Chris Heble of GE HealthCare on the market potential of theranostics.

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CT Scanners

Is There Hope for CT Lung Screening?

New data on CT lung cancer screening rates offer a good news/bad news story. The bad news is that only 21.2% of eligible individuals in four US states got screened, far lower than other exams like breast or colon screening.

The good news is that, as low as the rate was relative to other tests, 21.2% is still much higher than previous estimates. And the study itself found that the rate of CT lung screening has risen over 8 percentage points in 3 years. 

Compliance has lagged with CT lung screening ever since Medicare approved payments for the exam in 2015. A recent JACR study found that screening rates were low for eligible people for both Medicare and commercial insurance (3.4% and 1.8%).

Why is screening compliance so low? Explanations have ranged from fatalism among people who smoke to reimbursement requirements for “shared decision-making,” which unlike other screening exams require patients and providers to discuss CT lung screening before an exam can be ordered.

In this new study in JAMA Network Open, researchers examined screening rates in four states – Maine, Michigan, New Jersey, and Rhode Island – from January 2021 to January 2022. The study drew data from the National Health Interview Survey and weighted it to reflect the population of the US of individuals eligible for CT lung screening, based on the criteria of ages 55-79, 30-pack-year smoking history, and having smoked or quit within the past 15 years. Major findings included: 

• The rate for CT lung cancer screening was 21.2%, up from 12.8% in 2019
• People with a primary health professional (PHP) were nearly 6 times more likely to get screened (OR=5.62)
• The age sweet spot for screening was 65-77, with lower odds for those 55-64 (OR=0.43) and 78-79 (OR=0.17)
• Rates varied between states, with Rhode Island having the highest rate (30.3%) and New Jersey the lowest (17.5%).
• Of those who got screened, 27.7% were in poor health and 4.5% had no health insurance

The Takeaway

The findings offer some hope for CT lung screening, as the compliance rate is among the highest we’ve seen among recent research studies. On the other hand, many of those screened were in such poor health they might not benefit from treatment. The high rate of compliance in people with PHPs indicates that promoting screening with these providers could pay off, especially given the requirement for shared decision-making. 

Stories of Imaging Resilience

Healthcare providers can’t feel confident in the impact they make for their patients without feeling their IT environments are resilient and reliable. This eBook from Merge by Merative breaks down 3 essential ingredients of a resilient imaging IT environment: hybrid cloud, reliable uptime, and zero-trust security.

Unlock the Power of Images to Advance Healthcare

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.

The Wire

• Cardiac MRI for Chest Pain: Cardiac MRI can be a good alternative to invasive techniques for evaluating patients presenting to the ER with acute chest pain and mildly elevated troponin levels. So say findings from the CMR-IMPACT study in Circulation: Cardiovascular Imaging in which US researchers studied 312 people from 2013 to 2018; 58% of patients with negative CMR were safely discharged without need for further intervention within 90 days. Also, there was no statistically significant difference in adverse events, and invasive angiography rates were lower (52% vs. 74%). 

• Rads Read Widely: Radiology supposedly is becoming more subspecialized, but radiologists are still required to read images from a wide range of clinical areas. A new report by practice development platform Medality that surveyed 2.7k radiologists from 108 countries shows that radiologists are reading an average of 4.7 subspecialty areas in their daily practice. The report also found that many radiologists lacked confidence when reading in high-growth imaging areas like cardiac (41% not confident), nuclear medicine (28%), and pediatrics (25%).

• Photon-Counting Cardiac CT: More high-risk patients being prepped for TAVR might be suitable for workup with coronary CT angiography (CCTA) thanks to ultra-high-resolution (UHR) photon-counting CT. In Radiology, German researchers used Siemens Healthineers’ Naeotom Alpha ultra-high-resolution photon-counting CT scanner in 68 patients with severe aortic valve stenosis who were scheduled for TAVR. They found that UHR-CCTA generated high image quality and AUC comparable to gold-standard invasive coronary angiography for detecting coronary artery disease (AUC=0.93 per participant and 0.92 per segment). 

• Posluma PET Starts Shipping: Blue Earth Diagnostics and its partner PETNet Solutions have begun shipping Posluma (flotufolastat fluorine-18), a PET radiotracer targeting PSMA in prostate cancer patients. Posluma is indicated for men with PSMA-positive lesions who are candidates for initial therapy or with suspected recurrence based on PSA levels; the radiotracer was approved by the FDA in May, and Blue Earth, a Bracco subsidiary, will highlight presentations on the radiopharmaceutical at SNMMI 2023 June 24-27 in Chicago. 

• Breast Cancer Survival Jumps: Breast cancer survival in women has jumped dramatically over the past 20 years, with women diagnosed with breast cancer today 66% less likely to die in the next five years than in the 1990s. That’s according to a study of over 512k women in the UK published in BMJ. Researchers found the five-year breast cancer mortality risk was higher from 1993-1999 compared to 2010-2015 (14.4% vs. 4.9%). For almost two-thirds of women diagnosed in the later period, mortality risk was less than 3%. 

• New Theranostics Center: GE HealthCare is creating a new theranostics center of excellence in Canada through a collaboration with St. Joseph’s Health Care London and the Lawson Health Research Institute in Ontario. The parties will collaborate to expand production and access to theranostic radioisotopes; work to improve image quality, dose calculation, care coordination, and operations; and educate and train practitioners and government bodies in theranostics. GE HealthCare notes that theranostics is gaining momentum with approvals of new theranostics-related drugs and therapies in the U.S. and Canada. 

• AI Enables CT BMD Analysis: In a demonstration of AI’s value for opportunistic screening, an AI algorithm performed well for analyzing noncontrast CT coronary artery calcium (CAC) scans for bone mineral density to detect osteoporosis. In JACR, researchers validated HeartLung Technologies’ AutoBMD software on over 6.7k CT CAC scans and compared it to manual measurements. AutoBMD showed good agreement with manual measurements (R=0.84 where 1.0 is perfect agreement) and was much faster on a per-report basis (15 seconds vs. 5.5 minutes).

• Esaote’s Extremity MRI Deal: Esaote North America has been awarded a national group purchasing agreement by Premier, enabling members of the GPO to take advantage of special pre-negotiated pricing and terms for the company’s O-scan dedicated extremity MRI scanner. The deal is a shot in the arm for Esaote and its effort to market O-scan as an alternative for dedicated MRI scans that’s less expensive than a full-body scanner. 

• DL Model Detects ICH on CT: A deep learning model was able to detect intracranial hemorrhage (ICH) on brain CT scans at a level that was noninferior to residents for sensitivity, but lagged in terms of specificity. In Nature, researchers used a variation of the DeepMedic model to analyze brain CT scans in 300 patients. The algorithm had sensitivity higher than radiology residents (0.82 vs. 0.74), but lower specificity (0.90 vs. 0.99).  

• Omary to Step Down at Vanderbilt: Reed Omary, MD, is stepping down as chair of the department of radiology at Vanderbilt University. Omary is one of radiology’s preeminent thought leaders and has served in the role for the past 10 years, helping found initiatives such as the university’s Strategy Share innovation summit and an agreement with Philips to reduce Vanderbilt’s carbon footprint. Department vice chair Daniel Brown, MD, has been picked to serve as its interim chair.

• Gradient Closes $2.75M Round: AI data sharing developer Gradient Health closed a $2.75M funding round that the company will use to further build out its annotated medical imaging library into a secure and unified platform. Gradient has created a large database of medical images that are annotated and anonymized; researchers and AI developers can contract with the company to access the database to train algorithms. Getting access to such data is key for the development of AI algorithms that are generalizable and unbiased.

Collaboration Improves Platform AI

What’s the latest on the ongoing AI platform collaboration between Bayer and Blackford Analysis? Get an update from Bayer leader Thanos Karras and Blackford’s Ben Panter in this video interview from SIIM 2023.

Overcoming Barriers in Launching a Cardiac PET/CT Program

Adding cardiac PET to your PET/CT practice may present challenges, but the potential clinical and operational benefits make it worthwhile. Learn how to get started in this free webinar from Siemens Healthineers.

The Resource Wire

• 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).  

• What kinds of medical imaging exams are radiologists reading today, and how confident do they feel across different subspecialties? Find out in the 2023 Radiology Practice Development Report from Medality.  

• The quality and appearance of CT scans can vary considerably. In this white paper from Riverain Technologies, find out how image normalization can standardize CT images, making them easier to analyze and interpret.

• Learn about how Us2.ai is bringing simplicity and clarity to the world of cardiac ultrasound, on the latest episode of The Bleeding Edge of Digital Health featuring Us2.ai’s founders, James Hare and Dr. Carolyn Lam. 

• Radiology faces numerous challenges to more efficient workflow, from the siloed nature of healthcare enterprises to mundane tasks that are ripe for automation. In this Imaging Wire Show, we talked to Dr. Matthew Lungren and Calum Cunningham of Nuance Communications.

• The One Viewer philosophy from Visage Imaging offers end users from across the enterprise the chance to get access to Visage 7’s powerful tools based on their clinical need, with the same #1 rated viewer for multiple workflows. Find out today how it works.

• Arterys’ Cardio AI solution recently added a new Atrial Volumes feature that allows cardiologists and radiologists to easily quantify volumes for both left and right atria in cardiac MRI images.

• When SyntheticMR validated its SyMRI MSK solution, they leveraged the CARPL platform to compare conventional knee and spine MRI image quality with SyntheticMR images. Check out their validation process and results here.

• How is Hyperfine changing how we think 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. 

• New AI-based reconstruction tools are making it possible to perform imaging exams that are faster and at lower radiation dose. Learn from the experts how it’s done in this webinar recording hosted by Subtle Medical and Incepto.

• This Bayer Radiology white paper details how the right people, plan, and systems can help imaging teams achieve their dose management goals. 

• What is theranostics, and how is it changing cancer diagnosis and treatment? We talked to Shari Manuel, Chris Heble, and Elfareato Remekie of GE HealthCare in this Imaging Wire Show about the exciting new developments happening in theranostics that are enabling a new era of precision healthcare.

• Check out this Change Healthcare video explaining the difference between single-tenant and multitenant cloud architecture, and how multitenant solutions can improve your efficiency and flexibility.

• What does United Imaging Healthcare have on tap for the upcoming SNMMI 2023 meeting? Two satellite symposia – on total-body PET/CT and PET/CT for clinical molecular imaging – are among the many exciting events in Chicago.

• The cloud will play a foundational role for a variety of healthcare applications, but perhaps one of its biggest impacts will be in supporting patient-centered care. Explore how the cloud will prove critical for ensuring patient-centered care in this editorial by Intelerad’s Morris Panner.