The immortal Dr. Saurabh Jha’s opening line at last week’s AI After Dark event.

Imaging Wire Sponsors

annalise.ai  •  Arterys  •  Bayer  •  Blackford  •  Canon Medical  •  CARPL.ai  •  Change Healthcare  •  Enlitic  •  GE Healthcare  •  Hyperfine  •  Intelerad  •  Novarad  •  Riverain Technologies  •  Siemens Healthineers  •  United Imaging  •  Us2.ai

Medical Imaging

The Imaging Wire’s RSNA 2022 Reflections

RSNA 2022 is officially a wrap. We hope you had a blast if you made it, and had a great week if you stayed home. We also hope you enjoy our recap of radiology’s most important event in at least three years.

Crowds & Conversations – RSNA’s attendance and overall energy continued to trend upward, as most of the 31k people on-site were super engaged and truly excited to be there. Although attendance was still well below RSNA 2019 (~49k on-site), it was a big jump from last year (~23k on-site), and infinitely better than 2020’s virtual RSNA.

Much Rad Love – If you had “I’m not a radiologist but…” on your RSNA bingo card you’d be in a good spot, because the exhibit hall was full of non-rads talking about how to help radiology teams be more effective and more satisfied.

Focus on Productivity – Perhaps due to all that vendor empathy, just about every new product (hardware and software) focused on eliminating steps / clicks / interruptions, improving workflow integration, alleviating burnout and labor challenges, and better matching diagnostic processes.

Getting Cloudy – There’s no debate that imaging’s shift to the cloud was one of RSNA’s top trends, as informatics vendors continued to strengthen their cloud capabilities and expand their list of cloud-based customers (especially if you include hybrid). There were, however, plenty of debates about who’s cloud tech is truly native and who’s aren’t.

AI’s Two Sides – It seems like many folks are still in AI’s “trough of disillusionment,” as conversations often drifted towards problems with AI’s performance, use cases, funding climate, and provider ROI. However, AI adoption has never been wider, AI products have never worked better, and there are plenty of AI trends to be excited about…

• AI is becoming less narrow
• AI workflow integration keeps getting better
• More radiologists are interested in AI
• There’s solid traction with operational and efficiency AI
• We’re not talking about AI replacing radiologists (as much)

Modality Progress – Although there were only a handful of completely new scanners at RSNA, the major OEMs showed continued advancements in MR (image quality, low-helium, low-field, reconstruction, coils) and CT (spectral, photon-counting, upgradability), while nearly all scanners took big strides in operator efficiency.

The Takeaway

Radiology faces plenty of challenges, but it’s populated by some of the smartest people in medicine/medtech who are working hard to solve those challenges. Hats off to the RSNA team for getting all the smart people together every year to push those solutions forward.

Purpose-Built for the Cloud

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.

Lunit’s Case for CARPL.ai

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.

The Wire

• Pediatric Deprioritization: Most imaging AI solutions are only cleared for adult patients, and it appears that these adult AI solutions can inadvertently cause pediatric treatment delays. At least three hospitals and practices have revealed situations where ICH and LVO triage solutions prioritized adult cases (as intended), but because rads didn’t realize that the AI tools only flag adult patients, urgent pediatric cases were missed or delayed. The ACR Pediatrics AI Workgroup is calling for awareness, policy, and product changes to ensure that adult AI adoption doesn’t come at the expense of pediatric care.

• Canon Healthcare USA: Canon Inc. announced the formation of its Canon Healthcare USA subsidiary, which will drive Canon’s North American strategy, and play a central role in its ambitions to become the US and global medical imaging leader. Equipped with up to $300M in funding and targeting a Cleveland home base, the Canon Healthcare USA team will work to better understand the American market, expand Canon’s joint research collaborations, and play a major role in Canon’s future strategy.

• Riverain & Thynk Health’s Lung Cancer Alliance: Riverain Technologies and Thynk Health will combine their technologies to create an end-to-end lung cancer screening and pulmonary nodule management solution. Thynk Health analyzes health system data to identify patients with incidental findings or higher lung cancer risks, then automates lung cancer screening follow-up processes. Riverain’s ClearRead solutions give radiologists an unobstructed view into these patients’ imaging exams to improve nodule detection and characterization.

• Photon Counting CT’s Post-Covid Advantage: A new Radiology study showed that photon counting CT (PCD CT) outperforms energy-integrating CT (EID CT) for assessing post-COVID-19 lung abnormalities. Among 20 adults with persistent COVID symptoms who underwent same-day PCD and EID CT exams, PCD CT found abnormalities in ten participants that were missed by EID CT, while producing higher image quality (1 on a -2 to 2 Likert scale) and lung signal-to-noise ratio (mean SNR difference: 0.53). 

• Google’s AI Alliances: Google Health’s AI strategy took an interesting new step, following technology licensing agreements with iCAD and Aidence. iCAD will leverage Google’s breast cancer detection and risk assessment AI to enhance its own mammography AI products, while Aidence will use Google’s CT-based lung nodule malignancy AI to develop and commercialize a new lung cancer risk solution. Google has been arguably the most active AI developer among the imaging hyperscalers, and these alliances seem to answer any questions about what Google planned to do with all those AI projects.

• No Post-Mastectomy Surveillance: A new JAMA meta-analysis suggests that post-mastectomy imaging surveillance is “unnecessary.” Researchers analyzed data from 16 studies, finding that overall post-mastectomy cancer detection rates were lower than BI-RADS benchmarks for all modalities (mammography, ultrasound, MRI). Clinically occult (nonpalpable) cancer detection rates were significantly lower than overall cancer detection rates, including patients who underwent reconstruction (1.06 vs. 4.73 per 1k exams) and patients who underwent mastectomy without reconstruction (2.96 vs. 6.41).

• Siemens & Atrium’s Value Partnership: Siemens Healthineers and Atrium Health announced a massive multi-year value partnership that will include more than $140M in Siemens equipment (imaging, radiation oncology, endovascular robotics), and will focus on imaging technologist workforce development, improving access across Atrium’s southeast US network, and deeper clinical collaborations. Siemens and Atrium worked together previously, but this deal significantly expands the size and scope of their partnership.

• Viz.ai Doubles Down on Radiology: Viz.ai solidified its radiology positioning with the launch of its Viz Radiology Suite and Radiology Advisory Board. The Viz Radiology Suite integrates Viz.ai’s range of imaging AI and care coordination solutions into radiology PACS workflows, helping radiologists address urgent cases and connect with care teams. Meanwhile, the Radiology Advisory Board will support Viz.ai’s radiology strategy and R&D. Although Viz.ai got its start with neuro interventionalists / surgeons, recent announcements and messaging has made Viz.ai’s commitment to radiology abundantly clear.

• Altered Mental Status CT Overuse: A JAMA meta-analysis found that use of head CTs in patients with acute-onset atraumatic altered mental status (AMS) is “exceedingly high.” Researchers reviewed 25 studies (w/ 79k patients), finding that 94% of patients with AMS received a noncontrast head CT, and only 11% of those patients had positive findings. The rate of positive findings was highest in the ED (17%) and lowest in inpatient settings (3%).

• Nuance’s AI Expansion: Nuance announced a trio of new AI alliances that expand its Precision Imaging Network (PIN) and enhance its clinical analytics capabilities. Annalise.ai was the highlight of Nuance’s AI announcements, as the high-buzz comprehensive AI startup joined both the PIN and Nuance’s mPower Clinical Analytics platform (combines pixel AI and NLP to improve imaging team performance). Nuance also made Densitas’ mammography AI tools (density, risk, image quality) and Perspectum’s quantitative multiparametric MR solutions available to its PIN-connected healthcare facilities.

• Rad AI Acquires Equium: Two of the biggest players in operational radiology AI are joining forces, following Rad AI’s acquisition of Equium Intelligence. The acquisition adds Equium’s resource optimization and exam scheduling solutions to RAD AI’s portfolio, which previously focused on reporting and incidental follow-up automation. However, RAD AI placed just as much emphasis on how the Equium team (including Bill Boonn and Woojin Kim) will impact its future strategy and product development.

• Siemens’ New Mobile MR: Siemens Healthineers continued its MRI lineup update, unveiling its new Magnetom Viato.mobile 1.5T scanner at RSNA (FDA pending). The Magnetom Viato.mobile features Siemens’ latest MR technology, can be set up in a mobile facility (coach), brought to any location, and operated and serviced remotely. The Magnetom Viato.Mobile was unveiled just a few weeks after the Magnetom Cima.X 3T and Magnetom Terra.X 7T MRIs, and continues what appears to be Siemens’ high-field MR refresh.

BSW and QEHB’s Symbia Pro.specta Upgrades

Learn why Texas’ Baylor Scott & White Medical Center and the UK’s Queen Elizabeth Hospital Birmingham decided to upgrade their SPECT-only cameras and first-generation SPECT/CTs to Siemens Healthineers’ Symbia Pro.specta SPECT/CT and how they’ve benefited since then.

Riverain and the VA’s Precision Alliance

When the VA adopts your technology nationwide, you know you’ve been making an impact. That’s exactly what’s happening with Riverain Technologies’ ClearRead CT, which will be implemented across the VA Lung Precision Oncology Program (22 hub and 87 spoke locations).

The Resource Wire

• Enterprise imaging is mainly adopted in the largest hospitals, but that doesn’t have to be the case. Check out this Imaging Wire Show featuring Novarad product leader Dave GrandPre, where we discuss what’s caused this divide and why smaller hospitals should adopt enterprise imaging.

• Can you tell which of these images are from a 3T MRI and which are from a 1.5T scanner and enhanced with Canon’s AiCE Deep Learning Reconstruction? Take the AiCE Challenge to find out.

• What if your X-ray system could help you do more by doing less? See how GE’s AI-based X-ray workflow automations can reduce your repeat and rejected exams, while improving image quality, consistency, and productivity. 

• We may be entering a third wave of imaging AI’s rapid evolution, that brings a shift from narrow point solutions to comprehensive multi-finding AI systems. Join this discussion with annalise.ai Chief Medical Officer, Rick Abramson, MD, exploring how this transition could take place, how radiologist and VC perspectives on AI are changing, and how AI might continue to evolve in the future.

• See how Enlitic’s Curie|ENDEX application transforms imaging data to a consistent, clinically relevant standard nomenclature, so radiology and AI workflows work the way they’re supposed to.

• Intelerad just launched its Intelerad Cloud suite of imaging solutions, marking the culmination of over four years of cloud investments and acquisitions. The new Intelerad Cloud allows imaging organizations to adopt a variety of hybrid, public, or private cloud solutions based on their specific needs (including: PACS, VNA, image exchange storage, long-term archiving, disaster recovery, patient portal).

• Relive RSNA 2022 with this Imaging Wire Show, featuring Bayer Radiology’s Barbara Ruhland. We reflect on radiology’s major themes and trends since the last RSNA, how they affected this year’s conversations, and how Bayer is supporting imaging teams’ changing needs.

• Check out our Cardiac Wire publication’s latest Q&A with Us2.ai president and co-founder, Yoran Hummel, discussing how his career as a sonographer led him to echo AI, and how Us2.ai’s upcoming automated strain analysis feature brings the company even closer to democratizing echo.

• When this 66 year-old woman was referred for pain and functional impotence of the wrist, her initial X-ray images were normal. However, Arterys’ Chest I MSK AI detected a fracture on the dorsal side of her cortical bone, alerting the radiologist and confirming her injury.

• Fast. Flexible. Modern. United Imaging’s service organization is called Customer Success for a reason. Their mission is to think ahead, understand their customers’ goals and proactively help customers achieve them. They also store critical service parts in the U.S. and back up their promises with the United Performance Guarantee.

• Check out this Blackford Analysis white paper detailing how children’s hospital imaging teams can leverage AI to improve modality throughput and imaging device availability.

• With rising patient acuity rates creating “unsustainable financial challenges,” health systems are looking for innovative ways to increase critical care throughput. A growing number of health systems are achieving this goal with the Hyperfine Swoop point-of-care MRI, which can eliminate risks associated with intrahospital transport and keeps more critical care team members in the ICU.