One Twitter comment on the radiologist undersupply.

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Imaging Centers

RadNet’s Bellwether Briefing

RadNet’s investor briefings have come to serve as a medical imaging industry bellwether, and last week’s Q2 call lived up to that reputation, providing key insights into how RadNet is approaching imaging’s biggest trends (and by proxy, where its hospital partners, competitors, and vendors are also likely focusing).

Here are some of the big takeaways…

Hospital system joint ventures remain core to RadNet’s strategy, as payors’ outpatient emphasis helped RadNet expand hospital JV agreements to 29% of its imaging centers (vs. 25% in 2021). It’s targeting 50% in the next 2-3 years.

RadNet acquired three imaging centers in 2022, but much of its short-term imaging center growth will likely come from the 15 net new locations that are under construction.

A long list of headwinds (reimbursements cuts, labor shortages, access to capital, recession) could lead to greater imaging center market consolidation, and RadNet believes it’s better equipped to take advantage of a downturn than its competitors. 

RadNet forecasts that the tight imaging center labor market is “here to stay” and “needs to be addressed with technology.” Following that advice, RadNet highlighted its efficiency-focused moves to adopt MRI DLIR software, launch a remote MRI technologist management solution, and transition its eRAD PACS to the cloud.

RadNet’s AI strategy remains focused on cancer detection / diagnosis leadership and it still views AI extremely optimistically, although the briefing served as a helpful reminder of how early we are in AI’s evolution:

• Q2 AI revenues reached just $1.5M (that’s including Aidence & Quantib), while heavy investments led to a -$5.9M pre-tax loss for the AI division.

• RadNet is rolling-out its DeepHealth mammography AI solution through Q4 2022 or Q1 2023, calling the implementation’s installation and training requirements a “tall task” (and they developed it…).

• Nonetheless, RadNet is confident that the mammo AI solution will deliver immediate benefits to its team’s accuracy, productivity (up to 15-20%), and imaging center scan volumes.

• RadNet also installed its ` prostate MRI solution at select imaging centers that perform prostate cancer screening, although its overall prostate and lung cancer AI adoption will come later.

The Takeaway

The main takeaway from RadNet’s Q2 call likely depends on your role within imaging. That said, its statements and activities certainly suggest that the major imaging center companies will get larger and more JV-centric, there’s still plenty of reasons to be optimistic about AI (and to be patient with it), and the demand for technologies that solve imaging’s efficiency problems continues to grow.

A Fast and Reliable Second Opinion

See why radiologist Dr. Eleanna Saloura called Arterys’ Lung AI solution “a fast and reliable second opinion” for chest CT lung nodule analysis and tracking, allowing “more accurate diagnostic and treatment decisions.”

COPC Ditches the Disk with Novarad

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.

The Wire

• Qure.ai’s Opportunistic AI Study: A new Qure.ai study highlighted AI’s potential to detect serious incidental findings. The AI startup used its qCT solution to analyze 2,502 chest CTs that were originally performed for COVID assessments, flagging 653 exams for potential lung nodules including 593 cases that didn’t mention nodules in their initial radiology report. Follow-up radiologist reviews identified 115 confirmed nodules that were initially overlooked, including 19 that were potentially malignant and 2 that were likely malignant.

• MPFS’ Rad Practice Impact: Healthcare Administrative Partners published a complete breakdown of how the 2023 MPFS proposed rule changes will impact radiology. Big picture, HAP expects radiology practices’ professional component and global services reimbursements to fall by 7% and 5%, respectively, due to a combination of cuts to the Conversion Factor (-4.4%) and RVUs (-4% & -8% depending on case mix), and changes to Geographic Practice Cost Index (from -12.4% to +7.8% depending on location). HAP provides far more details, so check this report out to understand how these changes might impact your practice.

• ClearPoint Maestro Cleared: ClearPoint Neuro (formerly known as MRI Interventions) announced the FDA clearance of its ClearPoint Maestro Brain Model solution, which is intended to automate the process of identifying, labeling, and quantifying the volume and shape of brain structures visible in MRI images. Now that Maestro Brain Model is cleared as a standalone solution, ClearPoint Neuro will begin its efforts to integrate it into its core ClearPoint Navigation platform for neurological procedures and therapy delivery.

• RAPID Aneurysm Accuracy: A study in Stroke Journal highlighted RapidAI’s RAPID Aneurysm solution’s extremely high accuracy detecting cerebral aneurysms in CTA studies. The researchers applied RAPID Aneurysm to CTAs from 51 patients (w/ 60 aneurysms), achieving 95% sensitivity, 100% specificity, a 100% PPV and 99.7% NPV, 99.7% accuracy.

• SRC Joins SR: Southern Radiology Consultants (SRC) became the latest independent radiology practice to join Strategic Radiology, increasing SR’s consortium to 33 practices and over 1,500 radiologists, while bringing it into the state of Louisiana for the first time. Established in 1951, SCR has become a Baton Rouge local leader, supporting eight of the area’s largest hospitals with its team of 22 subspecialized radiologists.

• UCCs for Low-Acuity C-Spines: A new MGH study suggests that sending patients with low-acuity cervical spine trauma to urgent care centers instead of hospital emergency departments (UCCs & EDs), significantly reduces healthcare costs and rarely leads to follow-up ED visits. Out of 143 patients who received c-spine X-rays at UCCs during a four-month period, only three required referrals to the ED, leading to $3.7k in imaging wRVU savings (versus CTs in the ED) and $146k in overall healthcare savings.

• The Hot Rad Job Market: The radiologist supply/demand imbalance might have hit a new peak this month. In addition to the usual radiologist recruitment posts on LinkedIn, a revealing new Twitter thread confirmed that “everyone” is looking for new rads, vRad just commissioned a recruitment-focused advertorial on radiologybusiness.com, and the ACR job board has its most rad jobs ever. I even received a recruitment postcard from UVA Health, and I’m definitely not a radiologist. It looks like this imbalance will persist, making processes and solutions that improve efficiency or reduce unnecessary imaging even more important.

• Reducing ED CTs: Speaking of reducing unnecessary imaging, a systematic review of 149 studies found that multidisciplinary-led efforts that provide an alternative to CT were most effective at reducing emergency department CT volumes, without compromising patient safety. The review also found that interventions that introduced diagnostic pathways, alternative tests, specialist involvement, and provider feedback also effectively reduced ED CT imaging, while interventions focused on patient/family education, clinical decision support tools, or passively distributing guidelines weren’t effective.

• Mindray’s TE X POCUS: Mindray unveiled its new TE X point of care ultrasound system, highlighted by its unique inclusion of a wireless transducer (can be used w/ TE X system or mobile device), its suite of AI-powered Smart Tools (ventricle strain analysis, echo capture, nerve bundle guidance, LV / EF automation), and its rotating 23.8-inch touchscreen display. The innovative new system appears to be positioned at the top of Mindray’s POCUS lineup, and similarly targets emergency medicine and critical care.

• CTs Before LAAO: New research from Henry Ford Hospital found that using CT scans to plan left atrial appendage occlusion procedures is superior to relying solely on transesophageal echocardiogram imaging guidance. The researchers reviewed 485 Watchman implantation procedures and found that clinicians who used CTs for additional preprocedural planning had a higher implantation success rate (98.5% vs. 94.9%), operated for a shorter amount of time (median of 45.5 mins vs. 51 mins), and were less likely to change Watchman device sizes (5.6% versus 12.1%). 

• Breakthrough Devices: FDA breakthrough device designations looked poised for another record year, with 129 devices earning the designation through the midpoint of 2022. Devices are eligible for the designation if they have the potential to be “more effective” treatments to life-threatening conditions, and this year’s current velocity puts BDDs on pace to surpass last year’s record of 206 designations as more companies seek an expedited review pathway for full clearance (plus a healthy dose of perceived superiority).

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The Resource Wire

• See how Enlitic’s mission to create time for radiologists led to its shift from point solutions towards enterprise-level solutions that are fundamental to workflow.

• See how adopting ClearRead CT allowed Michigan’s Regional Medical Imaging’s radiologists to complete their chest CT reads faster and more accurately in this Riverain Technologies case study.

• Nuclear medicine teams are facing three significant SPECT/CT challenges: balancing dose with image optimization, addressing staffing constraints, and preparing for continued theranostics advances. See how redefining your SPECT/CT standards can address these challenges in this Siemens Healthineers report.

• The flow of new AI applications makes it hard for radiology groups to determine which tools would help them and how IT teams can handle increased AI adoption. In this Blackford Analysis white paper, radiology and IT leaders from NYU and Canopy Partners share how a platform approach alongside a curated marketplace can help solve these challenges.

• Patients are ready for (and expecting) their healthcare to be supported by AI, and its gaining traction in radiology. See how AI is delivering clinical value today and in the future, in this editorial by Intelerad’s Morris Panner.

• 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.

• Digitization and AI are an era-defining reality for radiology, and GE Healthcare is rising to the challenge by creating tools to build a world that works better for healthcare. Check out this report detailing GE’s digitization and AI innovations and its vision for precision medicine.

• Hyperfine’s Swoop Portable MR Imaging System might look like hardware, but its deep learning-based image reconstruction pipeline is what makes the MRI’s point-of-care performance possible. See how Hyperfine’s reconstruction technology improves image quality, while allowing advanced gridding and denoising.

• Precision medicine startup BAMF Health just installed United Imaging’s uEXPLORER scanner, making it the first total-body PET/CT used for theranostics in the US. See how this combination will allow BAMF Health to deliver more effective and efficient theranostics treatments.

• See how cloud-native imaging avoids traditional software’s resource utilization constraints and eliminates unexpected disruptions in this Change Healthcare animation.

• See how Canon Medical’s AiCE image reconstruction solution allows Cartesion Prime digital PET/CT users to further improve image quality and reduce scan times.

• 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.