Laurie Fenton Ambrose, president and CEO of GO2 for Lung Cancer, in a STAT article on low rates of CT lung cancer screening.

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Population Health

Value of Cancer Screening

A new study claims that medical screening for diseases like breast and cervical cancer has saved lives and generated value of at least $7.5T (yes, trillion) over the last 25 years. The findings, published in BMC Health Services Research, are a stunning rebuke to critics of screening exams.

While the vast majority of doctors and public health officials support evidence-based screening, a vocal minority of skeptics continues to raise questions about screening’s efficacy. These critics emphasize the “harms” of screening, such as overdiagnosis and patient anxiety – an accusation often levied against breast screening. 

Screening’s critics also target the downstream costs of medical tests intended to confirm suspicious findings. They argue that a single screen-detected finding can lead to a cascade of additional healthcare spending that drives up medical costs.

But the new study offers a counter-argument, putting a dollar figure on how much screening exams have saved by detecting disease earlier, when it can be treated more effectively. 

The research focused on the four main cancer screening tests – breast, cervical, colon, and lung cancer – analyzing the impact of preventive screening on life-years saved and its economic impact from 1996 to 2020, finding …

• Americans enjoyed at least 12M more years of life thanks to cancer screening
• The economic value of these life-years added up to at least $7.5T
• If everyone who qualified for screening exams got them, it would save at least another 3.3M life-years and $1.7T in economic impact
• Cervical cancer screening had by far the biggest economic impact ($5.2T-$5.7T), followed by breast ($0.8T-$1.9T), colorectal ($0.4T-$1T), and finally lung ($40B). 

Lung cancer’s paltry value was due to a small eligible population and low screening adherence rates. This finding is underscored by a new article in STAT that ponders why CT lung cancer screening rates are so low, with one observer calling it the “redheaded stepchild” of screening tests.  

The Takeaway
Screening skeptics have been taking it on the chin lately (witness the USPSTF’s U-turn on mammography for younger women) and the new findings will be another blow. We may continue to see a dribble of papers on the “harms” of overdiagnosis, but the momentum is definitely shifting in screening’s favor – to the benefit of patients.

5 Innovations in Radiology

What are the top 5 innovations in radiology? In this article, find out what the folks at Enlitic think are the trends transforming medical imaging and improving patient care.

Why AI in Radiology Is a Game-Changer

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. 

The Wire

• Clinical Cost of Delayed Diagnosis: Meanwhile, a new study in European Journal of Radiology chronicles the clinical cost of delayed diagnosis, specifically as it applies to breast screening. Dutch researchers tracked 4.5k women with breast cancer from 2009 to 2019, tracking those who experienced a delay in diagnosis such as delayed workup or cancer missed on a previous screening round. Women with delays had larger tumors (P<0.001) and lymph node metastases (P<0.001), and also had higher rates of mastectomy (P<0.001). 

• Allstate Broker Lawsuit Revived: Allstate has won a court victory in its campaign to crack down on unnecessary imaging utilization. A California appellate court reinstated a lawsuit dismissed by a lower court against Sattar Mirtabatabaee, who Allstate claims is a “broker” who runs medical corporations that refer patients to imaging centers that contract with him. Payors like Allstate have been waging legal battles against brokers that they claim steer patients to imaging centers in exchange for kickbacks or split fees.

• Half of Residents Are Burned Out: Half of radiology residents show signs of burnout, says a new meta-analysis in European Radiology. Researchers analyzed 11 studies with responses from 2.2k radiology residents conducted through November 2022, categorizing answers according to three measures of emotional burnout. They found high prevalence of emotional exhaustion (50%), depersonalization (45%), and diminished personal accomplishment (58%). The study warrants attention from residency program directors and highlights the need for better solutions to address burnout. 

• Blackford Adds Brainreader to Platform: Blackford Analysis has added Brainreader’s Neuroreader automated brain image analysis software to its Blackford Platform. The move will give users of the platform access to Neuroreader’s advanced image analysis tools for assessing complex brain conditions on MRI scans within their existing workflow, with features like volume measurements of brain structures. Other recent additions to Blackford Platform include AI4MedImaging for cardiac MRI quantification and Lunit for chest X-ray and mammography. 

• Trouble with Alzheimer’s Drugs? Only a limited number of people with early-stage Alzheimer’s disease will qualify for treatment with new monoclonal antibody drugs like Leqembi, says a new study in Neurology. In an analysis of 237 people aged 50-90, only 8% met Leqembi criteria, but removing the need for cognitive tests expanded eligibility to 17%. Meanwhile, ACR has sent a letter to CMS urging the agency to adopt broader coverage criteria for PET scans for Leqembi patients, rather than rely on decisions by local Medicare Administrative Contractors.

• FDA Clears AI for Chest X-Ray: There’s a new player in the chest radiography AI segment. The FDA has cleared Imidex’s VisiRad XR algorithm that analyzes chest X-rays and highlights suspicious lung nodules and masses. After analysis, VisiRad XR routes images with AI markings back to radiologists for interpretation in their native viewing environment, next to primary images. In trials of 11k patient images in support of the FDA filing, VisiRad XR had sensitivity of 83% at a fixed false-positive rate per image.

• Sectra Scores Massive $227M Deal: Sectra has landed a massive deal worth $227M to provide its cloud-based Sectra One Cloud enterprise image management software to a US health system under a SaaS model. Sectra is already working with the system (which remains nameless) in ophthalmology image management, and the deal expands the relationship into radiology, pathology, cardiology, and orthopedics. The deal is a major victory for Sectra as it transitions to offering cloud-based subscription services. 

• Contrast Shortage Depressed CT Volume: Last year’s shortage of GE HealthCare’s Omnipaque iodinated contrast medium depressed procedure volume for CT angiography (CTA) and CT perfusion (CTP) studies. In AJNR, researchers tracked data on 72.5k stroke patients from February to July 2022, before and during the shortage. Both CTA and CTP volumes fell (10% and 26%, respectively); volumes dropped even more for CTP using GE contrast but not for other vendors (-43% vs. +3%). The impact on patient care hasn’t yet been assessed.  

• Riverain Lands Fountain Life: Riverain Technologies has installed its ClearRead CT with Clear Visual Intelligence (CVI) software for analyzing chest CT scans at preventive health provider Fountain Life. The partnership will enable Fountain Life to offer cutting-edge AI technology when providing imaging and diagnoses for its members. Expanding in the preventive medicine segment is an interesting wrinkle for Riverain, which has made inroads with traditional health systems like the VA.

• Cardiac PET Reveals Coronary Disease: A new study in JNM shows that cardiac PET with an F-18 sodium fluoride radiotracer revealed coronary microcalcification activity related to coronary artery disease (CAD). In 111 people with CAD or recent heart attack, researchers found that those with chronic CAD had higher radiotracer uptake as measured in Agatston units for baseline calcium scores (294 vs. 72) and more rapid progression of calcification scores (39 vs. 12). But scores didn’t change over a year, indicating stable disease. The findings could help guide CAD therapies.

• The Hidden Fee For Doctors: A ProPublica exposé told the brutal tale of how it became common practice for payors to require doctors to fork up a 5% fee if they want to be paid electronically. The story is told through the lens of payment processor Zelis’ lobbying efforts against CMS, revealing how the company splits the revenue with payors while saddling doctors with another cost. Spoiler alert: CMS now believes its oversight extends only to payors, not to their “business associates.” 

• Nanox Settles SEC Probe: Israeli digital imaging developer Nanox has settled an SEC securities fraud investigation by agreeing to pay a $650k civil penalty; chairman Ron Poliakane separately will pay about $500k. The SEC launched the probe to investigate the company’s claims on the development and manufacturing costs of its flagship Nanox.ARC digital X-ray system. Settling the investigation clears the deck for a commercial launch of a multisource version of Nanox.ARC, which the FDA cleared in April.

Empowering Patients to Manage Follow-Ups

Looking for a better way to get patients to comply with follow-up instructions? PocketHealth now offers Follow-Up Navigator, a new solution that puts follow-ups directly in the patient’s hands. Learn more in this article.

Building a Mobile Lung Cancer CT Screening Program

The number of patients eligible for low-dose CT lung cancer screening has expanded, and so has the need to reach at-risk patients closer to where they live. That’s why Siemens Healthineers’ Mobile Lung Screening Solution combines the quality, ease of use, and flexibility needed to create a program that meets the real-life needs of your community.

Creating a Modern Imaging Network in Costa Rica

SOIN Soluciones Integrales of Costa Rica turned to enterprise imaging solutions from Merge by 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.

The Resource Wire

• A new platform from Clearpath now enables healthcare providers to delight their patients by sharing images and medical records digitally. Find out how it integrates simply into your practice. 

• 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.

• Allina Health needed to replace its on-premises PACS to better serve patients. Learn how Allina turned to Amazon Web Services (AWS) and Visage Imaging for a cloud-based implementation of the Visage 7 enterprise imaging platform. 

• What’s the best way to eliminate patient frustration and get them engaged with healthcare again? Find out how technology can revamp the patient engagement experience in this article produced in collaboration with Nuance in Becker’s Hospital Review.

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

• How can radiology practices use innovative training and education techniques to grow and overcome the ongoing shortage of radiologists? Find out in this Imaging Wire Show interview with Daniel Arnold and Deanna Heier of Medality.

• Creating your AI adoption plan? This Arterys report details what clinical, efficiency, and regulatory factors to look for in radiology AI vendors.

• 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. 

• We may be entering a third wave of imaging AI’s rapid evolution, one that brings a shift from narrow point solutions to comprehensive multi-finding AI systems. Hear this discussion with Annalise.ai Chief Medical Officer Rick Abramson, MD, exploring how this transition could take place, how radiologist and VC perspectives on AI are changing, and how AI might continue to evolve in the future.

• 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. 

• Are you sure your imaging archive is safe and recoverable? See how Intelerad’s Cloud DR disaster recovery solution mitigates the many risks facing your archive by securely storing copies of every image.

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

• Are you sure your imaging archive is safe and recoverable? See how Intelerad’s Cloud DR disaster recovery solution mitigates the many risks facing your archive by securely storing copies of every image.

• 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.

• What are the trends in medical imaging technology that are coming, and how can you prepare for them? Learn more in this August 23 webinar featuring Luann Culbreth of United Imaging. 

• 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.