A bold forecast from Penn Medicine’s Dr. Saurabh Jha. He might be right, but we went ahead and published our own 2023 predictions anyway (see below).

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Medical Imaging

Medical Imaging in 2023

Happy New Year, and welcome to the first Imaging Wire of 2023. For those of you getting started on your annual gameplans, here are some potential imaging trends that you might want to consider.

Provider Strain – Many providers limped into 2023 with shaky finances, workforce shortages, and burnout problems, and now they have to navigate an economic downturn. That means they might only be open to “must have” initiatives/technologies that address that list of challenges.

Startup Strain – A market full of strained healthcare providers is generally bad news for medtech startups, especially considering that many of those startups are still in search of their next funding round (from a smaller / more selective group of VCs) or are trying to make their previous rounds last longer than they initially planned.

Paying Down Imaging IT Debt – Southwest’s holiday shutdown prompted many radiology leaders to reevaluate which of their long-delayed tech updates should be now viewed as “must haves” in 2023. These leaders will have a lot to choose from, given how many imaging IT infrastructures are patched together and how many tech initiatives were delayed by COVID.

The Year of AI (again) – There’s a lot of activity in imaging AI and perhaps even more attention, qualifying the AI segment for a wide range of 2023 predictions:

• AI tools will continue to become more comprehensive
• Pharma companies will play a growing role in AI funding and strategies
• AI research will shift towards evaluating commercial tools
• New chatGPT-inspired reporting/communications use cases will emerge
• The AI consolidation wave will peak
• AI adoption will expand among mid-sized hospitals and practices
• Administrative/operational AI solutions will have another big year
• The list of reimbursable AI solutions will continue to expand

Diversified Diagnostics – 2022 brought more imaging informatics players into digital pathology, welcomed ambitious new theranostics efforts, and saw a surge of intriguing multi-omics/olgy studies. Those trends should intensify in 2023, as traditionally separate diagnostic areas slowly converge with imaging technologies and teams.

Non-Imaging Biomarkers – Speaking of which, 2023 will bring more progress towards the development and adoption of imaging-related (or imaging-alternative) biomarker tests, including three brand new biomarker techniques that we covered below in today’s newsletter.

More Home Imaging – Medical imaging will continue its shift beyond hospital walls, as home and outpatient care boom, and mobile and DIY imaging technologies evolve.

United Imaging’s Software for Life

Because of United Imaging’s Software Upgrades for Life program, every time United Imaging launches a new solution it can automatically be installed in every compatible system at no cost.

Us2.ai Matches Experts

What if AI could produce echo measurements that are comparable to expert physicians, but with less variability? That’s exactly what this Nature study revealed about Us2.ai’s solution, finding that its measurements had fewer and smaller differences compared to three human experts than when the experts were compared with each other.

The Wire

• AI Fails the FRCR Exam: AI skeptics enjoyed a recent BMJ study showing that an AI solution would usually fail the Fellowship of the Royal College of Radiologists exam, even after removing “non-interpretable” images. When tested against 10 mock FRCR exams (30 X-rays each, 90% required to pass), AI fell short of 26 radiologists’ accuracy (79.5% vs. 84.8%), sensitivity (83.6% vs. 84.1%), and specificity (75.2% vs. 87.3%), while passing just two exams (vs. four). However, some argued that AI tools designed to support radiologists shouldn’t be tested as autonomous solutions.

• GE Spinoff Complete: A new medtech giant was born yesterday, as GE HealthCare completed its long-awaited spinoff and began trading on the Nasdaq stock exchange (“GEHC”). GE HealthCare emerges as an $18B precision care company operating four key businesses (Imaging, Ultrasound, Patient Care Solutions, and Pharmaceutical Diagnostics) that will be supported by $1B in annual R&D and a 51k-person workforce. It also emerges with a new level of focus that can be hard to achieve when operating as part of a conglomerate (or while executing a spinoff).

• Prostate MRI Positivity: London-based researchers added more evidence supporting MRI’s value for prostate cancer detection and biopsy guidance, showing an incremental relationship between MRI visibility and clinically significant prostate cancer burden. Among 161 men (3,179 Barzell zones), MRI zone visibility was far more likely if the zone contained cancer with Gleason scores of 3+4 or ≥4+3 (odds ratios: 3.1 & 8.7). However, cancer-free prostate zones with prostatic intraepithelial neoplasia were more likely to show MRI false-positives (OR: 3.7).

• ED Diagnostics False Alarm: A WSJ editorial made a solid argument against last month’s U.S. government study that suggested ED diagnostic errors drive a disproportionate share of patient harm. The editorial particularly targeted the study’s estimate that 250k patients die from ED misdiagnoses in the U.S. annually, which was largely extrapolated from a 503-patient Canadian study that included one mortality. As the author noted, “this is not how epidemiology works.” 

• Five Minute PET/CT Melanoma Scans: A new study out of Germany showed that long axial field-of-view (LAFOV) PET/CT scanners can cut whole-body melanoma exam acquisition times down to five minutes (vs. 10min). Researchers analyzed 42 head-to-thigh LAFOV PET/CTs (119 lesions) acquired using Siemens’ Biograph Vision Quadra scanner, finding that its higher sensitivity allowed shorter scan times with comparable lesion detection rates (8min = 97.5%, 6min = 95.0%, 5min = 89.9%)

• More Biomarker Tests: The last week brought three new advancements in imaging-related/alternative biomarker testing, continuing a trend that has been gaining momentum in recent years. UPMC researchers developed an antibody-based blood test to diagnose Alzheimer’s disease, the FDA granted ‘Breakthrough’ status to a blood test for diagnosing inaccessible brain tumors, and Scottish researchers identified a urine metabolite that could lead to liver cancer urine tests.

• Stroke AI’s NHS Impact: The UK NHS highlighted Brainomix e-Stroke solution’s impact on stroke care, finding that facilities using e-Stroke significantly reduced arrival-to-treatment times (140 to 79 minutes) and tripled their ratio of stroke patients who recovered “with no or only slight disability” (16% to 48%). The UK NHSX’s AI in Health and Care Awards funded e-Stroke’s implementation at five English stroke networks since 2020, who have used e-Stroke with 111k patients to detect over 4.5k large vessel occlusions.

• Gesund & Merck: Gesund announced its acceptance into the Merck Digital Sciences Studio (MDSS) program, giving the AI testing/validation company a strategic investment from Merck, plus opportunities to have Merck scientists pilot its MLOps tech. In addition to showing progress for the “picks-and-shovels” side of AI, this alliance is another sign of deepening ties between major pharma companies and imaging AI startups.

• PET/CT MACE-Revasc Risk Scores: Intermountain Healthcare researchers developed an “easy to calculate” and “highly predictive” PET/CT-based cardiac event risk scoring system. After training and validation using 11.5k patients’ PET/CTs, a test with 5k patients’ PET/CTs showed that the Intermountain MACE-Revasc system’s risk scores outperformed ischemic burden for predicting MACE and revascularization at 90-days and one-year (AUCs: 90-day 0.85 vs. 0.83; 1yr 0.80 vs. 0.76). The MACE-Revasc system also predicted events with far higher sensitivity at 90-days and one-year than cardiologist assessments (59% vs. 29%; 48% vs. 21%).

• Polarean XENOVIEW Approved: Polarean announced the FDA approval of its XENOVIEW hyperpolarized MRI contrast agent for the evaluation of lung ventilation (patients ≥12 years), along with the FDA 510(k) clearances for its companion image processing software and MRI coil. Prepared from a Xenon Xe 129 Gas Blend, XENOVIEW is the first inhaled MRI hyperpolarized contrast agent, providing clinicians with lung ventilation regional maps to support disease management.

• MS Vascular Ultrasound Indicators: A JMIRS study suggests that vascular ultrasound could help identify multiple sclerosis patients who have greater risk of future disability, and would benefit from lifestyle changes. The researchers performed extracranial vascular ultrasound on 51 MS patients and 25 controls, finding that MS patients with increased carotid intima-media thickness (an atherosclerosis surrogate marker) and reduced carotid artery blood flow had greater disability risks.

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.”

Democratizing Enterprise Imaging

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.

Lake Medical Imaging’s Subtle Solution

Faced with rising scan volumes and many elderly patients, Lake Medical Imaging implemented Subtle Medical’s Subtle MR efficiency solution across its eight MR scanners, allowing it to scan 40 additional patients per day while maintaining quality of care.

The Resource Wire

• See how Thomas Jefferson University relied on CARPL.ai to accelerate its AI validation and clinical adoption in this presentation by informatics and AI leader, Dr. Paras Lakhani.

• If you’re in the business of using or providing AI, there’s a good chance you spend a lot of time managing AI evaluations. But are your evaluations as efficient or effective as they could be? Check out this Imaging Wire Show with Riverain Technologies CEO, Steve Worrell, detailing the best practices for mitigating AI adoption risks, today and into the future.

• Adopting a platform strategy can simplify the deployment and management of imaging applications and AI algorithms, but there’s a lot to consider. In this eBook, Blackford Analysis and its clients detail how AI platforms can benefit clinical and IT teams, and share guidelines to consider when selecting a platform.

• Check out this first-of-its-kind Imaging Wire Show held on-site at RSNA 2022, with Intelerad leaders Morris Panner and A.J. Watson. We discuss Intelerad’s latest initiatives and acquisitions, its expanding cloud focus, and its strategy heading into 2023, making this a must-watch episode if you’re involved with Intelerad or working on your own enterprise imaging strategy.

• Ready to act today in order to thrive tomorrow? This GE HealthCare report details the three steps that healthcare institutions can take to improve productivity, effectiveness, efficiency, and patient outcomes.

• MRI machines require 7,000 tons of helium every year, with per-machine helium costs of up to $39k annually, but it doesn’t have to be that way. See how the low-field Hyperfine Swoop avoids helium and infrastructure costs, while bringing MR neuroimaging into completely new clinical settings.

• 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.

• When Geisinger Health set a goal to improve access to care, it leveraged Siemens Healthineers’ syngo Virtual Cockpit to ensure that its expert radiologic technologists were accessible to all 11 of its radiology facilities. Hear what Geisinger’s technologists and administrators had to say about how the remote scanning solution allowed them to extend hours and improve patient throughput.

• Bayer’s cloud-based Calantic Digital Solutions AI platform features a suite of disease-specific AI apps that integrate into radiologist workflows, helping radiology teams scale AI deployment and improve efficiency and quality of care.

• Imaging data can come with a big cost or big ROI, and this Enlitic post shows you exactly how unstandardized imaging might be costing your organization.

• 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.

• Deciding between public and private cloud? Watch this brief Change Healthcare animation detailing the operational benefits of public cloud hosting for imaging.