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Creating A Screening Giant | Stockholm3
January 31, 2022
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Together with
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“This is a critical juncture for society, in general, to make cancer screening a reality.”
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RadNet CEO Dr. Howard Berger on how AI and imaging advancements could make cancer screening far more mainstream.
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A few days after shocking the AI and imaging center industries with its acquisitions of Aidence and Quantib, RadNet’s Friday investor briefing revealed a far more ambitious AI-enabled cancer screening strategy than many might have imagined.
Expanding to Colon Cancer – RadNet will complete its AI screening platform by developing a homegrown colon cancer detection system, estimating that its four AI-based cancer detection solutions (breast, prostate, lung, colon) could screen for 70% of cancers that are imaging-detectable at early stages.
Population Detection – Once its AI platform is complete, RadNet plans to launch a strategy to expand cancer screening’s role in population health, while making prostate, lung, and colon cancer screening as mainstream as breast cancer screening.
Becoming an AI Vendor – RadNet revealed plans to launch an externally-focused AI business that will lead with its multi-cancer AI screening platform, but will also create opportunities for RadNet’s eRAD PACS/RIS software. There are plenty of players in the AI-based cancer detection arena, but RadNet’s unique multi-cancer platform, significant funding, and training data advantage would make it a formidable competitor.
Geographic Expansion – RadNet will leverage Aidence and Quantib’s European presence to expand its software business internationally, as well as into parts of the US where RadNet doesn’t own imaging centers (RadNet has centers in just 7 states).
Imaging Center Upsides – RadNet’s cancer screening AI strategy will of course benefit its core imaging center business. In addition to improving operational efficiency and driving more cancer screening volumes, RadNet believes that the unique benefits of its AI platform will drive more hospital system joint ventures.
AI Financials – The briefing also provided rare insights into AI vendor finances, revealing that DeepHealth has been running at a $4M-$5M annual loss and adding Aidence / Quantib might expand that loss to $10M- $12M (seems OK given RadNet’s $215M EBITDA). RadNet hopes its AI division will become cash flow neutral within the next few years as revenue from outside companies ramp up.
The Takeaway
RadNet has very big ambitions to become a global cancer screening leader and significantly expand cancer screening’s role in society. Changing society doesn’t come fast or easy, but a goal like that reveals how much emphasis RadNet is going to place on developing and distributing its AI cancer screening platform going forward.
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United Imaging’s Software for Life in 2021
Last year, as part of their Software Upgrades for Life commitment, United Imaging upgraded its entire U.S. MR installed base with the latest major releases, including 12 new applications, Windows 10, and its United Compressed Sensing (uCS 2.0) platform.
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- Stockholm3 Effectiveness: A new study out of Sweden added evidence that the novel Stockholm3 prostate cancer risk model (uses PSA, plasma biomarkers, and other clinical variables) reduces unnecessary exams while maintaining detection levels. The study found that using Stockholm3 with PSA ≥2 ng/ml as an MRI threshold reduced lifetime prostate MRI exams (-60%) and unnecessary biopsies (-9%) versus PSA-based screening, with comparable quality life year gains.
- ThedaCare’s Great Resignation: A legal battle involving a team of interventional radiology techs went viral last week. Wisconsin hospital ThedaCare sued to stop seven of its stroke team members (out of 11) from leaving to work for Ascension, but a judge allowed the team to leave, noting that Ascension didn’t recruit them and ThedaCare declined to match Ascension’s offer. While national news coverage focused on healthcare labor dynamics, radiology social platforms focused on ThedaCare’s CEO’s previous attempt to force radiology practice members to become hospital employees.
- CTC DL Evidence: A European Radiology study detailed a DL model that effectively differentiated premalignant and benign colorectal polyps in CT colonography scans, while suggesting that CTC models might not require expert polyp segmentation. The researchers used CTCs from 63 patients (w/ 107 polyps) to train DL models with and without polyp segmentation. Against an external test set (59 patients, 77 polyps), the models detected the same number of premalignant nodules, but the DL model trained with segmentations had fewer false positives (sensitivity 80% vs. 80%, specificity 69% vs. 44%). Heatmaps revealed that the models also used the same image regions for decision making.
- VUZE’s FDA: VUZE Medical announced the FDA 510(k) clearance of its VUZE System, which would allow minimally invasive spinal surgery teams to reference CT-based views in the OR. The VUZE System overlays a graphical representation of spinal surgery tools captured with intraoperative 2D X-ray systems onto axial and sagittal views generated from the patient’s preoperative 3D CT scans.
- INSIGHT CXR for Pnx: A new Radiology Journal study showed that Lunit’s INSIGHT CXR solution improved pneumothorax detection in CXRs after patients receive percutaneous transthoracic needle biopsies. A Seoul National University Hospital team analyzed their pneumothorax detection results before and after adopting INSIGHT CXR (676 CXRs w/ both groups), finding that the AI tool achieved higher sensitivity (85.4% vs. 67.1%), negative predictive value (96.8% vs. 91.3%), and accuracy (96.8% vs. 92.3%), while reducing the proportion of patients with pneumothorax who required a drainage catheter (2.4% vs. 5%).
- KPMG Healthcare Survey: KPMG’s 2022 Healthcare and Life Sciences Investment Outlook Survey of 300 industry executives suggests we might be in for another record-setting year of M&A and investments. Over 70% of respondents expect to increase their M&A activity in 2022, while 30% plan on increasing investment activity by 10% or more. The most attractive investment areas for the next 12 to 24 months were telehealth, EHRs, and clinical workflow solutions – all of which can be tied to addressing staffing issues and workflow inefficiencies.
- Imaging’s OOP Impact: A new JACR study highlighted the significant impact that out-of-pocket imaging costs have on some patients. A survey of 671 patients undergoing CT or MRI exams at five different Midwest outpatient imaging centers revealed that 22% experienced financial anxiety due to OOP imaging costs, 35% resorted to financial coping strategies (e.g. reducing other spending or using credit), and 15% didn’t follow their care plan because of imaging costs (e.g. taking less medication or skipping imaging exams).
- Mammography AI Concerns: A growing field of studies suggest that mammography AI can improve cancer detection, but design flaws undermine these results. That’s from a JACR review of 13 external validation studies (77% using commercial AI) that found AI improved accuracy when used as a standalone system (AUC improvement: 0.02-0.13) or when rads have AI support (AUC improvement: 0.028-0.115). However, all of the studies were retrospective, simulated, or both (n = 6, 5, 2), most studies had bias risk or applicability concerns (9 & 9), and only two studies used ground-truth cancer outcomes.
- Medical Device Vulnerabilities: According to a report from security firm Cynerio, 53% of internet-connected hospital devices are vulnerable to cyberattacks. Ultrasound systems, IV pumps, and cardiac monitoring systems were among the most vulnerable devices, as well as any equipment running Linux-based software (unfortunately that’s most medical equipment) since traditional Windows-based cybersecurity is incompatible. Cynerio notes that most vulnerabilities were due to simple problems such as weak default passwords, which are easily fixable if acted upon.
- Fixing England’s Sonographer Shortage: The NHS awarded over £1M to the Universities of Cumbria and Salford to help address North West England’s sonographer shortage. The funding will be used to build upon the universities’ new virtual ultrasound academy, including improving their training facilities, adding new ultrasound training rooms across the region’s hospitals, and creating new educator and clinical coordinator roles.
- Intracranial Aneurysm AI: An EJR study detailed a CTA AI tool that improved less experienced radiologists’ ability to detect intracranial aneurysms, while boosting all radiologists’ efficiency. Using CTAs from 212 patients (179 w/ aneurysms) the AI system had mixed performance as a standalone system (sensitivity 84.9%, specificity 18.2%, accuracy 74.5%), but it allowed junior physicians to rival experienced rads without AI (sensitivity 95% vs. 95%, specificity 48.5% vs. 57.6%, accuracy 87.7% vs. 89.2%). More notably, the tool significantly improved the junior and senior rads’ reporting efficiency (-20.7% to 112 seconds & -18.8% to 92 seconds).
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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.
- Easy access to patient records, reduced inefficiencies and costs, improved collaboration and compliance, and enhanced security. These are just a few of the benefits of Novarad’s enterprise imaging solution detailed right here.
- 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 Fujifilm Healthcare VidiStar users have benefitted from the cardiovascular information system’s flexible SaaS-based model and leveraged its productivity advantages to increase reimbursements.
- 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.
- Discover how Magnolia Regional Health Center started catching more cancers sooner when it adopted Nuance’s PowerScribe Lung Cancer Screening Program and PowerScribe Follow-up Manager.
- The American Medical Association recently added new CPT III codes for quantitative CT tissue characterization, paving the way for more health systems to adopt Nanox AI’s HealthCCSng CAC scoring population health solution.
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