Raym Geis, MD, commenting on a new study on the cost of peer review.

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Contrast

GE HealthCare’s MRI Contrast Play

GE HealthCare has expanded its MRI contrast portfolio with the European debut of Pixxoscan. The gadolinium-based contrast agent gives GE another macrocyclic gadolinium-based contrast agent to sell in Europe, in addition to its Clariscan GBCA.

MRI contrast developers have been working to address one of the most persistent problems in MRI: their reliance on gadolinium. Gadolinium works great for lighting up MR images, but it’s a toxic metal that has to be bonded with a chelate – a sort of molecular cage – in order to be used safely in humans. 

Pixxoscan is a macrocyclic GBCA that’s based on gadobutrol, a formulation already used in Bayer’s Gadovist GBCA and that’s now available generically. Macrocyclic GBCAs are considered more stable and less likely to release gadolinium than linear agents. 

Most linear GBCAs have been barred from the European market since 2017. The FDA never took a similar approach, but the US market has largely shifted from linear GBCAs to macrocyclic agents due to safety concerns. 

GE HealthCare highlighted that Pixxoscan is formulated at twice the concentration of gadolinium ions, which reportedly enables it to be used at half the injection volume of other GBCAs. The company also said that the agent’s cage-like macrocyclic chelate provides high kinetic stability. 

Pixxoscan will start shipping initially in Austria, and GE HealthCare expects to expand it across Europe. A spokesperson didn’t confirm plans for a US rollout.   

Pixxoscan’s launch comes as two of GE HealthCare’s competitors, Guerbet and Bracco, are rolling out their formulations of gadopiclenol, a high-relaxivity agent that can be used at half the dose of conventional GBCAs. The companies collaborated on the development of the agent, which Guerbet is selling as Elucirem and Bracco as Vueway. 

The Takeaway

GE HealthCare’s launch of Pixxoscan gives the company another macrocyclic agent to sell in Europe in addition to Clariscan. The question is how the agent will compete with gadopiclenol from Bracco and Guerbet, which are already touting its dose and relaxivity advantages.

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The Wire

• Unpaid Peer Review: The rebellion against for-profit academic publishing is gaining steam. A new survey in Research Integrity and Peer Review of 354 journal reviewers found that editors who perform unpaid peer review for academic journals contribute work that would be valued at $6B annually worldwide – or $1,272 per person – if they were compensated. Last month, editors of an Elsevier-published neuroimaging journal quit en masse after Elsevier refused to lower publishing fees. 

• FDA Tweaks Kids Contrast Policy: The FDA is changing guidelines for follow-up monitoring of young kids who are given iodinated contrast media after imaging for signs of a decline in thyroid function. The FDA now says that decisions on thyroid monitoring for newborns and children up to age 3 should be made based on risk factors like low birth weight and underlying medical conditions. Previously, FDA advised universal monitoring, which according to ACR could lead to unnecessary testing. 

• TeraRecon Partners with Combinostics: TeraRecon has added an AI algorithm from Combinostics to its Eureka Clinical AI platform, which enables clinicians to launch AI applications from multiple developers. Combinostics is contributing cMRI for analyzing brain MRI scans and providing quantitative reports to support dementia assessments. Since launching an updated version of Eureka Clinical AI in October 2022, TeraRecon has added a string of partners in recent weeks, including Cercare Medical, Radiobotics, Riverain Technologies, Us2.ai, Coreline Soft, Infervision, and Avicenna.ai. 

• ChatGPT Helps with Radiology Reports: Do you hate writing the “impressions” section of radiology reports? Why not let ChatGPT do it for you? That’s exactly what researchers did in an arXiv paper, creating ImpressionGPT, a large language model they trained on existing radiology reports. In testing the algorithm on large chest X-ray datasets, they found that it performed “substantially better” than current methods for summarizing radiology reports. The paper shows radiology is moving quickly to leverage ChatGPT’s power, or at least radiology researchers are. 

• Partnership Boosts Outpatient Imaging: In a partnership designed to boost its expansion in outpatient imaging, Ohio imaging provider Lumina Imaging and Diagnostics has inked an agreement in which Siemens Healthineers will exclusively provide MRI and CT equipment to all future Lumina sites. Lumina was created by MetroHealth System of Cleveland as a nonprofit business to provide outpatient CT and MRI at a cost 50-70% lower than major hospitals; the new deal will help Lumina achieve that mission.

• Density’s Link to Breast Cancer: Changes in breast density over time could be a marker indicating which women will develop breast cancer later in life. In JAMA Oncology, researchers used an algorithm they developed to perform volumetric density analysis on screening mammograms and track it in 947 women. Breast density naturally declines over time, but cancer was more likely to develop in the breasts that had slower rates of density decline. The findings boost efforts to analyze breast density on mammograms.

• Vendors Partner in Photon-Counting CT: Kromek and Analogic are partnering in the development of photon-counting CT digital detectors based on CZT. Kromek will integrate its CZT sensors with Analogic’s detector designs for photon-counting scanners with better spatial and energy resolution, as well as lower radiation dose. Analogic will develop scanners for both medical imaging and security applications, giving potential customers an alternative to large OEMs for photon-counting CT technology. That’s notable, given that Canon and GE acquired two of the largest photon-counting detector suppliers in recent years.

• When Should Breast Screening Stop? The other side to the debate over when breast screening should start is when it should stop – especially in women who are already sick. In a talk at last week’s ASBrS meeting, researchers presented a study of 44,475 women over 67yrs, 55% of whom had at least one comorbidity. They found that 51% of women with a life expectancy of less than 1 year received screening mammograms, and would receive little benefit from these exams.

• Ultromics Gets Breakthrough Designation: The FDA granted Breakthrough Device Designation to Ultromics’ EchoGo Amyloidosis AI solution, which analyzes echocardiograms to identify patients with cardiac amyloidosis. Ultromics highlighted the solution’s potential to allow far earlier amyloidosis detection, citing the well-known challenges diagnosing the disease before it reaches advanced stages, and noting that many amyloidosis patients undergo echo exams well before being diagnosed. EchoGo Amyloidosis is a module within Ultromics’ EchoGo Platform, and is currently a candidate for FDA submission.

• ML Model Predicts Cardiac Events: A cardiac CT machine learning algorithm was able to predict major adverse cardiac events better than traditional methods. In Radiology: Cardiothoracic Imaging, German researchers used an ML model that combined CCTA data with clinical parameters such as patient age in 5,457 patients with suspected coronary artery disease. The model’s higher predictive power was higher than both a Cox proportional hazards model and segment stenosis scores (C-index 0.74 vs. 0.71 & 0.69).

• Self-Powered Photon-Counting Detectors: As if photon-counting CT couldn’t get any better, researchers from the University of North Carolina-Chapel Hill are working on self-powered photon-counting detectors. In Nature, they describe how the metal halide perovskite-based detectors can convert light photons into energy that powers the detector. They believe the detectors could offer advantages over traditional silicon photomultipliers, such as lower radiation dose and better image quality.

• Butterfly Taps New CEO: Handheld ultrasound developer Butterfly Networks has named Joseph DeVivo as the company’s new chairman, president, and CEO. DeVivo has 35 years of management experience, and most recently was in a senior role at Teladoc Health. Previously, he was CEO of telehealth company InTouch Health. Butterfly announced in December that its previous CEO, Dr. Todd Fruchterman, would be leaving the company.

Democratizing Echocardiography with AI

We talk a lot about AI’s potential to expand echo access, and this Imaging Wire Show reveals that ultrasound’s AI-driven expansion might go far beyond what many of us had in mind. Check out our discussion with Duke Health’s Madhav Swaminathan, MBBS, MD and Us2.ai’s Carolyn Lam MBBS, PhD and James Hare, to see how AI is democratizing echo exams.

Arterys’ Cloud Breast AI Cuts Turnaround Times

Ready to improve your mammography workflows? Arterys is the first and only cloud-native breast AI provider, and its solution dramatically reduces 3D mammography reading times, while supporting breast cancer detection, density measurements, and personalized risk assessments.  

How to Revamp Patient Engagement

What’s the best way to eliminate patient frustration and get them engaged with healthcare again? Find out how technology can revamp the patient engagement experience in this article produced in collaboration with Nuance in Becker’s Hospital Review.

The Resource Wire

• 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.

• Your peers are supercharging CT spectral imaging with TrueFidelity for Gemstone Spectral Imaging (GSI) from GE HealthCare. Spectral CT has emerged as a powerful radiological evaluation tool, and this white paper summarizes recently released peer-reviewed evidence to demonstrate how TrueFidelity for GSI supercharges spectral CT by elevating image quality and diagnostic performance.

• Merative’s Merge Imaging Solutions had a big Best in KLAS 2023, winning the Cardiology and Hemodynamics categories, while scoring second-place honors in the Large PACS, Universal Viewer, and VNA categories. Merge Cardio previously scored Best in KLAS for six consecutive years, while Merge Hemo has been ranked #1 for 10 years.

• Looking for a way to do faster MRI scans without losing image quality? Learn about the impact that Subtle Medical’s SubtleMR software has on accelerated MRI sequences in this case review image series.

• 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. Hear 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.

• Crouse Hospital is a nationally recognized cardiac care center in the Syracuse, NY, area, but the hospital’s cardiovascular service relied on separate data islands. That is, until Crouse Hospital adopted the HealthView CVIS from Intelerad’s Lumedx business. 

• How is Hyperfine changing our thoughts about MRI by making it possible to move its Swoop portable MR imaging system directly to patients? Find out in this Let’s Talk Medtech podcast interview with President and CEO Maria Sainz. 

• Did you know one-quarter of healthcare organizations have experienced a cyber-attack in the last year? This Change Healthcare animation explains how third party-certified cloud-native enterprise imaging can help secure IT infrastructure that might be exposed with re-platformed imaging systems.

• United Imaging’s “all-in” approach means that every system ships with its entire suite of features and capabilities (no options), giving its clients more clinical flexibility and predictability.

• This Riverain Technologies case study details how the University of Colorado Hospital enhanced its chest X-ray workflow with ClearRead Xray Bone Suppress, which can improve the visibility and detection of focal lung densities, including nodules.

• Working on your organization’s AI strategy? This Blackford Analysis post outlines the key considerations for creating your AI goals and strategy, including some you might not have considered.

• Is your in-office MRI service prepared for the future? See how three macro trends will impact your in-office orthopedic MRI service, and the MRI capabilities you’ll need in the future in this Siemens Healthineers report.

• Your images have the power to advance healthcare research, but removing patient PHI can be a challenge. Learn how Enlitic’s Curie|ENCOG technology can de-identify and anonymize clinical data, enabling you to put your images to work.

• See how Dubai-based healthcare leader Aster DM Healthcare leveraged the CARPL platform to connect its doctors, data scientists, and imaging workflows, and support its AI projects and development infrastructure.