Sonia Gupta, MD, chief medical officer of enterprise imaging at Change Healthcare, in an Imaging Wire Show episode on physician burnout.

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Clinical burnout is widespread in healthcare. What can be done to combat burnout in imaging? Listen to Sonia Gupta, MD, chief medical officer of enterprise imaging at Change Healthcare, as she addresses the concerns and offers possible solutions that you can use right now.

Breast Imaging

Taking Ultrasound Beyond Breast Density

When should breast ultrasound be used as part of mammography screening? It’s often used in cases of dense breast tissue, but other factors should also come into play, say researchers in a new study in Cancer. 

Conventional X-ray mammography has difficulties when used for screening women with dense breast tissue, so supplemental modalities like ultrasound and MRI are called into play. But focusing too much on breast density alone could mean that many women who are at high risk of breast cancer don’t get the additional imaging they need.

To study this issue, researchers analyzed the risk of mammography screening failures (defined as interval invasive cancer or advanced cancer) in ~825k screening mammograms in ~377k women, and more than ~38k screening ultrasound studies in ~29k women. All exams were acquired from 2014 to 2020 at 32 healthcare facilities across the US.

Researchers then compared the mammography failure rate in women who got ultrasound and mammography to those who got mammography alone. Their findings included: 

• Ultrasound was appropriately targeted at women with heterogeneously or extremely dense breasts, with 95.3% getting scans
• However, based on their complete risk factor profile, women with dense breasts who got ultrasound had only a modestly higher risk of interval breast cancer compared to women who only got mammography (23.7% vs. 18.5%) 
• More than half of women undergoing ultrasound screening had low or average risk of an interval breast cancer based on their risk factor profile, despite having dense breasts
• The risk of advanced cancer was very close between the two groups (32.0% vs. 30.5%), suggesting that a large fraction of women at risk of advanced cancer are getting only mammography screening with no supplemental imaging

The Takeaway 

On the positive side, ultrasound is being widely used in women with dense breast tissue, indicating success in identifying these women and getting them the supplemental imaging they need. But the high rate of advanced cancer in women who only received mammography indicates that consideration of other risk factors – such as family history of breast cancer and body mass index – is necessary beyond just breast tissue density to identify women in need of supplemental imaging. 

What Can We Do About Physician Burnout?

Clinical burnout is widespread in healthcare. What can be done to combat burnout in imaging? Listen to Sonia Gupta, MD, chief medical officer of enterprise imaging at Change Healthcare, as she addresses concerns and offers possible solutions that you can use right now.

The First Total-Body PET

See what UC Davis has to say about United Imaging’s EXPLORER Total Body Scanner, the first total-body PET.

The Key to MRI Efficiency

Radiologists shouldn’t have to compromise between speed and clarity. Find out how SpinTech MRI’s STAGE solution can help you find the key to MRI efficiency in this webinar on June 21.

The Wire

• COVID Affects Cancer Screening: The number of cancer diagnoses from screening programs in Alberta, Canada dropped during the COVID-19 emergency, with new breast cancer diagnoses falling 33% versus what would have been expected; prostate, melanoma, and colorectal diagnoses also fell. Researchers in the Canadian Medical Association Journal tracked nearly 43k cancer diagnoses from January 2018 to December 2020, during which they calculated some 350 breast cancers were missed. The results echo previous studies on the pandemic’s impact on screening.

• More Mammography=More Survival: In other screening news, American Cancer Society researchers at last week’s ASCO 2023 meeting showed that women who received more mammography screening exams had better survival odds. Data from over 37k women in Sweden from 1992 to 2016 showed that women who went through all 5 mammography rounds had a much lower hazard ratio of breast cancer mortality compared to women who didn’t get screened at all (HR=0.28). What’s more, survival went up with every screening round attended.

• Imaging IT Market Valued at $5.2B: The global market for imaging IT was valued at $5.2B in 2022, representing growth of about 4% versus 2021. That’s according to a new report from Signify Research, which projects growth to accelerate slightly to over 5% in 2023 and produce revenues of $5.5B, but then decelerate to low-single-digit growth 2024-2026. Signify sees continued investment in enterprise imaging, cloud technologies, and vendor collaborations to deliver image management across specialities, such as radiology and pathology. 

• ChatGPT Decodes Reports: In another ChatGPT use case, researchers tasked the generative AI model with simplifying radiology reports for patients. In a paper in Clinical Imaging, researchers asked ChatGPT to simplify 400 radiology reports from different modalities. The algorithm produced simpler reports with shorter mean word length (103 vs. 164 words), higher ease-of-reading scores (83.5 vs. 38.0, where 90-100 can be understood by a 5th grader), and lower required reading level (6th grade vs. 10th grade).

• AI Affects Radiologists, Redux: Radiologists following incorrect AI prompts had lower accuracy for making a correct diagnosis compared to when AI is correct (72% vs. 78%). That’s according to a new paper in Nature in which researchers analyzed 2,760 decisions by 92 radiologists interpreting 15 mammograms. Radiologists found “explainability” tools like heatmaps to be useful, but such tools had “limited effect” on their accuracy. The study confirms previous research on the impact of incorrect AI on radiologist performance.

• Clinicians Don’t Trust AI: With these findings in mind, perhaps it’s no surprise that a GE HealthCare study of 2k clinicians across eight countries found that only a minority (42%) said they thought AI data can be trusted, a number that fell to 26% among US respondents. The survey also found high burnout levels, with 42% of clinicians saying they are considering leaving healthcare. Other frustrations included low technological interoperability, fragmented care collaboration, and barriers to accessible care. 

• SNMMI Awards ‘Mars Shot’ Grants: The Society of Nuclear Medicine and Molecular Imaging has issued five large research grants as part of its Mars Shot project to fund innovation in nuclear medicine, molecular imaging, and radiopharmaceutical therapy. Amir Iravani, MD, received $1M to study Lu-177 PSMA therapy. Other grants included $500k each to Paul Ellison, MD; Craig Levin, PhD; Randy Yeh, MD; and Julie Sutcliffe, PhD. The Mars Shot was announced in 2021, and this is the first year of grants.

• This Is Your Brain in Space: Speaking of Mars, in a new study in Scientific Reports, researchers used MRI to demonstrate the impact of spaceflight on brain structure. Researchers performed MRI scans on 30 astronauts before and after space missions, some that lasted six months and longer. Longer missions were associated with greater expansion of the brain’s right lateral and third ventricles; the effect was still seen three years later, suggesting it may take that long for ventricles to fully recover. 

• Hyperfine Partners with ISMRM: Portable MRI company Hyperfine has signed an agreement with ISMRM and the Bill & Melinda Gates Foundation to improve MRI education and reduce healthcare disparities in low- and medium-income countries by enabling access to ISMRM’s educational programs and by setting up a mentorship program for clinicians. The collaboration already sponsored travel for 100 participants to attend last week’s ISMRM 2023 meeting in Toronto. Hyperfine has been working with the Bill & Melinda Gates Foundation on MRI-centered projects in Africa.

• AI Out of Africa? Emerging trends in the development and use of AI could result in algorithms being deployed first in low- and middle-income countries and then migrated to developed nations. That’s according to a commentary in The Lancet by radiologist Saurabh Jha, MD, and cardiologist Eric Topol, MD. They note that some of the most promising AI use cases – like chest X-ray analysis – are in low-resource areas and are funded with grants, as opposed to being tied to commercial sales that could limit adoption. 

• FDA Clears VR Planning Software: The FDA has cleared virtual reality software from French IT developer Avatar Medical for surgical planning. Also called Avatar Medical, the software takes CT or MRI scans and creates patient avatars that can be used for pre-operative planning or as guidance during surgical procedures. The software is based on four years of research into human-data interaction and machine learning at the Institut Pasteur and Institut Curie in France.

• Royal Health Launches AI Unit: Radiology operations software developer Royal Health has launched a new AI subsidiary called RoyalAi. The new unit will focus on leveraging AI to enhance operational decision-making in radiology and related markets, and its algorithms will be incorporated into Royal’s offerings, which include EMR, RIS, and revenue cycle management software and services.

University of Colorado’s Case for ClearRead Bone Suppress

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

RP and I-MED’s Perspectives on CARPL.ai

Watch industry leaders and trendsetters in radiology, Dr. Krishna Nallamshetty, CMO at Radiology Partners, and Dr. Ron Shnier, CMO at I-MED Radiology Network, share their perspectives on the CARPL platform, from clinical trials to clinical deployment.

Swoop Portable MRI at Cure Hospital in Uganda

The Hyperfine Swoop Portable MRI has been used to care for children with hydrocephalus at Uganda’s Cure Hospital since 2021, improving imaging access without exposing patients to ionizing radiation. Learn more about the Swoop’s hydrocephalus impact here.

The Resource Wire

• Change is on the horizon for cath labs as more interventional cardiologists are starting to use coronary CT angiography to plan and guide percutaneous coronary intervention (PCI) procedures. Read more on how Carlos Collet, MD, PhD, co-director of the catheterization lab OLV Hospitals in Aalst, Belgium is leading the charge in both treating patients and educating interventionalists and cardiologists on CT-guided PCI using technology from GE HealthCare.

• Annalise.ai doubled down on its comprehensive AI strategy with the launch of its Annalise Enterprise CTB solution, which identifies a whopping 130 different non-contrast brain CT findings. Annalise Enterprise CTB analyzes brain CTs as they are acquired, prioritizes urgent cases, and provides radiologists with details on each finding (types, locations, likelihood).  

• Calantic Digital Solutions is a radiology AI suite developed to help you focus on providing quality care. Learn about the use cases for Calantic in this talk at SIIM 2023 on Thursday June 15 by Pamela Habib, head of commercial development at Bayer Digital Solutions. 

• Patient-centric care was one of the major highlights at HIMSS 2023. What role does medical imaging play in this patient care pathway? We talked to Morris Panner and A.J. Watson of Intelerad at the meeting.

• SOIN Soluciones Integrales of Costa Rica turned to Merge enterprise imaging solutions from Merative when it wanted to modernize the imaging environments of 50 hospitals across the country. Download this PDF white paper to find out how they did it.

• 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.”

• CloudPACS has finally arrived. Learn more about the benefits that cloud-based PACS can have for your radiology practice and how Visage Imaging’s Visage 7 was built from the ground up to ensure maximum performance, security, and scale. 

• How much can your practice save by converting your messy radiology metadata to a standard convention using Enlitic’s CURIE|Endex solution? Find out now with their ROI Calculator. 

• Despite significant interest, there’s still confusion about the value of imaging AI. This Blackford Analysis white paper explores the key cost considerations and ROI factors that radiology groups can use to figure out how to make AI valuable for them.

• What kind of pressures are radiologists seeing, and how can imaging IT help? And what role will AI play? We talked to Peter Shen of Siemens Healthineers in this Imaging Wire Show.

• What are the factors that contribute to errors and misreads in radiology – and how can they be prevented? Find out how to improve your practice’s quality and accuracy in this white paper from Medality. 

• 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.

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

• 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.