MGH’s Keith Dreyer, DO, PhD at yesterday’s SIIM ACR Data Science Summit.

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

Artificial Intelligence

Burdenless Incidental AI

A team of IBM Watson Health researchers developed an interesting image and text-based AI system that could significantly improve incidental lung nodule detection, without being “overly burdensome” for radiologists. That seems like a clinical and workflow win-win for any incidental AI system, and makes this study worth a deeper look.

Watson Health’s R&D-stage AI system automatically detects potential lung nodules in chest and abdominal CTs, and then analyzes the text in corresponding radiology reports to confirm whether they mention lung nodules. In clinical practice, the system would flag exams with potentially missed nodules for radiologist review.

The researchers used the AI system to analyze 32k CTs sourced from three health systems in the US and UK. They then had radiologists review the 415 studies that the AI system flagged for potentially missed pulmonary nodules, finding that it:

• Caught 100 exams containing at least one missed nodule
• Flagged 315 exams that didn’t feature nodules (false positives)
• Achieved a 24% overall positive predictive value
• Produced just a 1% false positive rate

The AI system’s combined ability to detect missed pulmonology nodules while “minimizing” radiologists’ re-reading labor was enough to make the authors optimistic about this type of AI. They specifically suggested that it could be a valuable addition to Quality Assurance programs, improving patient care while avoiding the healthcare and litigation costs that can come from missed findings.

The Takeaway

Watson Health’s new AI system adds to incidental AI’s growing momentum, joining a number of research and clinical-stage solutions that emerged in the last two years. However, this system’s ability to cross-reference radiology report text and apparent ability to minimize false positives are relatively unique. 

Even if most incidental AI tools aren’t ready for everyday clinical use, and their potential to increase re-read labor might be alarming to some rads, these solutions’ ability to catch earlier stage diseases and minimize the impact of diagnostic “misses” could earn the attention of a wide range of healthcare stakeholders going forward.

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.

Seamless Imaging at SIIM

Catch the Intelerad team at SIIM 2022 this week, where they’ll be participating in panels discussing the cloud, data anonymization, and diversity, equity, and inclusion (including Intelerad’s partners from RADequal – formerly RADxx).

The Wire

• Us2.ai’s CE Mark and Multi-Modal Patent: Us2.ai continued its momentum, achieving its European CE Mark and a U.S. patent for using AI analysis of echo images combined with cardiac biomarkers for heart disease diagnosis. With its CE Mark, the Us2.v1 solution can now automate echo reporting in the US, Canada, Australia, New Zealand, Singapore, the UK, and 32 European countries. That’s quite a commercial presence for a company that was working on these approvals a year ago and just completed its Series A several months ago. It should also provide a major boost for Us2.ai’s ambitious global expansion plans.

• MRI CVD Markers: Analysis from the multigenerational Framingham Heart Study revealed that high thoracic aortic wall area (AWA) and arterial plaque volumes could serve as MRI-based biomarkers for future cardiovascular events. Researchers analyzed baseline MRIs from 1,513 middle-aged adults, finding that higher AWA and plaque were correlated with future CVD events (~13-year hazard ratios: 1.20 & 1.63), with elevated AWA most closely linked to stroke (HR: 1.32) and plaque volume to heart disease (HR: 2.20).

• Surgeon General Takes on Burnout: The U.S. Surgeon General issued a call to collectively address rising healthcare worker burnout and resignations. Dr. Murthy’s burnout recommendations include: (1) involving workers in process and culture improvement initiatives; (2) eliminating punitive policies for seeking mental health care; (3) ensuring sufficient compensation, labor levels, and safety; (4) reducing administrative burdens so workers can focus on patients; (5) prioritizing social connection & community as healthcare system core values; and (6) increasing public health focus on social determinants of health.

• UCLA’s ETT AI: UCLA researchers developed a deep learning model that was able to accurately confirm endotracheal tube (ETT) placement on chest X-rays. Using 512 test CXRs (285 w/ ETTs), the model detected 95% of scans with ETTs and 97% without ETTs, while accurately identifying 86% of scans with correct ETT tip placements. The model’s automatic alerts, which indicate that the ETT was misplaced or not detected, achieved an 83% PPV and 98% NPV.

• Ultrasound-Guided Immunotherapy: MD Anderson researchers developed a new cancer immunotherapy platform, Microbubble-assisted UltraSound-guided Immunotherapy of Cancer (MUSIC), which uses ultrasound to identify tumor location and ultrasonic frequencies to pop microbubbles filled with anticancer immunotransmitters. MUSIC eradicated 60% of tumors in breast cancer mouse models, and when used as a combination therapy with an anti-PD-1 antibody, it helped control primary tumors and decrease disease progression. The combination therapy also increased median survival by 76% compared to either therapy alone. 

• Visage Adds Allina Health: Visage Imaging added Allina Health to its growing list of Visage 7 Enterprise Imaging IDN clients, announcing a 7yr/$28M contract that will replace several PACS brands. Allina Health will deploy Visage 7 and the Visage 7 Workflow module via the public cloud, with initial go-lives targeted for the second half of 2022.

• Ramping Up Radiation Research: The National Academies of Sciences, Engineering, and Medicine proposed significantly more research into the risks of occupational low dose radiation (LDR) exposure, calling for a 15-year study period and a $100M annual budget. This major research project would explore LDR’s role in cancer, cardiovascular disease, neurological disorders, and other disease risks, while better defining the impacts of radiation doses, dose rates, types of radiation, and exposure duration.

• CAC’s Statin Guidance: A new JACC study suggests that CT-based coronary artery calcium (CAC) scores are more effective for guiding statin therapy decisions than risk-based PCE scores (the current standard). The researchers provided physicians with either CAC or PCE scores to assess 540 patients, finding that the physicians were more likely to apply CAC scores to their statin recommendations than PCE scores (88% vs. 75%) and patients in the CAC group were far more likely follow their doctors’ orders after three months (62.2% vs. 42.2%). By the one-year mark, patients in the CAC group had superior statin adherence, lower LDL-C levels, and similar or lower healthcare costs.

• DiA & ScImage: DiA Imaging Analysis announced a partnership with ScImage, combining its LVivo Seamless AI-based cardiac ultrasound analysis system with ScImage’s PICOM365 cloud enterprise imaging platform. LVivo Seamless selects the optimal cardiac ultrasound images and generates clinical indications of left and right ventricle function to aid clinician assessments. The alliance bolsters ScImage’s cardiac ultrasound capabilities, while further expanding DiA Imaging Analysis’ growing list of PACS and ultrasound partners (also: Change Healthcare, GE, Philips, Konica, Terason, SonoScape, Circle CVI, Watson Health).

• Pylarify PSMA Staging Evidence: In a recent Radiology Journal study, PET scans using the Pylarify PSMA radiotracer outperformed conventional imaging techniques (bone scan & CT w/ or w/o multiparametric MRI) for staging intermediate or high-risk prostate cancer. Among the 108 participants, Pylarify PET achieved higher detection rates for nodal (34% vs. 11%) and distant metastasis (22% vs. 10%), while altering staging for 43 men and treatment plans for 24 men (40% & 22%).

• Hospital Margins Decline: Kauffman Hall’s latest National Hospital Flash Report shows that declining new patient visits and rising expenses contributed to the fourth consecutive month of negative hospital margins, which averaged -3.09% in April. System revenues fell 7% following a 5.7% month-over-month decline in patient days, reversing the modest rise in patient volumes recorded in March.

Photon-Counting CT Breakthroughs

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.

The Resource Wire

• 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.

• See how New Jersey’s Ramapo Radiology Associates overcame their CD burning problems and improved their physician and patient experiences with Novarad CryptoChart.

• The Future of Radiology Starts on June 30th. Reserve your spot for AI Visions 2022, featuring live discussions from the top radiology and AI leaders and the global launch of Bayer’s Calantic Digital Solutions AI marketplace.

• See how Us2.ai cuts echocardiography’s manual work, subjectivity, and turnaround times to automate the fight against heart disease.

• When SyntheticMR validated its SyMRI MSK solution, they leveraged the CARPL platform to compare conventional knee and spine MRI image quality with SyntheticMR images. Check out their validation process and results here.

• Learn how Memorial MRI and Diagnostics’ efforts to improve its MRI patient experience impacted its patient referrals, clinical case mix, throughput, and accessibility in this on-demand webinar from United Imaging and AuntMinnie.

• This presentation from Dr. Brian Goldner, MD details UC Davis Sacramento’s experience with Canon’s Ultra High Resolution CT and how it can be applied to cardiothoracic interpretations.

• See how Ochsner Health overcame its CT imaging challenges by leveraging University of Wisconsin’s CT imaging protocols across its fleet of GE Healthcare scanners.

• 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%.

• Check out this editorial by Nuance EVP Peter Durlach on how AI-augmented diagnostic imaging is driving new approaches to collaborative, patient-specific precision care.

• With radiologist workloads growing in volume and complexity, having the wrong PACS can lead to radiologist burnout. This helpful Fujifilm post shows how having the right PACS that functions as a centralized and integrated enterprise imaging system can be part of the solution.

• Change Healthcare’s cloud-native, zero-footprint Stratus Imaging PACS is now live in clinical use. See how Stratus Imaging PACS is helping radiology practices improve productivity and patient care, while eliminating the cost and resource constraints of on-premise systems.