Norwegian public health director, Bjørn Egil Vikse, after learning that Unilabs Norway has been offshoring radiology reporting to Romania since 2016.

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Cardiac Imaging

Creating A Novice Echo Screening Pathway

We hear a lot about AI’s potential to expand ultrasound to far more users and clinical settings, and a new study out of Singapore suggests that ultrasound’s AI-driven expansion might go far beyond what many of us had in mind.

The PANES-HF trial set up a home-based echo heart failure screening program that equipped a team of complete novices (no experience with echo, or in healthcare) with EchoNous’s AI-guided handheld ultrasound system and Us2.ai’s AI-automated echo analysis and reporting solution.

After just two weeks of training, the novices performed at-home echocardiography exams on 100 patients with suspected heart failure, completing the studies in an average of 11.5 minutes per patient.

When compared to the same 100 patients’ NT-proBNP blood test results and reference standard echo exams (expert sonographers, cart-based echo systems, and cardiologist interpretations), the novice echo AI pathway…

• Yielded interpretable results in 96 patients 
• Improved risk prediction accuracy versus NT-proBNP by 30% 
• Detected abnormal LVEF <50% scans with an 0.880 AUC (vs. NT-proBNP’s 0.651-0.690 AUCs)
• Achieved good agreement with expert clinicians for LVEF<50% detection (k=0.742)

These findings were strong enough for the authors to suggest that emerging ultrasound and AI technologies will enable healthcare organizations to create completely new heart failure pathways. That might start with task-shifting from cardiologists to primary care, but could extend to novice-performed exams and home-based care.

The Takeaway

Considering the rising prevalence of heart failure, the recent advances in HF treatments, and the continued sonographer shortage, there’s clearly a need for more accessible and efficient echo pathways — and this study is arguably the strongest evidence that AI might be at the center of those new pathways.

Data Standardization’s Cascading Benefits

The benefits of imaging data standardization might seem obvious, but its downstream impact might be greater than you might think. Enlitic explores imaging standardization’s cascading benefits, starting with workflow and reading efficiencies, and leading to diagnostic, billing,  interoperability, research, and data monetization improvements.

Leveraging Pediatric Imaging AI

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.

The Wire

• Unilabs’ Norwegian Offshoring Scandal: The Norwegian branch of major European diagnostic company Unilabs is facing scrutiny for offshoring 170k radiology interpretations and reports to a Romanian group since 2016, even though local laws require Norway-authorized physicians to interpret and sign-off on these exams. Unilabs Norway has already canceled its agreement with the Romanian clinic, and emphasizes that it hasn’t identified any errors with these cases.

• PocketHealth and SIH Ditch the Disk: Southern Illinois Healthcare (SIH, four hospitals, 30 outpatient centers) took a big step towards eliminating CD-based image sharing after launching its partnership with PocketHealth. SIH patients can now instantly access and share their imaging from any device, and leverage PocketHealth’s Report Reader to better understand their reports, while allowing their providers to view or import all imaging without adding software or setting up an account.

• Mammography Radiomics for Phyllodes Tumors: A Clinical Radiology study showed that mammography radiomics could be used to predict phyllodes tumor (PT) malignancy risk. The researchers used mammography exams from 75 patients (36 w/ borderline or malignant PTs) to train and test a radiomics model, detecting malignant PTs with an 0.879 AUC, 91.7% sensitivity, and 81.8% specificity in the validation dataset. Notably, the researchers were unable to differentiate benign and borderline/malignant PTs using the same patients’ mammography, ultrasound, and histogram features.

• Riverain Joins TeraRecon Platform: TeraRecon announced the addition of Riverain Technologies’ ClearRead CT solution to its Eureka Clinical AI platform, giving TeraRecon users access to Riverain’s well-established Clear Visual Intelligence vessel suppression technology for chest CT exams. The alliance adds to Riverain’s comprehensive list of channel partners (Blackford, Canon, Fujifilm, GE, Nuance, Sectra, Siemens, Visage.. and more), while continuing TeraRecon’s recent AI partner expansion.

• Novice RHD Echo Screening: A new JASE study showed how echocardiography-based rheumatic heart disease (RHD) screening could expand to healthcare settings that don’t staff sonographers. The researchers had novice practitioners perform handheld echo exams on 3,329 at-risk participants (4% w/ borderline or definite RHD), finding that relying on non-experts to perform the echos and offsite experts to review the exams achieved slightly higher sensitivity (88.4% vs. 86.5%) and much higher specificity (77.1% vs. 61.4%) than relying on non-experts for both steps.

• Hyperfine’s CE Mark: Hyperfine’s Swoop portable MRI system just landed CE Mark approval under Europe’s stringent new MDR guidelines. Although Hyperfine will continue to focus on the U.S. in 2023, the Swoop’s CE Mark opens the door for future commercial expansion into the European Economic Area, while bolstering the innovative point-of-care MRI’s regulatory resume.

• High-Res Photon Counting CTA’s Stenosis Advantage: A new EJR study highlighted ultra-high resolution Photon Counting CTA’s (UHR-PCD) advantages versus standard resolution exams for coronary stenosis evaluations. When used with two vessel phantoms, UHR-PCD outperformed standard resolution exams across all heart rate levels, producing more accurate percent diameter stenosis measurements and decreasing blooming artifacts.

• BWH Adopts Us2.ai: Brigham and Women’s Hospital is adopting Us2.ai’s echocardiography AI software, with the goal of improving the speed and scalability of its Cardiac Imaging Core Laboratory’s echo-related research projects. BWH cited its previous research showing that Us2.ai’s echo measurements are comparable to those from human sonographers, while suggesting that Us2.ai’s ability to reduce echo interpretations from 30 minutes to under 2 minutes will allow the lab to “get novel therapies to patients faster.”

• Qure.ai’s CE MDR: Qure.ai announced the CE Mark MDR class IIb recertification of its AI portfolio, including its solutions for chest CT, head CT, CXR, and MSK X-ray analysis. Europe’s MDR certification program launched in 2021, requiring AI products to attain higher risk classifications (IIa, IIb, or III… no longer class I), and setting a 2024 recertification deadline for existing products. However, recertification has proven difficult for many AI companies.

• Gadolinium Kidney Deposits: University of New Mexico researchers found that Gadolinium nanoparticles from MRI contrast can be deposited in kidney cells. The researchers examined kidney tissue samples from five patients who were previously exposed to MRI GBCAs and samples from five control patients, finding that all five previously-exposed patients had gadolinium deposits in their kidneys. Mice exposed to GBCA contrast agents also had gadolinium deposited in their kidney tissue.

• Avicenna.AI Adds Incidental PE: Avicenna.AI launched its new CINA-iPE incidental pulmonary embolism detection solution. The CT-based and CE Marked solution is the first product from Avicenna.AI’s new “CINA Incidental” AI suite, which will be offered alongside its established AI tools for neurovascular and thoraco-abdominal emergencies. Avicenna.AI joins a relatively small list of AI vendors with incidental-targeted solutions, which also includes companies like Aidoc (who also has an iPE tool) and Nanox AI (CAC scores and osteoporosis).

Building a Mobile Lung Cancer CT Screening Program

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.

Green Imaging Optimizes with SubtleMR

When faced with deciding whether to upgrade its two aging 1.5T MRIs, Green Imaging instead boosted its MR efficiency with Subtle Medical’s SubtleMR solution, quickly increasing its daily exams by 57% without having to buy a new $1M-plus magnet. See why Green Imaging’s CEO called SubtleMR a “game-changer.”

The Resource Wire

• Curious how certain your AI is about its own finding? annalise.ai’s confidence bar displays the likelihood of each finding and the AI model’s level of certainty, helping clinicians perform their interpretations with greater confidence.

• 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.

• 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.

• 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.

• Efficiency and quality are the name of the game at RadNet, and that’s exactly what the imaging center giant achieved when it adopted Subtle Medical’s SubtleMR solution, optimizing its already-accelerated MRI protocols by 33-45% while maintaining consistent diagnostic image quality.

• PACS efficiency and accuracy can have a major impact on radiologist workflows, but these qualities aren’t guaranteed. Check out this Novarad report detailing how to improve your PACS efficiency and accuracy.

• AI automates what radiologists can’t stand, surfaces what radiologists can’t see, and identifies what radiologists can’t miss. But only if it’s implemented in the way radiologists work. See how Nuance helps radiologists achieve these results through a single, streamlined, end-to-end AI experience.

• Radiology is leading healthcare’s AI revolution, and yet many people in radiology are just starting to build their understanding of AI. That’s why Bayer published its truly Complete Guide to Artificial Intelligence in Radiology, detailing how AI can address radiology’s challenges, AI’s core use cases, and AI’s path towards adoption.

• Having the right workflows and efficiency tools to make the most of a department’s resources is imperative. See how GE HealthCare can help you improve staff satisfaction and patient outcomes and have an easier time making a clinical decision with the Revolution Apex Platform.

• Imaging AI is evolving fast, but radiology leaders’ expectations for their AI technologies might be evolving even faster. In this Imaging Wire Show with Dr. Charlene Liew of SingHealth and Dr. Nina Kottler of Radiology Partners, we explore radiology leaders’ current and future expectations for AI, and the central role platforms play in their AI roadmaps.

• See how Canon AiCE DLR is achieving new levels of cardiovascular imaging in this presentation from Jeannie Yu MD, FACC, FSCCT.

• “It has changed the face of neuroimaging.” That’s one of the takeaways from Christ Hospital’s experience becoming the first healthcare system in New Jersey to implement point-of-care MR imaging into neurocritical care. Learn about their implementation process and the impact of providing quick bedside MRIs in this Hyperfine webinar.

• Listen to a panel of medical imaging experts – including Merative CMO Dr. David Gruen, TeraRecon CTO Sinan Batman, and Dr. Eliot Siegel, Vice Chair at the University of Maryland School of Medicine – share their perspectives on the value of AI in improving patient outcomes, streamlining workflows and reducing physician burnout. Merative and TeraRecon, in partnership with AI Med, will host this panel discussion in a webinar on March 9th. Sign up here.

• Have more echo studies than sonographers? See how Us2.ai was able to classify, segment, and annotate echocardiographic videos with similar accuracy as expert sonographers.

• This Riverain Technologies case study details how the University of Colorado Hospital enhanced its chest X-ray workflow with ClearRead Bone Suppress.

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