Rick Abramson, MD, chief medical officer of Annalise.ai, on the state of the radiology AI industry.

AI for medical imaging is evolving rapidly. From generative large language models to foundational algorithm training, the field is generating new headlines every week. In this edition of the Imaging Wire Show, we got an update on the latest developments from Rick Abramson, MD, chief medical officer of Annalise.ai.

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Breast Imaging

Canada’s Breast Screening Push

As Canada examines revisions to its breast cancer screening guidelines, a new study adds support to the proposal of lowering its screening age to 40 – a move made in the US earlier this year. 

When to start breast screening has long been one of the most controversial aspects of mammography. 

• In the US, a firestorm erupted in 2009 when the USPSTF withdrew its recommendation that women start in their 40s … a policy that wasn’t rescinded until May. 

In Canada, the Canadian Task Force on Preventive Health Care is reviewing its 2018 screening guidelines, which currently advise women to wait until 50 to start routine breast screening, and then be screened every 2-3 years after that. 

• The Canadian task force’s 2018 guidelines also don’t mention dense breast tissue, a known risk factor for breast cancer (the FDA earlier this year said it would begin requiring breast density reporting). 

Canadian breast specialists have been pushing for the task force to lower the screening age, and their efforts got a boost with a new study that found starting breast screening at age 40 and continuing with it annually saved the greatest number of lives.

Researchers in MDPI used the OncoSim-Breast microsimulation model to simulate various screening regimens in a cohort of 1.5M Canadian women born in 1975. They assessed the earlier screening strategy by various metrics, including impact on breast cancer mortality, number needed to be screened to avert one breast cancer death, and stage at diagnosis, finding …

• Annual screening starting at age 40 had the biggest mortality reduction compared to no screening, at 7.9 fewer deaths per 1,000 women, compared to biennial 40-74 (5.9) and biennial 50-74 (4.6) 
• Annual screening from 40-74 had the lowest number of women who must be screened to avert one death (127) compared to biennial 40-74 (169) and biennial 50-74 (220)
• Earlier annual screening would produce the greatest stage shift to more early invasive (stage 1 and stage 2a) cancers detected compared to other regimens 

The Takeaway

The Canadian task force is expected to complete its review by the end of the year – where it will land on the issue is anyone’s guess. It’s hoped that the new study – as well as other research on mammography’s effectiveness in Canada published in the last couple years – will spur the group to lower the screening age. But breast imaging experts we spoke with are skeptical given the task force’s preference for randomized clinical trials, which haven’t been performed in Canada on breast screening in decades.

Learn about Subtle Solutions

How can Subtle Medical’s advanced solutions like SubtleMR and SubtlePET – and upcoming SubtleSYNTH launch – improve image quality, workflow efficiency, and patient care? Find out in this RSNA 2023 Lunch & Learn session at Noon Tuesday November 28.

Discover the Power of the AI Platform

Do you want to streamline your diagnosis, improve your efficiency, and measure your ROI? Then reserve a slot at the Bayer Experience Center at RSNA 2023 to discover the power of the AI platform with Calantic Digital Solutions and Bayer’s ROI calculator.

The Wire

• RSNA to Move to Earlier Dates: If you’re tired of losing half your Thanksgiving weekend to the annual RSNA meeting, help is on the way – but not for four more years. In an email to exhibitors, RSNA said it would be moving the 2027 edition of the conference to mid-November. After that, the show would alternate between mid-November dates and the traditional post-Thanksgiving time frame, with odd-numbered years (2027, 2029, 2031) taking place earlier. 

• Implants Produce Prostate MRI Artifacts: MRI’s role for imaging prostate cancer is growing rapidly, but there are situations where the modality can be stymied. A new paper in European Radiology details how prostate MRI’s performance is affected in patients with implanted hip prostheses. Mayo Clinic researchers analyzed 11.3k MRI exams, 5% of which were of patients with hip prostheses. The cancer detection rate was 26% lower in patients with moderate and severe artifacts on MRI.

• Philips Signs Collaboration with Quibim: Philips has signed an agreement with Spanish software developer Quibim to integrate that company’s QP-Prostate image analysis application with its MRI protocols. The companies will develop an integrated solution that automates real-time segmentation of the prostate gland on MRI, supporting quantified and standardized reporting of MRI prostate exams. Quibim secured European regulatory approvals for QP-Prostate in late 2022 and in the US in 2021.

• Radiology Applicants Dip in ERAS: The number of medical students applying for radiology residency slots fell 7.5% in the most recent round of the Electronic Residency Application Service (ERAS), which began in late September. An analysis by Francis Deng, MD, found that radiology had the biggest pullback among medical specialties, but the number of radiology applicants is still up 21% compared to five years ago. The recent decline could indicate medical students shying away from a field seen as too competitive. 

• PET Supports new Leqembi Formulation: Researchers used PET to demonstrate that a new weekly subcutaneous formation of Alzheimer’s drug Leqembi cleared 14% more amyloid plaque in the brain at six months than biweekly intravenous administration. In other data presented at the Clinical Trials on Alzheimer’s Disease (CTAD) conference, researchers presented data showing a clinical response in patients with low tau levels, indicating the drug’s potential for treating early disease. CMS in October indicated it would loosen its reimbursement rules for PET scans of dementia patients. 

• Cutting Medical Device Waste: GE HealthCare is partnering with reLink Medical in a collaboration to help healthcare providers reduce medical device waste. GE notes that providers each year retire about 10% of their medical assets; the collaboration will standardize the disposition process by helping them sell, recycle, or donate equipment. If devices are sold, a percentage of revenue will be returned to the provider as credits they can use for new equipment, parts, or other goods and services.

• Feds Offer Clarity on Surprise Billing: Late last week the Biden Administration released a proposed rule clarifying the independent dispute resolution (IDR) process in the federal No Surprises Act on surprise billing. The IDR process was the subject of a lawsuit by physician groups over fees that prompted CMS to pull its policy. The new proposal would set rules governing communication between payors and providers, create an open negotiation period, determine eligibility, and lay the ground rules for administrative fees.

• New Lung Screening Model Reduces Bias: Using individualized risk criteria rather than USPSTF guidelines to select CT lung cancer screening could reduce racial disparities. In JAMA Oncology, researchers found that in a population of 105k people, an updated version of the PLCOm2012 model boosted African-American screening eligibility compared to USPSTF 2021 criteria (36% vs. 21%) and had better sensitivity across multiple ethnic groups (67% vs. 58%), as well as a lower number needed to screen (26 vs. 30). The study builds on previous research looking for better models than USPSTF criteria. 

• NewVue Launches Command Center: Radiology software developer NewVue has launched EmpowerSuite, a cloud-based radiologist command center. The application uses AI to summarize clinical data and balance the reading preferences of radiologists with a facility’s workload, giving what the company calls a “radiologist-friendly” approach to workload balancing. NewVue was co-founded by Kyle Lawton, who was president and CEO of peerVue until that company was acquired by McKesson in 2012. 

• TeraRecon Releases Cardiology Suite: At last week’s TCT meeting, software developer TeraRecon launched a new Cardiology Suite package on its Eureka Clinical AI platform, including applications for echo AI from Us2.ai and chest CT from Coreline Soft. In other news from TCT 2023, TeraRecon partnered with Belgian developer FEops to add its HEARTguide Digital Twin solution to the company’s Intuition advanced visualization application to help plan left atrial appendage closure procedures. TeraRecon has also added software from ImageBiopsy Lab and Optellum to Eureka Clinical AI. 

• Paragon’s Health IT Pivot: Healthcare technology consulting firm Paragon Consulting Partners is pivoting to a stronger emphasis on healthcare IT. The firm has changed its name to Paragon Health IT and plans to emphasize Strings, its software for collecting and analyzing data generated across healthcare enterprises. Strings enables healthcare sites to better understand their use of medical devices and software; Paragon recently signed a deal to integrate Strings with AI and image processing tools from Claritas HealthTech.

Advancing Neuroimaging to See the Unseen

Concussions and mild traumatic brain injury (mTBI) can be hard to identify on conventional imaging, even with 3T MRI. Find out how GE HealthCare’s MAGNUS gradient platform is changing the game in TBI imaging to see the unseen.

A Tactical Approach to Leadership Success

Learn new strategies for achieving leadership success in this on-demand recording of a RadEqual webinar sponsored by Intelerad and the American Association for Women in Radiology, and featuring Geraldine McGinty, MD, and Melissa Davis, MD.

The Resource Wire

• Calculate Your Cost Savings: Instantly calculate your savings from data standardization with the Curie|ENDEX solution using Enlitic’s ROI Calculator. ENDEX conforms messy metadata to a standard convention, making it searchable and making hanging protocols more reliable.

• 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.

• Why SyntheticMR Went with CARPL.ai: 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.

• Starting a CT Lung Cancer Screening Program: There’s no doubt CT lung cancer screening reduces lung cancer mortality. In this Imaging Wire Show, we discuss how to set up CT lung screening and the technologies available to help with Chip Gilkeson, MD, of University Hospitals Cleveland Medical Center and Steve Worrell of Riverain Technologies.

• Power at the Point of Care: Are you ready to upgrade your X-ray technology? Check out United Imaging’s high-performance X-ray systems at RSNA 2023 at Booth #4100 and see the uDR 380i Pro Mobile X-ray system navigate its own obstacle course.

• The Path to Modernization in Enterprise Imaging: Meet your challenges with innovation as you blaze a path to modernization with Merge Imaging Suite, an array of solutions designed to enable imaging clinicians to enjoy a seamless and frictionless workflow experience.

• The Case for Enterprise Cloud: Is your organization ready to move enterprise imaging to the cloud? Check out this Change Healthcare and ACHE webinar detailing cloud-native imaging’s benefits, best practices, and ROI.

• Streamlining AI Adoption and Workflow: Check out this Blackford Analysis video detailing how its AI platform streamlines AI adoption and workflows, allowing radiology teams to achieve AI’s clinical benefits without operational sacrifices.

• Enhancing Patient Engagement through Effective Communication: A new downloadable guide from PocketHealth shows how you can create positive patient experiences, eliminate patient anxiety and increase appointment and follow-up adherence.

• Echo AI Hits the High Notes in OPERA Study: New results from the OPERA study show how Us2.ai’s echo AI solution improved heart failure screening in the NHS, reducing echo waiting times from 12 months to under 6 weeks. Find out more in this article.

• A Perfect Balance of Utility and Nirvana: 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.

• How to Grow Your Practice When It’s Impossible to Recruit and Retain: 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. 

• Advanced Imaging Access for All: Patients’ zip codes shouldn’t determine the healthcare they receive. Siemens Healthineers aims to make advanced diagnostic imaging accessible for all patients. Register today for a launch event on November 16 at 12:00 p.m. ET to meet the company’s new Somatom CT family member. 

• Next-Generation Radiology Reporting: Join the conversation in this webinar recording and hear from PACS administrator Griff R. Van Dusen of Memorial Health System how Nuance PowerScribe One’s next-generation reporting experience helps streamline workflow and improve report quality so radiologists can get more done in less time.