Truhn D et al, in a new study in European Radiology on the environmental impact of AI.

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Radiology

Radiation and Cancer Risk

New research on the cancer risk of low-dose ionizing radiation could have disturbing implications for those who are exposed to radiation on the job – including medical professionals. In a new study in BMJ, researchers found that nuclear workers exposed to occupational levels of radiation had a cancer mortality risk that was higher than previously estimated.

The link between low-dose radiation and cancer has long been controversial. Most studies on the radiation-cancer connection are based on Japanese atomic bomb survivors, many of whom were exposed to far higher levels of radiation than most people receive over their lifetimes – even those who work with ionizing radiation. 

The question is whether that data can be extrapolated to people exposed to much lower levels of radiation, such as nuclear workers, medical professionals, or even patients. To that end, researchers in the International Nuclear Workers Study (INWORKS) have been tracking low-dose radiation exposure and its connection to mortality in nearly 310k people in France, the UK, and the US who worked in the nuclear industry from 1944 to 2016.

INWORKS researchers previously published studies showing low-dose radiation exposure to be carcinogenic, but the new findings in BMJ offer an even stronger link. For the study, researchers tracked radiation exposure based on dosimetry badges worn by the workers and then rates of cancer mortality, and calculated rates of death from solid cancer based on their exposure levels, finding: 

• Mortality risk was higher for solid cancers, at 52% per 1 Gy of exposure
• Individuals who received the occupational radiation limit of 20 mSv per year would have a 5.2% increased solid cancer mortality rate over five years
• There was a linear association between low-dose radiation exposure and cancer mortality, meaning that cancer mortality risk was also found at lower levels of exposure 
• The dose-response association seen the study was even higher than in studies of atomic bomb survivors (52% vs. 32%)

The Takeaway

Even though the INWORKS study was conducted on nuclear workers rather than medical professionals, the findings could have implications for those who might be exposed to medical radiation, such as interventional radiologists and radiologic technologists. The study will undoubtedly be examined by radiation protection organizations and government regulators; the question is whether it leads to any changes in rules on occupational radiation exposure.

Lake Medical Imaging’s Subtle Solution

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.

Exploring the Role of AI in Radiology

How did Capital Health in New Jersey approach its investment in AI for radiology? For one, it’s necessary to have a comprehensive solution that goes beyond single-feature detection, according to this discussion between Dr. Ajay Choudhri and Annalise Chief Medical Officer Dr. Rick Abramson. 

The Wire

• Is AI Bad for the Planet? Is medical AI bad for the planet? In European Radiology, German researchers observe that the computer horsepower required to train a large language model (LLM) AI algorithm had the same carbon footprint as 262 people taking a roundtrip flight from New York to Munich, or running an MRI scanner for 9.5 years, and that’s not including the extra compute power LLMs need to run. They advise AI developers and users to reduce the burden through careful planning such as centralized data centers.

• Qure Partners with xWave on CDS: Qure.ai has signed a partnership with clinical decision support (CDS) software developer xWave Technologies. The deal covers product co-development and integration to provide CDS in combination with AI to help radiology teams order and report on the right diagnostic tests. The companies see the partnership as slowing the growth of waiting lists, particularly in the UK’s NHS health system. Qure has seen recent success implementing its AI solutions at NHS facilities. 

• Mixed Results with Breast MRI Protocol: Abbreviated breast MRI (ABMRI) had mixed results versus standard breast MRI and contrast-enhanced mammography (CEM) in a study in Radiology. In 492 patients, ABMRI was comparable to standard MRI and had better sensitivity than CEM (88.9% vs. 61%) and a better cancer detection rate per 1k patients (32.5 vs. 22.4), but had a higher recall rate (26.6% vs. 14%). Given that the point of screening is to detect cancer, we give the edge to ABMRI. 

• Gender Shift in Early-Onset Cancer: The rate of early-onset cancers (those in people younger than 50) grew a total of just 0.74% in a population of 562k people from 2010 to 2019. But that rate obscures growth of 4.4% in women and a decline of 4.9% in men, says an article in JAMA Network Open. The increase in women was driven by more cancers of the breast and uterus; the incidence rate of breast cancer grew from 21% to 24% over the study period. 

• ProPublica Exposé Targets IVRad: A Pennsylvania interventional radiologist was the target of an investigative story by ProPublica that questions why he’s practicing despite being accused of performing unnecessary peripheral artery procedures. James McGuckin, MD, has been named in a federal lawsuit accusing him of billing $6.5M in procedures that allegedly weren’t necessary, but he is still performing procedures. The story claims the case illustrates the challenges in regulating vascular medicine, which has been the target of critical articles by both ProPublica and The New York Times. 

• Radiologist Accused in Opioid Bust: Meanwhile in California, an interventional radiologist has been arrested and charged with illegally obtaining opioids. Arash Padidar, MD, faces seven felony counts on charges he obtained the pain medication Norco “without a legitimate medical purpose.” The complaint filed in the case lists 98 occasions from 2018 to 2020 in which the opioid was allegedly fraudulently obtained, in the name of himself and family members. Padidar is listed as maintaining offices at Minimally Invasive Surgical Solutions in San Jose. 

• CMS Relents on Dispute Fee: In the wake of an adverse court decision, CMS has reinstated the $50 administrative fee for managing disputes on surprise billing under the No Surprises Act. CMS had planned to charge $350 per dispute under the act’s independent dispute resolution (IDR) process, but physician groups sued successfully, saying the charge was so high it might exceed the cost of many medical procedures. CMS may still reopen a process to set a new IDR fee amount.

• PocketHealth Adds Follow-Up: PocketHealth has added a new feature that helps patients using its Report Reader solution comply with follow-up instructions from imaging providers. Follow-Up Navigator can help patients manage their follow-up instructions on radiology reports from within their PocketHealth accounts, whether scheduling another imaging appointment or requiring additional tests or lab work. Follow-Up Navigator is intended to improve patient care by reducing the 60% non-compliance rate for follow-up imaging; PocketHealth also recently introduced an Appointment Reminders feature.

• Pediatric Sedation Use Edges Down: In a research letter in JAMA Pediatrics, researchers saw only a slight decline in the number of pediatric emergency CT and MRI procedures using sedation. In a group of 560k children, use of sedation fell only one percentage point from 2012 to 2022 (13.1% to 12.1%). Studies at individual centers have shown that sedation use can be reduced by much greater levels, indicating that best practices on pediatric anesthesia may not be filtering out to more hospitals.

• Subtle Medical Signs Florida Center: Subtle Medical has installed its SubtleMR software at Hope Imaging at Indian River Radiology in Vero Beach, Florida. The installation gives Hope Imaging patients access to Subtle’s technology for enhancing MRI scans, contributing to short scan times and improving workflow efficiency. Subtle was just named to CB Insights’ list of top 50 most promising privately held generative AI companies. 

• Hospitals Among Most Dangerous Workplaces: About 3 in 4 nonfatal workplace violence injuries now involve workers in healthcare and social work, making hospitals and clinics the most dangerous workplaces in the US. Healthcare workers suffer more nonfatal injuries from workplace assaults than any other field – including law enforcement – and backlash against pandemic public health measures isn’t helping the situation. Healthcare saw 10.4 injuries from workplace violence per 10k workers in 2018, up 62% from 2011.

• iCAD Expands Google Tie-Up: iCAD has expanded its relationship with Google Health to integrate Google’s AI technology into its ProFound Breast Health Suite for analyzing 2D mammograms. The goal of the expansion – which builds on an alliance announced last year – is to develop AI that will be powerful enough to use as an independent reader of screening mammograms, eliminating the need for double-reading of most studies in regions that require double-reading. 

• Daytime Telerad Service Launches: US Radiology Specialists is launching US Radiology Connexia, a new teleradiology service that plans to focus on daytime subspecialized interpretations. Connexia is recruiting subspecialized radiologists with a pitch that’s heavy on the lifestyle play, targeting the “next generation of physicians” who want remote, flexible work options.

AI Governance in Radiology

AI in healthcare has grown quickly, as have discussions about AI regulation. Join this August 23 webinar from Bayer and Calantic Digital Solutions to hear expert perspectives on the current and future state of AI governance in healthcare and radiology.

A Comprehensive Approach to Theranostics

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.

What Is CPACS in Cardiology?

What is CPACS in Cardiology? It stands for Cardiovascular Picture Archive and Communication System, and it’s used to store, manage, and share cardiology images. Learn how CPACS can improve patient care in this Intelerad blog post.

The Resource Wire

• Imaging’s cloud evolution didn’t happen all at once. This Change Healthcare animation details the history of digital imaging architectures, and how cloud-native imaging improves stability and scalability, ease of management, patient data security, and operating costs.

• Faced with the task of monitoring the thousands of exams its algorithms analyze each day, Qure.ai leveraged CARPL.ai’s validation workflow to create a real-time performance dashboard. See how they did it here.

• Texas has one of the highest obesity rates in the US. So to best serve its patients, Memorial MRI & Diagnostic in Houston turned to United Imaging and its 3.0T uMR OMEGA MRI scanner with 75cm ultra-wide-bore. Learn more about their story. 

• 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 fast, quantitative SPECT/CT supporting quicker assessment of treatment response in patients with metastatic prostate cancer? Find out in this case study from New York-Presbyterian Hospital/Weill Cornell Medical Center, provided by Siemens Healthineers. 

• Radiology follows a structured workflow to ensure accurate and timely imaging. But where does efficiency break down between referral and diagnosis, and how can you prevent this from happening? Find out in this Enlitic white paper.

• Get to know Clearpath and its novel approach to empowering patients by giving them digital access to their images and medical records in this video interview from SIIM 2023. 

• Transthyretin (ATTR) amyloidosis is emerging as an under-recognized form of heart failure, especially in the elderly. In this video, Marianna Fontana, MD, PhD, of UCL describes how Us2.ai technology was used to assess ATTR. 

• What’s happening at the intersection of AI and precision medicine? In this Imaging Wire Show, we talked to Chiranjiv Singh, general manager at Arterys, a Tempus Labs company, about their vision for building a 360° view of the patient.

• Clinical applications for healthcare AI are rapidly expanding, but many barriers are still preventing widespread adoption. This Nuance post explores a critical set of questions: what happens after an AI model goes into production, and how to know if it continues to perform as expected?

• Knowing an individual’s mammographic breast density is key to understanding their risk for cancer. A new article from Visage Imaging explains how an AI-based solution can improve breast density assessment. 

• 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. 

• 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.

• Still sharing patient images with CDs? It may be time to move on. Find out how PocketHealth can help you make the transition to fully digital image exchange in this article.

• What are the benefits of AI in radiology? Quite simply, they are game-changing and will drive improved hospital efficiency, according to this article that features Blackford Analysis CEO Ben Panter.