Stamatia Destounis, MD, in an Imaging Wire Show on the relationship between breast density and cancer risk.

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Imaging IT

Making Screening Better

While population-based cancer screening has demonstrated its value, there’s no question that screening could use improvement. Two new studies this week show how to improve on one of screening’s biggest challenges: getting patients to attend their follow-up exams.

In the first study in JACR, researchers from the University of Rochester wanted to see if notifying people about actionable findings shortly after screening exams had an impact on follow-up rates. Patients were notified within one to three weeks after the radiology report was completed. 

They also examined different methods for patient communication, including snail-mail letters, notifications from Epic’s MyChart electronic patient portal, and phone calls. In approximately 2.5k patients within one month of due date, they found that follow-up adherence rates varied for each outreach method as follows:

• Phone calls – 60%
• Letters – 57%
• Controls – 53%
• MyChart notifications – 36%

(The researchers noted that the COVID-19 pandemic may have disproportionately affected those in the MyChart group.) 

Fortunately, the university uses natural language processing-based software called Backstop to make sure no follow-up recommendations fall through the cracks. 

• Backstop includes Nuance’s mPower technology to identify actionable findings from unstructured radiology reports; it triggers notifications to both primary care providers and patients about the need to complete follow-up.

Once the full round of Backstop notifications had taken place, compliance rates rose and there was no statistically significant difference between how patients got the early notification: letter (89%), phone (91%), MyChart (90%), and control (88%). 

In the second study, researchers in JAMA described how they used automated algorithms to analyze EHR data from 12k patients to identify those eligible for follow-up for cancer screening exams.

• They then tested three levels of intervention to get people to their exams, ranging from EHR reminders to outreach to patient navigation to all three. 

Patients who got EHR reminders, outreach, and navigation or EHR reminders and outreach had the highest follow-up completion rates at 120 days compared to usual care (31% for both vs. 23%). Rates were similar to usual care for those who only got EHR reminders (23%).

The Takeaway

This week’s studies indicate that while health technology is great, it’s how you use it that matters. While IT tools can identify the people who need follow-up, it’s up to healthcare personnel to make sure patients get the care they need.

AI-Enabled Solutions for Advanced Radiology Insights

What is Tempus Pixel, and how is it optimizing how radiologists read images, detect findings, and share insights with referring physicians? Find out in this resource page from Tempus Radiology.

Nuance’s PIN Helps Identifies Emphysema

Emphysema is often underdiagnosed, and this can make treatment more difficult. FirstHealth of the Carolinas was able to improve its diagnosis of emphysema and enhance its CT lung screening service with AI algorithms available through Nuance Precision Imaging Network (PIN).

The Wire

• FDA Sets Up Digital Health Group: The FDA has established a new Digital Health Advisory Committee to help guide the agency’s policies on technologies like AI and machine learning, augmented and virtual reality, and wearable devices. The agency is accepting nominations of experts to serve as members of the committee, which will have nine members including the chair. The move illustrates digital health’s growing importance – and the FDA’s belief that it’s worthy of increased attention.

• Mobile Cardiac PET Firm to Pay $85M: A mobile cardiac PET scan provider has agreed to pay an $85M settlement to resolve charges that it paid kickbacks to cardiologists for patient referrals. Cardiac Imaging of Oakbrook Terrace, Illinois will pay $75M and its founder Sam Kancherlapalli will pay $10M to US authorities to settle allegations that they paid cardiologists fees of $500 or more to supervise PET scans for patients they referred to Cardiac Imaging from 2014 to 2023, in violation of federal law.

• Setback for Amyloid PET for Alzheimer’s: Amyloid PET scans failed to have a statistically significant impact on management of Alzheimer’s patients in a new study in JAMA Neurology.  In an analysis of 12.7k patients in the IDEAS trial, UCSF researchers had hoped that amyloid PET would have at least a 10% relative reduction in 12-month hospitalization or ED visits, but instead saw just a 4.5% decline versus controls (24% vs. 25%). The findings could complicate efforts to secure greater reimbursement for amyloid PET.

• GE’s Photon-Counting CT Ramps Up: Researchers at Stanford University have begun scanning human subjects with a photon-counting CT scanner from GE HealthCare. The Stanford team will perform research and provide technical feedback to GE on the scanner, which uses the company’s Deep Silicon-based semiconductor detector technology. Stanford joins the University of Wisconsin-Madison and Karolinska Institutet in Sweden as GE’s development partners; the Stanford alliance indicates that GE is moving closer to commercial availability of photon-counting CT.

• CT Lung Screening Moves Ahead in Germany: Germany is on the verge of implementing a national low-dose CT (LDCT) lung cancer screening program after publication of a position paper by specialist societies detailing how the program should be set up. In a German-language paper in RoFo, authors present the rationale for nationwide screening and discuss the dangers of “unstructured screening.” German regulatory authorities by the end of 2023 will introduce legislation setting up screening; studies from Italy and Taiwan have shown that LDCT programs are effective. 

• Deepc Helps at Oktoberfest: In other news from Germany, AI platform developer deepc brought its BrainScan CT software to this year’s Oktoberfest in Munich as part of a partnership with Ludwig Maximilian University (LMU) Hospital, which provided medical services at the festival. LMU Hospital radiologists used the company’s deepcOS platform to deploy BrainScan CT to detect 16 classes of lesions, including brain bleeds and strokes. Oktoberfest organizers have looked to CT to quickly assess injured revelers on-site and determine if they need hospital referral.

• MRI Falls Short in Predicting Psychosis: Brain MRI scans of people at high risk of psychosis were unable to predict which individuals would develop a psychotic disorder. In JAMA Psychiatry, researchers performed scans on 1.3k at-risk people and measured areas of brain structure, finding that their measurements were similar to those of normal controls. The findings seem to run counter to another recent study indicating that structural brain changes found on MRI could predict risk of psychosis. 

• AI Spots Ischemia on Brain MRI: Cerebriu’s Apollo AI triage algorithm was effective in detecting acute ischemia on brain MRI scans in a study in EJR. Researchers from Denmark compared Apollo’s findings to those of an experienced neuroradiologist in 995 patients scanned from January 2020 to April 2023. Apollo turned in high sensitivity and specificity for acute/subacute ischemia (89% and 90%), and there was no difference in the algorithm’s performance based on age, sex, or comorbidities. Apollo has the CE Mark in Europe and Cerebriu is moving it toward a US clearance.

• Qure Taps Shah as CMO: AI developer Qure.ai has tapped Samir Shah, MD, as its chief medical officer. Shah has been a practicing radiologist for 20 years, and most recently was chief clinical officer of teleradiology and senior VP of radiology at Envision Healthcare. He has also served executive stints at NightHawk Radiology Services, Virtual Radiologic, and Radiology Partners. Qure recently cemented a three-year alliance with teleradiology provider USARAD.

• Annalise Enters Nordics via HumanBytes: Annalise.ai has entered the Nordic region through a distribution partnership with Human Bytes, a Danish provider of healthcare AI solutions. Human Bytes will be Annalise’s preferred provider in the Nordic region, selling the company’s AI applications for chest X-ray and brain CT. Annalise has been expanding its global footprint, recently gaining access to Singapore and Malaysia. 

• BMD Software Gets Breakthrough Label: Naitive Technologies’ OsteoSight software for estimating bone mineral density (BMD) from routine X-rays has received Breakthrough Device designation from the FDA. OsteoSight analyzes X-rays – often acquired for other reasons – and generates an estimate of bone density and an osteoporosis classification based on WHO guidelines. Such opportunistic screening could detect osteoporosis before a chronic event like a fracture occurs, and can make imaging exams more cost-effective by detecting multiple conditions. 

• Imaging Reveals Speed Eating’s Perils: Before you enter that competitive speed eating contest, you might want to read this case study from Singapore in Gastroenterology of a 30-year-old man who ate a 7lb (3.2kg) hamburger in 30 minutes. CT images show his stomach and proximal duodenum “grossly distended” with so much food material that it compressed his pancreas and shifted his bowels. His physicians considered stomach surgery to remove food particles, but eventually his digestive processes resumed and he was discharged after five days. 

Breast Density Classification: From Conception to Routine Use

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.

The Intersection of Health Technology and Business

How are the worlds of health technology and business intersecting? In this episode of The Radiology Report, Intelerad Medical Systems President Morris Panner sits down with Medality CEO Daniel Arnold to explore his career and discuss the evolution of the industry.

Automating the Fight Against Heart Disease

How can AI be mobilized to automate the fight against heart disease? Us2.ai President Yoran Hummel, PhD, discusses how echocardiography can be optimized in an interview on The Medical AI Podcast. 

The Resource Wire

• Meet the women who inspire GE HealthCare to keep pushing for progress and pioneering mammography technology that improves health and can save lives. Hear their stories in these videos.

• 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.

• Cleaning up radiology data takes more time than you might think. Learn how Enlitic’s Curie|ENDEX solution transforms medical image data descriptions to a consistent, clinically relevant standard nomenclature.

• Join Merge on October 19 for a conversation on how to provide better patient outcomes and user experiences in mammography. Hear from thought leaders on the development and deployment of breast imaging solutions driven by patient needs.

• True time-of-flight (TOF) PET/CT based on lutetium oxyorthosilicate (LSO) detectors offers numerous clinical advantages, such as better definition of small lesions and improved uniformity. Learn the other advantages in this article from Siemens Healthineers. 

• A new downloadable guide from PocketHealth shows how you can create positive patient experiences, eliminate patient anxiety, and increase appointment and follow-up adherence.

• Join industry experts in this October 18 webinar from Bayer as they provide insight on streamlining radiology’s transition to AI, including addressing resistance to change and optimizing AI’s potential to impact patient care. 

• 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. 

• 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.

• When it began implementing its AimSG nationwide AI program, Singapore’s Synapxe health technology agency relied on the CARPL.ai platform to make everything work. Learn more in this article. 

• 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.

• Subtle Medical has been named to CB Insights’ 2023 list of top 100 AI companies worldwide. The laureates were picked from a pool of nearly 9k companies, and were chosen based on a variety of criteria developed by CB Insights.

• The FDA has ruled that healthcare providers must inform patients of their breast density status. Learn how Intelerad’s solutions can help mammography facilities comply with this new rule well ahead of next year’s deadline. 

• What’s the latest news from Clearpath? Find out how its fully automated patient and provider solutions for sharing medical records and images are making waves in healthcare.