Geoffrey Hinton, PhD, on his 2016 prediction that computers with AI would be better at reading medical images than radiologists.

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Brain Imaging

When TIA Imaging Is Incomplete

A new study in AJR calculates the cost to patients when imaging evaluation is incomplete, finding that people with transient ischemic attack (TIA) who didn’t get full imaging workups were 30% more likely to have a new stroke diagnosis within the next 90 days.

Some 240,000 people experience TIA annually in the US. While TIAs typically last only a few minutes and don’t cause lasting neurological damage, they can be a warning sign of future neurological events to come.

Medical imaging – typically CT and MRI – are key in the neurological workup of TIA patients, and TIA can be treated with antithrombotic therapy, which reduces the likelihood of a stroke 90 days later. Therefore, guidelines call for prompt neuroimaging of the brain and neck in TIA patients, typically within 48 hours, with MRI the primary and CT the secondary options.

But what happens if TIA patients don’t get complete imaging as part of their workup? To answer this question, researchers from Colorado and California analyzed a database of 111,417 people seen at 4,253 hospitals who presented to the ED with TIA symptoms from 2016 to 2017. 

They tracked which patients received complete neurovascular imaging within 48 hours as part of their workup, then followed how many received a primary diagnosis of stroke within 90 days of the initial TIA encounter. Findings included:

• 62.7% of patients received brain imaging and complete neurovascular imaging (both head and neck) within 48 hours
• 37.3% received brain imaging but incomplete neurovascular imaging 
• There was a higher rate of stroke at 90 days in TIA patients with incomplete imaging workup (7.0% vs. 4.4%)
• Patients with incomplete neurovascular imaging also had a greater chance of stroke at 90 days (OR=1.3)

The Takeaway 

While the benefits of neuroimaging for stroke have been demonstrated in the literature, imaging’s value for TIA has been less certain – until now. The AJR study shows that neuroimaging is just as vital for TIA workup, and it supports guidelines calling for cross-sectional imaging of the head and neck within 48 hours of TIA.

Adopting An AI Platform Strategy

Imaging AI’s clinical and productivity benefits are becoming increasingly clear, but selecting and implementing the right solution can be difficult. This Arterys paper details how an AI platform strategy allows providers to efficiently and accurately evaluate AI applications, so they can start realizing their targeted AI benefits.

How to Help Radiologists Thrive

With burnout and staffing shortages on the rise, and the increasing volume of imaging, radiology teams are searching for solutions. This interactive guide from Nuance can help you create an environment where radiologists thrive by building a powerful imaging strategy with AI-driven, real-time intelligence.

The Wire

• AI Guru Moves Goalposts: AI guru Geoffrey Hinton, PhD, has moved the goalposts on his now-infamous 2016 prediction that radiologist training should be halted due to the impact of AI. In a March 1 interview with CBS Saturday Morning that got traction on Twitter this week, Hinton says he wasn’t wrong “in spirit” about AI making radiologists obsolete, only he now believes it will take 10 years, not 5. Maybe next time Hinton should ask ChatGPT for help with his predictions.

• CT of PE in the ED: Patients with acute pulmonary embolism who are at low risk can be discharged and managed at home, even if they have worrisome findings on CT, says a new study in JAMA Network Open. Among 331 low-risk patients with acute PE seen in the emergency department, there were no deaths in patients with suspicious CT PE findings compared to a 2.2% death rate in those with no such findings. At-home PE management may be a safe option that reduces costs and downstream testing.

• FDA Approves PSMA PET Agent: Blue Earth Diagnostics has received FDA approval for Posluma (flotufolastat fluorine-18), a PET radiotracer that targets PSMA in prostate cancer patients. Previously known as 18F‐rhPSMA‐7.3, Posluma is indicated for men with PSMA-positive lesions who are candidates for initial therapy or with suspected recurrence based on PSA levels. The PSMA-PET segment is becoming crowded with a growing number of FDA-approved radiotracers, but Blue Earth is highlighting the advantages of Posluma’s novel radiohybrid (rh) technology.

• PET Detects Long COVID: In other PET news, researchers in JAMA Psychiatry used the modality to detect elevated levels of neuroinflammation markers in COVID long-haulers with depression. In 40 people scanned from April 2021 to June 2022, PET scans with a fluorine-18 FEPPA radiotracer showed higher volume of translocator protein (TSPO) in the COVID patients versus healthy controls (20% to 22% depending on brain region). Researchers tied the findings to chronic gliosis, the activation of glial brain cells in response to injury.

• FDA Clears PET/CT Recon: Meanwhile, the FDA has cleared Precision DL, a new deep learning-based image reconstruction PET/CT application from GE HealthCare. Precision DL uses software to achieve the high image quality found with hardware-based time-of-flight PET reconstruction, such as better contrast-to-noise ratio, contrast recovery, and quantitative accuracy. Precision DL is available on GE’s Omni Legend PET/CT scanner, and GE believes it marks a transition from ToF technology to the next generation of PET/CT.

• ACR’s Thorwarth to Retire: The CEO of ACR, William Thorwarth, Jr., MD, is planning to retire at the end of June. Thorwarth has led ACR for the past 10 years, and during his tenure he has overseen a number of milestones and accomplishments, including the creation of the Radiology Health Equity Coalition and the launch of the ACR Data Science Institute. He also guided ACR through the COVID-19 pandemic, helping radiology practices survive the pandemic’s economic disruptions. 

• United Imaging Debuts 5T MRI: United Imaging Healthcare plans to make the North American debut of a 5-tesla MRI scanner at next week’s ISMRM 2023 meeting in Toronto. First shown at ECR 2023, uMR Jupiter creates a new product segment in ultra-high-field MRI (the scanner is not yet available for clinical use in the US). United will discuss the scanner – as well as its ADEPT open MR development platform – in a June 4 symposium at ISMRM. 

• Feds Accuse IV Rad: US law enforcement officials are accusing Pennsylvania interventional radiologist James McGuckin, MD, of performing unnecessary interventional radiology procedures. A complaint filed in the case claims that McGuckin received up to $6.5M from federal payers for over 500 claims, mostly leg peripheral artery procedures. They say McGuckin was sanctioned for unnecessary interventional procedures in 2015 and settled a lawsuit over unnecessary procedures in 2018. They also accuse him of making false statements in a 2019 bankruptcy filing.

• Subtle Medical at ISMRM: Subtle Medical plans to highlight six abstracts on its technology for MRI image enhancement that are being presented at next week’s ISMRM 2023 meeting in Toronto. The studies cover novel MR image registration methods, AI-powered image denoising and super-resolution, and advanced image synthesis techniques. The company’s SubtleMR application enables faster workflow by increasing sharpness and reducing noise in rapidly acquired MR images.

• Medality Adds Conn. Practice: Online education and training provider Medality has signed a partnership with Naugatuck Valley Radiological Associates (NVRA) of Connecticut. Medality will provide NVRA radiologists with evidence-based training and development opportunities in new subspecialties and modalities. The firms will work together to develop a personalized and self-directed training program to improve diagnostic quality, reduce turnaround times, and accelerate practice growth. NVRA is the latest in a growing stable of Medality partners. 

• From Block to Cube: Fresh off its deal to be acquired by Siemens Healthineers and CommonSpirit Health, Block Imaging is spinning off its mobile imaging business, to be run as Cube Mobile Imaging. Block had been expanding its mobile fleet over the past 5 years, and Cube will enable healthcare providers to rent the same CT and MRI technology it’s had access to through Block. Cube will operate as a standalone business that’s not included in the Siemens/CommonSpirit acquisition.

• Intelerad Integrates Augnito: Intelerad Medical Systems will integrate voice recognition technology from Augnito Voice Services into its InSight PACS reporting software. The partnership will give Intelerad clients new options for voice recognition, and will leverage the benefits of Augnito’s cloud-based platform, which can be used with a speech microphone or a smartphone app. Augnito will be available through the Intelerad Cloud platform. 

• GE Lands $30M CT Deal: GE HealthCare has signed its largest-ever CT sale in the US, a $30M contract with St. Luke’s University Health Network. GE will install 21 scanners across the St. Luke’s system in a deal that includes the company’s Smart Subscription service to keep the scanners updated with the latest CT technologies and solutions, including AI. 

Healthcare’s Shift to CloudPACS

What’s behind healthcare’s shift from legacy PACS to cloud-based enterprise imaging? We talked to Brad Levin of Visage Imaging at HIMSS 2023, and he explains the change and the benefits of Visage’s Visage 7 | CloudPACS solution.

How to Grow Your Practice When It’s Impossible to Recruit and Retain

Today’s employment environment in radiology has never been more challenging. But there are tools you can use to keep your radiologists happy and engaged, according to this white paper from Medality.

AI Echo Copilot – The Future of Echocardiography

New technology from Us2.ai called Us2.connect allows you to add AI automation to any echo device. Any echo machine can now have 100% automated reporting with disease detection and editable measurements – all generated in realtime as you scan.

The Resource Wire

• 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.

• What can be done to make radiology workflow more efficient? In this Imaging Wire Show, we talked to Ernest Montañà of teleradiology services provider TMC about their adoption of Enlitic’s Curie|ENDEX technology to help radiologists do their jobs more efficiently.

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

• What is theranostics, and how is it changing oncology patient care? Theranostics delivers precision therapy that’s personalized to every patient with targeted radioligand treatment. Learn more about theranostics and how Siemens Healthineers can support your theranostics journey by offering precision oncology tools that cater to every step of the care pathway.

• Medical image sharing technology from Intelerad made it possible to find faster organ matches at Gift of Life Michigan. Medical images of organ viability are now available with other clinical data, speeding the match between donor and recipient. 

• 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.

• More AI applications are becoming available, but many healthcare organizations are reporting challenges to achieving the benefits of the technology. Learn how Merge AI Orchestrator can provide access to AI without disrupting workflow.

• How can an AI platform change how radiology is practiced today? Find out in this presentation by Thanos Karras, head of Bayer Digital Solutions, Americas, on Tuesday June 6 at the AI Med conference in San Diego. 

• 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.

• 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 is being implemented across the VA Lung Precision Oncology Program (22 hub and 87 spoke locations).

• 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.

• Is your organization ready to move enterprise imaging to the cloud? Check out this Change Healthcare and ACHE webinar detailing cloud-native imaging’s benefits, best practices, and ROI.

• What’s going on in the development of photon-counting CT at the University of Wisconsin? Find out how researchers are working with GE HealthCare on deep silicon photon-counting detectors in this video interview in Radiology Business. 

• 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.