Subtle Medical’s Greg Zaharchuk, MD on efficient imaging’s long and diverse list of upsides.

I’m very happy to share the latest Imaging Wire Show featuring Subtle Medical’s Josh Gurewitz and Greg Zaharchuk, MD, PhD.

Join us for a detailed discussion exploring Subtle Medical’s unique origins, the many benefits of imaging efficiency, Subtle’s continued evolution, and their ambitious vision for the future.

Imaging Wire Sponsors

Arterys  •  Bayer Radiology  •  Blackford Analysis  •  Canon Medical Systems  •  CARPL.ai  •  Change Healthcare  •  Fujifilm Healthcare  •  GE Healthcare  •  Intelerad  •  Novarad  •  Nuance  •  Riverain Technologies  •  Siemens Healthineers  •  United Imaging  •  Us2.ai

Breast Imaging

iSono Health’s Wearable Breast Ultrasound

iSono Health announced the FDA clearance of its ATUSA automated wearable 3D breast ultrasound system, a first-of-its-kind device that taps into some of the biggest trends in imaging.

The wearable ATUSA system automatically captures the entire breast volume, producing standardized/repeatable breast ultrasound exams in two minutes without requiring a trained operator. The scanner combines with iSono’s ATUSA Software Suite to support real-time 2D visualization, advanced 3D visualization and localization, and AI integration (including iSono’s forthcoming AI tools). That positions the ATUSA for a range of interesting use cases:

• Enhancing routine exams in primary care and women’s health clinics
• Expanding breast imaging access in developing countries
• Supporting longitudinal monitoring for higher-risk women
• Allowing remote breast cancer monitoring

iSono might have to overcome some pretty big biases regarding how and where providers believe breast exams are supposed to take place. However, the ATUSA’s intended use cases and value propositions have already been gaining momentum across imaging.

• The rapid expansion of handheld POCUS systems and AI guidance solutions has made ultrasound an everyday tool for far more clinicians than just a few years ago.

• Wearable imaging continues to be an innovation hotspot, including a range of interesting projects that are developing imaging helmets, patches, and even a few other wearable breast ultrasound systems.

• There’s a growing focus on addressing the developing world’s imaging gap with portable imaging systems.

• We’re seeing greater momentum towards technology-enabled enhancements to routine breast exams, including Siemens Healthineers’ recent move to distribute UE LifeSciences’ iBreastExam device (uses vibrations, not imaging).

• At-home imaging is becoming a far more realistic idea, with commercial initiatives from companies like Butterfly and Pulsenmore in place, and earlier-stage efforts from other breast ultrasound startups. 

The Takeaway

iSono Health has a long way to go before it earns an established role in breast cancer pathways. However, the ATUSA’s use cases and value proposition are well aligned with some of imaging’s biggest trends, and there’s still plenty of demand to improve breast imaging access and efficiency across the world.

Einstein & Bayer’s Injection System Upgrade

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.

Working on your organization’s AI strategy?

This Blackford Analysis post outlines the key considerations for creating your AI goals and strategy, including some you might not have considered.

The Wire

• Cedars-Sinai’s Pancreatic Cancer AI: Cedars-Sinai researchers developed an AI-based approach for detecting early signs of pancreatic ductal adenocarcinoma (PDAC) in abdominal CT scans. The researchers used 66 abdominal CTs (22 before diagnosis, 22 after diagnosis, 22 healthy) to train the model to identify PDAC’s unique radiomic features. They then tested it against 42 CTs from an external dataset (14 before diagnosis, 14 after diagnosis, 14 healthy), accurately classifying 86% of the pre-diagnostic and healthy patients (11 of 14 & 13 of 14).

• Imaging Confidence Still Neutral: The AHRA’s Medical Imaging Confidence Index (n = 154; score range: 0-200) revealed that US imaging managers / directors’ expectations remained neutral in Q1 2022, closely matching sentiments from the previous quarter. The imaging leaders’ responses amounted to an “ambivalent” 106 overall score (vs. 108 in Q4 2021), as optimism around scan/IR volume growth (130 vs. 130) and imaging’s role as a profit center (135 vs. 130) were once again offset by low confidence in reimbursements (87 vs. 93), operating cost stability (84 vs. 89), and access to capital (98 vs. 98).

• Aurabox Enters: The imaging sharing segment might gain a new startup competitor, following Aurabox’s $500k Angel round that it will use to fund product development and a private beta, before launching later this year. The Australia-based startup’s image sharing platform (stores all images, supports viewing & sharing) would be offered to doctors via a monthly subscription to support their collaborative care of complex patients.

• Alzheimer’s PET Alternative: The FDA announced its clearance of the Lumipulse Alzheimer’s disease test, which uses cerebral spinal fluid to measure amyloid plaque presence (w/ same-day results), and could reduce the need for PET-based Alzheimer’s assessments. Perhaps most notable to Imaging Wire readers, the FDA announcement seemed to place as much focus on the benefits of eliminating PET as Lumipulse’s own capabilities (time, cost, radiation). That perspective might come into play as the various imaging alternatives in other diagnostic areas like cancer detection or TBI continue to advance.

• Aidoc & Atlantic’s AI Alliance: Aidoc announced an AI platform partnership with Atlantic Health System, following the implementation of its CT-based AI triage solutions across all of the major New Jersey-based network’s medical centers (ICH, PE, c-spine & rib fractures, bowel injury). Aidoc appears to be on a roll in 2022, following similar health system partnerships with Novant Health and WellSpan Health.

• No POCUS Cascade: A new EJR study provided solid evidence that the use of point-of-care ultrasound in the emergency department doesn’t drive significant downstream imaging overutilization. Analysis of 503 POCUS exams performed at a tertiary care center’s ED found that only 77 exams (15.3%) preceded downstream cross-sectional imaging. Most of those downstream scans targeted pathology that wasn’t assessed with POCUS (59.7%), followed by confirming conclusive or inconclusive POCUS findings (27.3% & 9.6%). There may be room to further reduce downstream imaging, as 90.5% of the cross-sectional exams to confirm conclusive POCUS findings agreed with the initial interpretations.

• BodyTom 64 Cleared: Samsung NeuroLogica’s long-awaited BodyTom 64 gained FDA 510(k) clearance, becoming the first commercially-available 64-slice mobile whole-body CT system. Although still somewhat niche, the BodyTom 64 should be a welcomed addition to NeuroLogica’s portfolio, given the 32-slice BodyTom Elite’s established use cases (e.g. multi-dept imaging, image-guided procedures, oncology) and the recent momentum seen in the portable advanced imaging segments.

• Statins Over Aspirin: A new RSNA study confirmed that statins are far more effective than aspirin for maintaining cardiovascular health. The researchers used CCTAs to identify 2,815 participants with nonobstructive CAD and 3,125 without detectable plaque. Over a ~5.7yr follow-up period, the nonobstructive CAD participants who were taking statins at baseline had lower rates of major cardiac events (9.5% vs. 13%), mortality (8.25% vs. 10.8%), and myocardial infarction (4.28% vs. 5.1%) than those not taking statins. Meanwhile, participants taking aspirin had worse outcomes than those not following any therapy (MACE: 14.7% vs. 10.9%; mortality 10.85% vs. 9.59%; MI: 6.2% vs. 4.38%). Neither therapy showed benefits among participants without plaque.

• MR Battery Grant: University of York professor Simon Duckett, landed a £2.2M grant to develop a hyperpolarisation battery that could improve MRI and NMR performance. Professor Duckett and his team will use molecular catalysis to develop the MR battery, which they believe could enhance MR’s ability to analyze chemical systems, leading to future image quality and environmental impact improvements.

• CT Emphysema and Lung Cancer Risk: A recent Radiology Journal study review (21 studies, 107k patients) showed that the presence and severity of emphysema in chest CTs are associated with higher lung cancer risks. Patients with emphysema present in their CTs had a 2.3 odds ratio of being diagnosed with lung cancer, while lung cancer risks became greater with every 1% increase in low attenuation (OR: 1.02). Patients with more severe emphysema findings in visual CT assessments had a far stronger association with cancer risk (ORs: 4.5 w/ “moderate to severe” findings vs. 2.5 w/ “trace” findings), compared to quantitative CT assessments (ORs: 2.5 vs. 1.9). 

• Hospital Financial Challenges: Health systems have lost billions since the beginning of the pandemic, with a new American Hospital Association report showing that 33% of hospitals are currently operating with negative margins. The report attributes the strain to labor shortages and an increased dependence on contracted nursing staff. Travel nurses accounted for a median of 4.7% of total nurse labor expenses in 2019, compared to a median of 38.6% in January 2022.

Canon’s Value-Based PET/CT

Canon’s Cartesion Prime is the only air-cooled digital PET/CT system, which means big reductions in service, chiller, and infrastructure costs. Check out Canon’s case for the air-cooled Cartesion Prime.

The Resource Wire

• Having Trouble Improving Your Radiology Workflow? This Novarad report details how a customizable PACS, high uptime and reliability, and digital image enhancement tools can improve your workflow.

• Clinicians are using the NAEOTOM Alpha to overcome limitations previously thought unavoidable in CT, with ultra-high spatial resolution without dose penalty and detailed spectral imaging without compromises. Get the facts about the technology and the benefits of photon-counting CT.

• This Riverain Technologies case study details how Duke University Medical Center integrated ClearRead CT into its chest CT workflows, reducing read times by 26% and improving nodule detection by 29%.

• After setting ambitious regulatory and commercialization goals, Lunit leveraged CARPL.ai’s platform and operational guidance to complete the clinical trials needed for its INSIGHT CXR and MMG AI tools’ FDA clearances.

• Explore how United Imaging is reinventing the medical imaging business, including downtime rebates, lifetime upgrades, and making sure their customers truly are successful.

• 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.

• Check out this Imaging Wire Show featuring GE Healthcare’s CT and MI Chief Marketing Officer, Sonia Sahney, for an excellent conversation exploring GE’s platform-based approach to solving imaging teams’ scalability challenges.

• Have more echo studies than sonographers? See how Us2.ai was able to classify, segment, and annotate echocardiographic videos with similar accuracy as expert sonographers. 

• Check out this patient case study showing how the Arterys Chest I MSK AI solution helped emergency physicians spot two rib fractures in a shoulder pain exam that might have gone unnoticed.

• Women’s imaging has come a long way, but operational efficiency remains a challenge for many facilities. To help address this challenge, this Fujifilm post details the five questions women’s imaging facilities should ask when evaluating workflow management solutions.

• When Birmingham Radiological Group-GV adopted Nuance PowerScribe One, the practice eliminated 60-75 minutes in daily reporting time and reduced calls to the radiology reading room by 80%. See how in this Nuance Case Study.

• See how Valley Radiology’s decision to make Intelerad IntelePACS its single reading environment helped the independent practice gain control of its growing volumes and rising case complexity, improve its efficiency and radiologist experience, and deliver better patient care.