Daniel Arnold, CEO of Medality, on a new report on radiologist training.

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Brain Imaging

MRI Findings Linked to Psychosis

Over one-quarter of patients presenting with a first episode of psychosis had some kind of abnormality on brain MRI scans, and about 6% of all findings were clinically relevant and required a change in patient management. Writing in JAMA Psychiatry, researchers from the UK and Germany say their study suggests that MRI should be used in the clinical workup of all patients presenting with psychosis. 

Psychosis caused by another medical condition – called secondary psychosis – can have causes that produce brain abnormalities visible on MRI scans. These are findings like white-matter hyperintensities that – while not themselves a form of pathology – are sometimes associated with more serious conditions like cognitive decline. 

MRI scans of people experiencing their first psychotic episode could detect some of these abnormalities before subsequent episodes occur. But at present there is no consensus as to whether MRI should be used in the evaluation of patients presenting with first-episode psychosis. 

In a meta-analysis, researchers wanted to investigate the prevalence of intracranial radiological abnormalities on MRI scans of patients with first-episode psychosis. They reviewed 12 independent studies that covered a total of 1,613 patients. Findings across all the studies included:

• A prevalence rate of 26.4% for all radiological abnormalities 
• A prevalence rate of 5.9% for clinically relevant abnormalities 
• One in 18 patients had a change in management after an MRI scan
• White-matter hyperintensities were the most common abnormality, with a prevalence of 7.9% for all abnormalities and 0.9% among clinically relevant abnormalities

Given the impact of MRI on patient management, the authors suggested that performing routine scans on people after their first psychotic episode could have both clinical and economic benefits. This could be especially true due to the financial costs of failing to identify a clinically relevant abnormality that could lead to a later episode if not treated.

The Takeaway 

These findings may break the logjam over whether MRI should be routinely used in the evaluation of patients with first-episode psychosis. The authors note that while many of the abnormalities found on MRI in the studies they reviewed did not require a change in patient management, abnormalities could be harbingers of poorer patient outcomes, even if they don’t eventually lead to a diagnosis of secondary psychosis.

Making AI Evaluations More Effective

If you’re in the business of using or providing AI, there’s a good chance you spend a lot of time managing AI evaluations. But are your evaluations as efficient or effective as they could be? Check out this Imaging Wire Show with Riverain Technologies CEO Steve Worrell, detailing the best practices for mitigating AI adoption risks, today and into the future.

How Thomas Jefferson Leveraged CARPL.ai

See how Thomas Jefferson University relied on CARPL.ai to accelerate its AI validation and clinical adoption in this presentation by informatics and AI leader, Dr. Paras Lakhani.

The Wire

• One-Stop PCCT for Lung Function: New research published in Radiology shows how photon-counting CT (PCCT) can be used to assess both lung function and structure simultaneously – a one-stop combo not possible with conventional CT. Researchers from Germany and the Netherlands studied 196 patients with impaired lung function using a protocol that involved intravenous contrast and inhalation-exhalation. In 84.7% of cases, PCCT acquired all CT-derived parameters of lung function, such as regional ventilation, perfusion, and late contrast enhancement. 

• Eyas Installs 3T Neonatal MRI: The emerging neonatal NICU MRI segment has a new entrant. Eyas Medical Imaging is debuting Ascent^3T, a new 3-tesla magnet that has been installed for research use at Cincinnati Children’s Hospital Medical Center. The scanner is designed to be installed at neonatal NICUs and eliminates the need to transport infants to the radiology department for scanning. Eyas plans to submit Ascent^3T for FDA clearance “in the near future.”

• VA to Develop Prostate AI: Five medical centers in the Department of Veterans Affairs healthcare system are collaborating to develop AI technology to predict whether prostate cancer will spread. The VA sites are working on algorithms that combine imaging data such as MRI scans with high-resolution scans of prostate biopsies and sociodemographic data as part of the Predicting Metastatic Progression of High Risk Localized Prostate Cancer project. The initiative could serve as a roadmap for similar work on AI for lung cancer and other diseases. 

• AI Confirms Lines & Tubes: An AI algorithm from Annalise performed well in detecting the presence and correct placement of lines and tubes on chest X-ray images. Writing in MDPI, Australian researchers tested CXR version 2.0 for detecting the presence of endotracheal tubes, enteric tubes, and central venous catheters on a dataset of over 4.5k chest X-ray images in nearly 2.3k patients. The algorithm detected the presence of nearly all lines and tubes (AUC > 0.99), and satisfactory placement of the devices, with AUCs ranging from 0.86-0.91.

• NHS Doubles Down on AI: The UK’s NHS continues to leverage AI’s benefits for radiology services. East Kent University Hospitals NHS Trust has begun using Qure.ai’s qXR software to analyze emergency department chest x-rays and alert physicians to potential issues. The software – also in use in NHS England’s same-day lung screening project – was one of the first to be procured under the NHS’ new Shared Business Service (SBS) framework; NHS has also been looking at a national rollout of AI with its AI Deployment Platform.

• AI Enables Diabetes Detection: An AI algorithm that analyzes chest X-rays and EHR data may make it possible to conduct opportunistic detection of type 2 diabetes, say researchers in Nature Communications. Researchers developed a deep-learning model and then applied it to a test cohort of almost 10k patients; they found it flagged 14% of cases as suspicious for type 2 diabetes and performed better than a logistic regression model with no chest X-ray data (AUCs: 0.84 vs. 0.79). The study shows the power of radiography for early disease detection when combined with EHR data. 

• Sonio Raises $14M: French software developer Sonio has raised $14M in a Series A round to further advance its ultrasound pregnancy monitoring technology. The company’s software is designed to ensure safer pregnancies by checking the quality of fetal ultrasound scans and analyzing them for abnormalities. The new funding round came after an initial commitment of the European Innovation Council in December 2022 and another funding round in July 2022. 

• Konica Minolta’s New Handheld US: Konica Minolta Healthcare Americas has launched PocketPro H2, a new wireless point-of-care ultrasound (POCUS) scanner. The device is optimized for soft-tissue imaging and is especially suited for MSK applications, as well as pain management, vascular access, and needle guidance procedures. PocketPro H2 is the newest POCUS device from Konica Minolta, which launched SONIMAGE MX1 Platinum in late 2022. 

• Canadian Dipyridamole Shortage: Canada is facing a severe shortage of dipyridamole, a vasodilator agent used in cardiac stress tests, due to production delays. The delays have caused Fresenius Kabi to reduce deliveries to 50% of historical order volumes through mid-August. The shortage could create cardiac imaging challenges, noting that patients who can’t participate in traditional myocardial perfusion imaging stress tests are administered dipyridamole to replicate the effect of exercise.

• Breast Density Tool Proves Accurate: An application for classifying breast density that’s integrated into PACS software produced high accuracy and agreement with radiologists’ assessments in a new study published in Clinical Imaging. Researchers assessed the performance of Visage Imaging’s Visage Breast Density application in classifying 1.2k mammography exams from two sites into one of the four BI-RADS categories. The algorithm had accuracy of 84.6% at site A and 89.7% at site B, suggesting it could be used to triage some women for supplemental breast screening.

• Are Checklist Reports More Thorough? A type of structured radiology report called a synoptic report that uses checklists proved more thorough than conventional structured reports for ovarian CT exams. In AJR, researchers tested synoptic reports that had a checklist of 45 anatomic sites relevant to ovarian cancer management in a group of 205 patients. Synoptic reports had a longer mean turnaround time compared to simple structured reports (29.8 vs. 54.5 minutes) but were far more likely to mention disease involvement at different anatomic sites (100% vs. 37%).

Solutions to Transform Medical Image Delivery

Medical providers and health systems are looking to ditch the disc and modernize their patients’ journey. Learn how Clearpath helps them reduce the cost of retrieving and fulfilling patient requests for imaging and medical records.

Unleash the Power of the Cloud

Change Healthcare’s cloud-native, zero-footprint Stratus Imaging PACS is live in clinical use. See how Stratus Imaging PACS is helping radiology practices improve productivity and patient care, while eliminating the cost and resource constraints of on-premise systems.

Reinventing How Medical Imaging is Done

Explore how United Imaging is reinventing the medical imaging business, including downtime rebates, lifetime upgrades, and making sure their customers truly are successful.

The Resource Wire

• 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.

• Is your department struggling with how to convert analog clinical documentation notes into actionable data that can be used in the EHR? Find out how Duke University turned that legacy information into structured data that can be used for registry reporting and analytics in this Intelerad white paper. 

• What if echo AI could produce measurements that are comparable to expert physicians, but with less variability? That’s exactly what this Nature Communications study revealed about Us2.ai’s solution, finding that its measurements had fewer and smaller differences compared to three human experts than when the experts were compared with each other.

• We talk a lot about radiology practices’ AI adoption, but usually don’t have much evidence to back it up. That changes with this new Arterys report detailing how and why 30 US radiology groups became imaging AI adopters.

• 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.

• This Bayer Radiology case study details how its Certegra P3T Software automates contrast-enhanced abdominal CT injection protocols based on patient characteristics and contrast concentration.

• 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 is Siemens Healthineers helping imaging providers meet their clinical and operational needs while maintaining high-quality care? Find out in this panel discussion with representatives from AdventHealth and WakeMed. 

• 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 the ROI Calculator. 

• This Blackford Analysis video details how imaging AI can improve radiology efficiency and patient care, and discusses the key role that AI assessments and curation plays in achieving these improvements.

• What were the top trends from SIIM 2023? In this article, PocketHealth Co-Founder and CEO Rishi Nayyar sees three major SIIM themes: 1. The development of holistic enterprise imaging strategies. 2. The use of AI to improve radiology workflow and patient outcomes. 3. New solutions for interoperability challenges.

• How do gradients affect the performance of an MRI scanner? Learn all about gradient technology and its role in MR image production in this white paper from GE HealthCare. 

• Visage Imaging’s Visage 7 was named the #1 Universal Viewer in the 2023 Best in KLAS Software and Services Report. Find out what’s behind this award-winning solution and learn more about Visage’s One Viewer philosophy. 

• Annalise.ai’s Annalise CXR solution detects up to 124 findings in a single chest X-ray. See how it detects such a wide range of abnormalities using these demo studies…  or upload your own CXR images.