat panels.
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CVIS Must Haves
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.
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- Fujifilm Velocity MRI: Fujifilm’s RSNA booth was highlighted by the company’s new Velocity MRI, combining the high-field Open MRI foundation that Fujifilm acquired from Hitachi (open gantry, patient comfort) with improved workflows and image quality (via integrated RF coils and enhanced reconstruction). The Velocity MRI is the first new product based on Hitachi’s core technology to launch under the unified Fujifilm Healthcare brand.
- COVID’s Rad Reimbursement Impact: A new American Medical Association (AMA) report revealed that Medicare spending on diagnostic radiology physician services was 16% below expected in 2020 ($4.7B vs. $5.6B). That’s a slightly sharper decline than overall physician services (-14% to $82.9B) and a far steeper decline than interventional radiology (-4% to $523M). Although much of these declines were COVID-related, the AMA warned that upcoming Medicare reductions could exacerbate the pandemic’s reimbursement impact.
- VA Cancer Diagnosis Declines: Speaking of COVID’s imaging impact. A recent Cancer Journal study revealed that pandemic disruptions led to substantial declines in new cancer diagnoses across the U.S. VA system in 2020. Although the VA’s cancer screening volumes rebounded by mid-2020, the health system detected far fewer prostate cancers (-23%), lung cancers (-13%), bladder cancers (-18%), and colorectal cancers (-20%) in 2020 compared to previous years.
- Therapixel DBT Cleared: Therapixel announced the FDA clearance of its MammoScreen reading aid for DBT screening mammography, coming 1.5-years after MammoScreen gained its 510(k) approval for 2D mammography. MammoScreen detects and characterizes suspicious soft tissue lesions and calcifications in mammogram images, scoring each lesion based on malignancy likelihood.
- Siemens’ Ultrasound Liver Analysis: Siemens Healthineers wrapped up its RSNA launches, adding advanced liver analysis to its ACUSON Sequoia ultrasound system. Siemens’ flagship general ultrasound now features Ultrasound Derived Fat Fraction (hepatic steatosis measurement tool) and Auto Point Shear Wave Elastography (liver stiffness quantification tool, reduces elastography exam times), allowing clinicians to perform liver tissue stiffness and hepatic fat quantification in a single acquisition.
- Subspecialist Discordance: When thoracic radiologists review CT exams with incidental lung nodule findings that were initially read by non-thoracic rads, they often disagree with their recommendations. NewYork-Presbyterian/Weill Cornell researchers had a thoracic radiologist review 215 emergency chest CTs exams that mentioned pulmonary nodules, finding that the thoracic rad disagreed with 82 of the initial recommendations (38%) and most commonly recommended more imaging (67%, 55/82).
- Mach7 & ImageMover’s Enterprise Imaging Alliance: Mach7 Technologies will make ImageMover’s software available with the Mach7 VNA and Viewer, creating an end-to-end solution to capture, archive, and view DICOM and Non-DICOM encounter-based images and videos. The alliance will expand Mach7 beyond radiology/cardiology, adding support for a range of multi-specialty workflows (e.g. POCUS, endoscopy, dermatology, and wound care).
- The Software Style Connection: A recent post from venture capital firm a16z detailed how consumers are increasingly choosing software based on a stylistic connection. The author makes the case that modern software’s shift to a “monotonously quirky, safe” aesthetic (this sums it up in one picture) has a broad appeal, but isn’t particularly compelling to any individual. This has caused many people to begin preferring software with a design that conveys personality, a useful lesson for imaging software companies (even if the author probably didn’t have medical imaging in mind).
- Echo Automation: A new Lancet Digital Health study found that echocardiography AI tools (specifically Us2.ai’s) can classify, segment, and annotate echocardiographic videos with similar accuracy as expert sonographers. The researchers trained Us2.ai’s echo AI product with 1,145 annotated echocardiograms and tested/validated it against an internal dataset and three external datasets. Against the internal data, the automated workflow accurately classified 2D videos and Doppler modalities (91% to 99%) and accurately segmented the left ventricle and left atrium (Dice similarity coefficient >93%). The AI system’s measurements also showed good agreement with the external datasets’ sonographer measurements.
- Medimaps’ $20M: Imaging AI startup Medimaps raised $20M that it will use to expand and commercialize its bone health assessment portfolio. Medimaps’ flagship product, TBS iNsight, analyzes X-ray images to support a range of bone health use cases (opportunistic screening, risk profiling, presurgical assessment) and will qualify for Medicare reimbursements starting in January 2022.
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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.
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- How could photon-counting CT impact your patients? In this video, the Medical University of South Carolina, one of the first users of the NAEOTOM Alpha, talks about the potential to visualize small lesions and fine details for high diagnostic confidence in neurology, cardiology, oncology, and pulmonology.
- It says a lot when a solution works so well for a radiology department that they decide to perform a study to quantify its benefits. In this Imaging Wire Q&A, University Hospital of Zurich’s Thomas Frauenfelder discusses his experience and study on Riverain Technologies ClearRead CT.
- Working out your AI business case? Check out this helpful Blackford Analysis post detailing how to create your AI Value Matrix based on your organizational objectives and value indicators.
- 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.
- Evaluating your patient engagement strategy? Check out this Imaging Wire Show featuring Novarad’s Paul Shumway for a great conversation about how new technologies are helping imaging providers safely and securely improve patient engagement.
- The evolution of United Imaging’s CT portfolio continued in 2020 and 2021 with new developments to help healthcare providers expand their practice, including the uCT ATLAS’ integrated uAI Vision 3D camera that enables AI-empowered operational efficiencies.
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