East River Medical’s Timothy Deyer, MD, discussing what it will take for AI products to achieve widespread adoption (minute 59).

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Artificial Intelligence

The Case for Operational AI

A trio of radiologists from Mount Sinai and East River Medical Imaging starred in a recent Aunt Minnie webinar, discussing their paths towards operational AI adoption, and sharing some very relevant takeaways for radiology groups and AI vendors.

The Cast – The Subtle Medical-sponsored webinar featured Mount Sinai’s Amish H. Doshi, MD and Idoia Corcuera-Solano, MD (neuro and MSK subspecialists) and East River Medical Imaging’s Timothy Deyer, MD (CMIO and MSK IR), all of whom were involved in evaluating and adopting Subtle Medical’s SubtleMR deep learning reconstruction solution.

Make it Easy – When discussing their AI evaluation criteria, the panelists placed a major emphasis on ease-of-evaluation and implementation, with one noting that “before even having a conversation” he’d have to be certain these early processes won’t be costly or cumbersome (clear process, no new hardware, minimal IT work, no up-front purchases, etc.). 

Why Operational AI – Much of the discussion focused on why the panelists support operational AI, noting that scan-shortening DLIR solutions like SubtleMR:

• Allow more revenue-generating scans per day
• Alleviate technologist burnout and staffing challenges
• Improve the patient experience (especially pediatric)
• Eliminate re-scans by reducing movement artifacts that occur in long exams
• Don’t require changes to radiologist workflows
• Maintain diagnostic image quality
• Receive less pushback from admins and physicians than diagnostic AI

Evaluating SubtleMR for MSK – Mount Sinai’s MSK SubtleMR evaluation process included comparing standard of care and SubtleMR-enhanced abbreviated MRI exams from 50-consecutive knee MR patients. They found that SubtleMR cut scan times by 50% (13:27 to 6:45), while achieving comparable image quality, artifacts, and diagnostic performance.

Evaluating SubtleMR for Neuro – Mount Sinai’s neuro evaluation process involved comparing SubtleMR and conventional MRI with 10-15 patients for each potential MR sequence. They then reviewed the scans with key stakeholders, worked with the Subtle Medical team to make requested imaging adjustments, and implemented the solution.

SubtleMR Results – SubtleMR’s list of benefits (scan speed, patient experience, patient throughput, revenue) earned it approval from all key stakeholders. Although one panelist noted that some of their radiologists critiqued the enhanced images, the radiologist pushback wasn’t nearly as strong as what they’ve seen in response to diagnostic AI products.

The Takeaway

We cover plenty of editorials about what it takes to drive AI adoption, but feedback from real world AI adopters is still rare, making this webinar particularly useful for AI vendors and adopters. The webinar also states a solid case for SubtleMR and other deep learning reconstruction solutions, even for groups who might not be ready to adopt the kind of “AI” that we usually focus on.

Innovation in Enterprise Imaging

Tune in to this value-packed Intelerad video to see imaging and clinical leaders discuss how they leverage the power of enterprise imaging.

Improving Radiology Accuracy and Scale with Cloud AI

See how AI and the cloud combine to alleviate IT challenges and amplify radiologist performance in this new Arterys white paper.

The Wire

• The e-Stroke Effect: A recent Cerebrovascular Diseases Extra study showed that Brainomix’s e-Stroke brain CT software can allow more and faster reperfusion therapies. Analysis of before and after a large stroke center adopted e-Stroke (n = 399 & 398 patients) revealed that the solution increased thrombolysis and thrombectomy rates (11.5% to 18.1%; 2.8% to 4.8%), while shortening door-to-needle and CT-to-groin puncture times (44 to 42 min; 174 to 145 min). Although the study didn’t show significant evidence of improved therapy outcomes, physicians noted that e-Stroke increased their decision-making confidence and improved patient flow.

• Canon Across America: Canon Medical Systems USA launched its 2022 US Mobile Tour, which will bring Canon’s mobile product showcase directly to hospitals and providers in 50 US cities, culminating in Chicago for RSNA. The mobile showcase will give healthcare providers hands-on access to Canon’s modalities, solutions, and team of experts, while tour highlights will be regularly promoted on Canon’s Tour Across America website. This is Canon Medical’s first mobile tour, and it appears to be one of its higher-profile 2022 initiatives.

• Prostate MRI Disparities: A JAMA Oncology study found that Black patients were less likely than White patients to receive a prostate MRI within 6 months of a prostate cancer diagnosis (6.3% vs 9.9%, n = 39,534 Medicare patients). This diagnostic disparity was largely attributed to geographic differences (24%), neighborhood-level socioeconomic status (19%), racialized residential segregation (19%), and individual-level socioeconomic status (11%).

• PocketHealth’s Report Reader: Image sharing company PocketHealth launched its new Report Reader solution, which helps patients understand complicated terminology in their radiology reports. With Report Reader, patients can tap on words that they don’t understand to view a patient-friendly definition (300 words so far, like “percutaneous” or “unremarkable”). PocketHealth joins the slowly-growing list of imaging vendors working to better inform/engage patients, including dedicated vendors like Scanslated (definitions & diagrams) and adjacent vendors like Visage (PACS-based radiologist video explanations).

• NS-RADS Unveiled: An AJR study detailed a new neuropathy classification and grading system, called The Neuropathy Score Reporting and Data System (NS-RADS), that might improve evaluation of peripheral neuropathies on MRI. The researchers had 11 readers use NS-RADS to classify and grade 100 patients’ nerve imaging studies, correctly identifying final diagnosis in 71% to 88% of cases and miscategorizing just 1.8% of NS-RADS subclasses. 

• Collaboration Live FDA Expansion: Philips’ Collaboration Live tele-ultrasound solution gained an expanded FDA 510(k) clearance, allowing remote diagnostic use via more mobile platforms (now includes: iOS, Android, Chrome, and Windows). Collaboration Live allows Philips EPIQ and Affiniti ultrasound users to talk, text, screen share, and transfer control to remote colleagues in real time.

• CTPA Quality Control AI: A new Radiology Journal study detailed a deep learning algorithm that helps imaging providers improve their CT pulmonary angiography (CTPA) diagnostic quality by automatically identifying suboptimal pulmonary artery (PA) contrast enhancement. The researchers used the DL model to assess PA enhancement in 450 CTPAs, identifying scans with suboptimal PA enhancement (< 250 HU) with high sensitivity and specificity (100% & 99.5%) and high agreements with manual radiologist measurements (r = 0.996).

• United Imaging & Vizient Expand: United Imaging and Vizient expanded their alliance to include X-ray and MRI systems, just a year after Vizient began offering UIH’s CT portfolio. United Imaging has actively expanded its partnerships over the last few years, including a similar alliance with Intalere (now part of Vizient) and channel partnerships with Radon Medical Imaging, Imaging Solutions, and Medimax.

• Breast Cancer Risk Fusion: A Journal of Digital Imaging study detailed a new short-term breast cancer risk model that could improve prediction accuracy by fusing information from craniocaudal and mediolateral-oblique mammography views (CC & MLO). When validated against a 556-patient dataset (278 w/ cancer), the CC+MLO fusion model predicted breast cancer risk with a 0.72 AUC and 11.99 maximum odds ratio, achieving far higher accuracy than a pair of CC and MLO-based models (AUC difference < 0.05; max ORs 8.09 and 5.25). 

• Circle CVI+Thoma Bravo: Circle Cardiovascular Imaging (Circle CVI) landed a growth investment from PE heavyweight, Thoma Bravo, that it will use to expand its cardiac imaging solutions portfolio and drive commercial growth. Circle CVI didn’t disclose terms of the deal, but it could be bigger than most of the AI funding rounds we’ve seen recently given that Circle CVI is relatively large/established (180 employees on LinkedIn, wide clinical adoption) and noting Thoma Bravo’s significant scale.

• Cybersecurity Warning: The US Cybersecurity and Infrastructure Security Agency identified vulnerabilities in PTC’s Axeda agent and Axeda Desktop Server equipment, which means products from several major medical imaging and radiation therapy manufacturers could be at risk of cyberattacks (Accuray, Bayer, Elekta, GE Healthcare, and Varian). The vulnerability could allow bad actors to take full control of the host operating system. PTC isn’t aware of any related cyberattacks, but recommends mitigations such as updating to the software latest version.

• Mach7 + Bialogics: Mach7 Technologies announced an integration partnership with Bialogics, allowing Mach7 users to leverage Bialogics’ business intelligence platform to analyze data/reports stored in their VNA, and use that information to support workflow and process improvement.

Breaking Enterprise Imaging and Reporting Barriers

Generate actionable insights by consolidating your data into one place, organized around the patient with Syngo Carbon.

The Resource Wire

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

• Curious about what’s new at HIMSS22? This Fujifilm post details how HIMSS 2022 revealed interrelated trends towards using a single comprehensive enterprise imaging solution, leveraging cloud services, and AI adoption. 

• We hear a lot about AI being the next big thing or being immature and overhyped. This set of Blackford Analysis editorials reviews the challenges that are still holding back imaging AI, and the areas that AI is delivering genuine clinical benefits.

• See how Nanox AI’s population health solutions are helping health systems and payers to improve the quality and cost of care through early disease detection.

• Us2.ai’s echocardiography analysis automation solution is being integrated into the EchoNous Kosmos ultrasound platform, creating the most powerful diagnostic “power tool” ever created for the hand-carried POCUS market. 

• See how Novarad’s CryptoChart solution allowed Central Ohio Primary Care (COPC, 70 practices, 400 physicians) to make the transition to digital imaging sharing in this Healthcare IT News case study.

• Molecular imaging has played a critical role in oncology for decades, and the development of new radiopharmaceuticals and targeted therapeutics might prove to be crucial for achieving the promise of precision medicine. See how in this thought provoking GE Healthcare post.

• See how Einstein Healthcare Network reduced its syringe expenses, enhanced its syringe loading, and improved its contrast documentation when it upgraded to Bayer Radiology’s MEDRAD Stellant FLEX CT Injection System.

• Midwest Radiology Outpatient Imaging of St. Paul, Minnesota recently became the proud owner of United Imaging’s uMI 550, giving its team and patients a PET/CT system that combines clinical flexibility with digital technology that prevents obsolescence.

• See how Fujifilm Healthcare helped Arkansas Children’s Hospital’s imaging IT infrastructure evolve from departmental silos to an interoperable architecture that improved its radiology and IT teams’ day-to-day flexibility and future scalability.
  
  This Riverain Technologies case study details how Einstein Medical Center adopted ClearRead CT enterprise-wide (all 13 CT scanners) and how the solution allowed Einstein radiologists to identify small nodules faster and more reliably.

• Imaging’s cloud evolution didn’t happen all at once. This Change Healthcare animation details the history of digital imaging architectures, and how cloud-native imaging improves stability and scalability, ease of management, patient data security, and operating costs.

• Join Microsoft and Nuance on March 24th at 2pm ET to learn how they are working together to develop Nuance’s next‑generation, AI‑powered diagnostic imaging platform.