Scott Dulchavsky, MD suggesting that AI improvements and falling costs might make ultrasound a device “everyone” uses.

Imaging Wire Sponsors

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

Cardiac Imaging

Echo AI Coronary Artery Calcium Scoring

A Cedars-Sinai-led team developed an echocardiography AI model that was able to accurately assess coronary artery calcium buildup, potentially revealing a safer, more economical, and more accessible approach to CAC scoring.

The researchers used 1,635 Cedars-Sinai patients’ transthoracic echocardiogram (TTE) videos paired with their CT-based Agatston CAC scores to train an AI model to predict patients’ CAC scores based on their PLAX view TTE videos. 

When tested against Cedars-Sinai TTEs that weren’t used for AI training, the TTE CAC AI model detected…

• Zero CAC patients with “high discriminatory abilities” (AUC: 0.81)
• Intermediate patients “modestly well” (≥200 scores; AUC: 0.75)
• High CAC patients “modestly well” (≥400 scores; AUC: 0.74)

When validated against 92 TTEs from an external Stanford dataset, the AI model similarly predicted which patients had zero and high CAC scores (AUCs: 0.75 & 0.85).

More importantly, the TTE AI CAC scores accurately predicted the patients’ future risks. TTE CAC scores predicted one-year mortality similarly to CT CAC scores, and they even improved overall prediction of low-risk patients by downgrading patients who had high CT CAC scores and zero TTE CAC scores.

The Takeaway

CT-based CAC scoring is widely accepted, but it isn’t accessible to many patients, and concerns about its safety and value (cost, radiation, incidentals) have kept the USPSTF from formally recommending it for coronary artery disease surveillance. We’d need a lot more research and AI development efforts, but if TTE CAC AI solutions like this prove to be reliable, it could make CAC scoring far more accessible and potentially even more accepted.

Anonymization & Deidentification Done Right

Proper patient data anonymization and deidentification is a must, but it can be challenging to do while still retaining clinical relevance. Join Enlitic and a panel of data anonymization experts on Tuesday, January 31 (tomorrow) for an interactive discussion about how to do anonymization and deidentification the right way, plus a sneak peek into Enlitic’s upcoming anonymization product, Curie|ENCOG.

Meaningful Innovation in 4D CT

If you’re ready to get more from your interventional suite, tune in to this Imaging Wire Show featuring Canon Medical Systems’ vascular leader, Bill Newsom, exploring the meaningful innovation that went into Canon’s 4D CT technology.

The Wire

• Could Ultrasound Replace the Stethoscope? The New Yorker revived the “handheld ultrasound will replace the stethoscope” storyline, detailing how technological and clinical advancements are bringing ultrasounds into new settings, potentially at the expense of the iconic stethoscope. The author noted handheld ultrasounds’ growing list of advantages (small, low-cost, no radiation, accurate, flexible, point-of-care accessible), while suggesting that recent progress in training, adoption, AI assistance, and telemedicine could make it a go-to device for a broad range of clinical settings – including in some patients’ homes.

• Bayer Ultravist’s EU CEM Approval: Bayer’s Ultravist iodine-based contrast agent (300 & 370 mg) is now approved in the EU for use in contrast-enhanced mammography, supporting lesion detection and evaluation as an adjunct to mammography or as an alternative when MRI is contraindicated or unavailable. Now that Ultravist has been approved for CE-mammography at the EU-level, country-specific approvals are expected during Q1 2023.

• Transforming Inflammation Imaging: After discovering that the investigative LW223 PET radiotracer could “transform” our ability to image and understand tissue inflammation, a team of Scottish researchers secured £2M in funding to begin testing the tracer on humans. LW223 is the first radiotracer that’s unaffected by the rs6971 polymorphism genetic mutation that limits inflammation imaging to just 40% of the population. The first LW223 trial will measure inflation in patients who’ve had a heart attack and healthy controls.  

• Radon’s Private Equity Expansion: Major mid-Atlantic U.S. imaging systems dealer Radon Medical Imaging took on a private equity investment from 5th Century Partners to fund its geographic and portfolio expansions. Radon is off to a fast start with that strategy, acquiring Georgia-based imaging sales and service company Premier Imaging Medical Systems. It appears that imaging dealer M&A might be heating up across the Eastern U.S., noting that Prestige Medical Imaging took on PE funding in 2021 and has since acquired two competitors.

• CMRI’s Dark-Paps Marker: A team of Italian researchers discovered a new cardiac MRI marker, called Dark-Paps (dark papillary muscles), that can help detect higher-risk patients with ventricular arrhythmias and LV preserved ejection fraction. After testing various LV papillary muscle features, they found that patients with end-systolic signal hypointensity of both papillary muscles in early post-contrast cine CMR images (aka Dark-Paps) had higher cardiac event risks over seven years (p < 0.0001). Adding Dark-Paps also improved the performance of other predictive models based on late gadolinium enhancement and non-sustained ventricular tachycardia.

• Quantum Recoil Breakthrough: Singapore-based researchers proved that the “quantum recoil” phenomenon is possible, over 80 years after it was first theorized, potentially leading to more precise X-ray imaging. The paper does a good job explaining the science behind the “quantum recoil” phenomenon. However, the more notable takeaway for most TIW readers is that this discovery could pave the way for smaller, lower-cost, more accurate, and more customizable X-ray systems used for both healthcare and manufacturing applications.

• Blackford & Brainomix Stroke AI Alliance: Blackford further expanded its stroke AI portfolio, adding Brainomix’s e-Stroke solutions. Brainomix’s CE-marked e-Stroke AI tools analyze non-contrast or contrast enhanced CTs to identify signs of stroke and cut treatment times.

• Ransomware Attacks Double: Ransomware attacks on US healthcare delivery organizations more than doubled from 2016 to 2021, climbing from 43 to 91 breaches per year. A University of Minnesota-led study identified 374 attacks that exposed 42M patients’ personal health information (that’s over 10% of the US population). Although only 15.8% of breaches resulted in health information making its way to the dark web, the authors “strongly suspect underreporting for basically everything.”

• Dementia Classification MRI AI: Team of German researchers developed a series of brain MRI AI models that accurately differentiated seven different dementia syndromes from healthy controls using atrophy patterns. The researchers applied the AI models to 477 patients’ T1-weighted brain MRIs (51 healthy controls), achieving promising accuracy for binary classification (71% to 95%; vs. 50% “chance level”), while their multi-syndrome model achieved 47% accuracy (low, but 3-times 14% “chance level”).

• Mammography Budget Boost: A new IMV Medical survey revealed that U.S. mammography departments expect their budgets to increase by 9.7% annually from 2023 to 2025 (vs. -17% in 2022), with 36% of sites considering adding a new system in the next three years. That demand is helped by rising mammography exam volumes, as the COVID pandemic suppressed volumes at just 21% of sites in 2022, down from 65% of sites in 2020.

Annalise CXR In Action

annalise.ai’s Annalise CXR solution detects up to 124 findings in a single chest X-ray. See how it detects such a wide range of abnormalities using these demo studies…  or upload your own CXR images.

Bedside MRI’s ICH Impact

A recent Nature paper detailed how Yale’s successful deployment of Hyperfine’s Swoop portable MRI allowed “for a reversal in the clinical paradigm,” while achieving accurate ICH detection and demonstrating its ease-of-use in ICU environments. Explore the study’s other key takeaways and next steps in this Hyperfine summary.

The Resource Wire

• 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

• Learn how Salem Regional Medical Center improved its radiology workflows and cut service and syringe expenses after adopting Bayer’s MEDRAD Stellant FLEX system.

• 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.

• Do your patients text more than they use CDs? Find out how Novarad’s CryptoChart simplifies image access, combining secure QR codes and text and email communications to help providers and patients ditch the disk.

• When Middlesex Health set out to adopt imaging AI, the Connecticut-based community hospital made the unique decision to start with non-interpretive AI solutions. See how that decision led them to Subtle Medical, and the impact it had with all of the hospital’s imaging stakeholders.

• With ongoing radiologist shortages and higher rates of burnout, there’s a great need for fast, effective, efficient medical imaging technologies – and those factors are driving medical imaging biggest trends detailed in this Arterys report.

• Check out this Imaging Wire Show featuring Us2.ai’s co-founders – James Hare and Dr. Carolyn Lam – for a great discussion about Us2.ai’s continued clinical and commercial expansion, and their efforts to improve echocardiography accuracy, efficiency, and accessibility.

• 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.

• 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.

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

• 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.

• 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. 

• The number of patients eligible for low-dose CT lung cancer screening has expanded, and so has the need to reach at-risk patients closer to where they live. That’s why Siemens Healthineers’ Mobile Lung Screening Solution combines the quality, ease of use, and flexibility needed to create a program that meets the real-life needs of your community.