Cameron Andrews, founder and CEO of Sirona Medical, in the latest Imaging Wire Show on Imaging’s Multimodal AI Future.

Interest in radiology AI is high, but many see AI’s real potential as being a multimodality tool that integrates areas like radiology, ophthalmology, and cardiology. In this edition of the Imaging Wire Show, we talked to Cameron Andrews, founder and CEO of Sirona Medical, and John Bertrand, co-founder and CEO of Digital Diagnostics, about this exciting future.

Imaging Wire Sponsors

Bayer  •  Blackford  •  CARPL.ai  •  Change Healthcare  •  Clearpath  •  Enlitic  •  GE HealthCare  •  Gleamer  •  Intelerad  •  Medality  •  Merge by Merative  •  Nuance  •  PocketHealth  •  Riverain Technologies  •  Siemens Healthineers  •  SpinTech MRI  •  Subtle Medical  •  United Imaging  •  Us2.ai  •  Visage Imaging

Lung Cancer Screening

More Support for CT Lung Cancer Screening

Yet another study supporting CT lung cancer screening has been published, adding to a growing body of evidence that population-based CT screening programs will be effective in reducing lung cancer deaths. 

The new study comes from European Radiology, where researchers from Hungary describe findings from HUNCHEST-II, a population-based program that screened 4.2k high-risk people at 18 institutions. 

• Screening criteria were largely similar to other studies: people between the ages of 50 and 75 who were current or former smokers with at least 25 pack-year histories. Former smokers had quit within the last 15 years. 

Recruitment for HUNCHEST-II took place from September 2019 to January 2022. Participants received a baseline low-dose CT (LDCT) scan, with the study protocol calling for annual follow-up scans (more on this later). Researchers found: 

• The prevalence of baseline screening exams positive for lung cancer was 4.1%, comparable to the NELSON trial (2.3%) but much lower than the NLST (27%)
• 1.8% of participants were diagnosed with lung cancer throughout screening rounds
• 1.5% of participants had their cancer found with the baseline exam
• Positive predictive value was 58%, at the high end of population-based lung screening programs
• 79% of screen-detected cancers were early stage, making them well-suited for treatment
• False-positive rate was 42%, a figure the authors said was “concerning”

Taking a deeper dive into the data produces interesting revelations. Overdiagnosis is a major concern with any screening test; it was a particular problem with NLST but was lower with HUNCHEST-II. 

• Researchers said they used a volume-based nodule evaluation protocol, which reduced the false-positive rate compared to the nodule diameter-based approach in NLST.

Also, a high attrition rate occurred between the baseline scan and annual screening rounds, with only 12% of individuals with negative baseline LDCT results going on to follow-up screening (although the COVID-19 pandemic may have affected these results). 

The Takeaway

The HUNCHEST-II results add to the growing momentum in favor of national population-based CT lung screening programs. Germany is planning to implement a program in early 2024, and Taiwan is moving in the same direction. The question is, does the US need to step up its game as screening compliance rates remain low?

Automated Solutions for Patient and Provider Sharing

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.

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.

The Wire

• Accessing Quality Data for AI Training: One of the biggest roadblocks in medical AI development is the lack of high-quality, diverse data for training AI algorithms. A new article from Gradient Health explains these challenges and offers a solution: one of the world’s largest libraries of anonymized medical images, sourced from hundreds of global hospitals, clinics, and research centers. These datasets can be used to train and validate AI algorithms, advancing the development of precise, high-quality medical solutions.

• CMS Drives Down MPFS Rates Again: CMS has released its final 2024 Medicare Physician Fee Schedule (MPFS), and the agency is once again driving down physician payments. Final 2024 payment amounts will be reduced by 1.25% overall compared to calendar 2023, and the finalized conversion factor for 2024 is $32.74, a decrease of $1.15, or 3.4%. On the positive side, CMS said it is finalizing a proposal to pause its appropriate use criteria (AUC) program for ordering advanced diagnostic imaging.

• CMS Punts on Radiotracer Bundling: Meanwhile, CMS postponed a final decision on whether to separate Medicare payments for diagnostic radiopharmaceuticals from imaging exam reimbursement in its Hospital Outpatient Prospective Payment System (HOPPS). Nuclear medicine proponents believe this bundling tends to reduce payment levels and have urged CMS to separate the two. CMS earlier this year solicited comments on five possible reimbursement approaches, but after receiving “considerable interest” from stakeholders said it plans to “consider these points for future notice and comment rulemaking.”

• UK to Spread AI Funds Widely: The UK government said it would be spreading funds from its £21M ($26M) AI Diagnostic Fund between 64 NHS trusts. NHS announced the fund in June to spur adoption of AI for healthcare, particularly for chest X-ray and CT, and individual trusts have been applying for the grants. The amount works out to £328k ($406k) per site, indicating that NHS is looking to make AI available broadly rather than focus on a small number of marquee sites.   

• False Positives Raise Breast Cancer Risk: Having a suspicious breast lesion turn out to be negative for cancer is usually a relief for patients, but a new study in JAMA Oncology suggests that such false positives can increase a woman’s risk of breast cancer later. Researchers studied 46k women in Sweden who got false-positive mammograms, finding they had a higher breast cancer incidence over 20 years compared to controls (11.3% vs. 7.3%), translating to a higher hazard ratio for breast cancer (HR=1.61).

• AI Predicts Immunotherapy Response: AI can predict patient response to immunotherapy before treatments begin with accuracy of 70% to 80%. That’s according to data presented at last week’s Society for Immunotherapy of Cancer (SITC) meeting by researchers from GE HealthCare, Vanderbilt University, and University Medicine Essen. AI models predicted both efficacy and likelihood of an adverse reaction, helping clinicians determine which patients are best suited for immunotherapy. The models are a key part of GE’s immuno-oncology portfolio, which includes the development of novel PET tracers. 

• FoCUS+AI Measures LVEF at Bedside: Researchers from Canada used AI with the Kosmos handheld ultrasound scanner from EchoNous to measure LVEF with focused cardiac ultrasound (FoCUS) at bedside in a study of 424 patients in npj Digital Medicine. They found that AI-assisted FoCUS matched up well to a cart-based TTE scanner for detecting abnormal LVEF (<50%), with an AUC of 0.98, sensitivity of 93%, and specificity of 92%. The findings show that novice users could use AI with Kosmos in settings where cart-based echo isn’t available. 

• Sirona Supports Starlink Platform: Radiology workflow software developer Sirona Medical has added support for SpaceX’s Starlink satellite network in a deal that makes it easier for radiologists to work anywhere in the world – even in extremely remote locations. Sirona sees the partnership as solving one of the big challenges in radiology’s transition to the cloud – load times for medical images in PACS. The agreement also supports Sirona’s upcoming launch of a new cloud-native unified radiology platform on November 13. 

• Radiology in Space: While we’re on the subject of space, radiology resident Michael Pohlen, MD, of Stanford University authored a fascinating article in AJR this month about growing opportunities for radiologists in space medicine. Pohlen has had a lifelong passion for space, and recently spent a month-long aerospace medicine clerkship at Johnson Space Center in Houston. He notes that ultrasound scans are now routinely performed on the International Space Station, and four universities have founded fellowships in space medicine in the last three years. Beam me up, Scotty?

• Prostate Mapping Gets CPT Code: The AMA plans to release a Category III CPT code for 2024 covering the creation of noninvasive prostate cancer estimation maps from MRI data. Software developer Avenda Health said the new code, X237T, will apply to its Unfold AI software, which uses machine learning to generate 3D cancer probability maps that help clinicians visualize the location of prostate tumors for interventional planning. Avenda raised $10M in a Series B round last year. 

• Covera Lands $50M: Covera Health raised $50M in a Series C financing and simultaneously completed its acquisition of CoRead, an AI quality assurance company that’s developing generative AI to improve radiology performance. CoRead’s technology is being used by more than 2k US hospitals, and its capabilities will be integrated into Covera’s quality platform. The recent funding round is an extension of a Series C funding round in 2021 and represents net new funding.

• IDoR Arrives November 8: If radiology had an annual holiday, it would be the International Day of Radiology (IDoR), celebrated every year on November 8, the anniversary of the day in 1895 when Wilhelm Conrad Röntgen discovered X-rays at his lab in Germany. The day is a great opportunity to step back and appreciate the accomplishments made in our incredible specialty, and also enjoy the often humorous celebrations radiology professionals post to social media. Follow along at #IDoR2023.

Celebrating Five Revolutionary Years

At RSNA 2023, United Imaging will be celebrating five years of commercial operations and over a decade of investment in the US. Learn about United’s passion for change and see the company’s full range of products across imaging modalities at Booth #4100.

Meet Riverain at RSNA 2023

Stop by Riverain Technologies at Booth #4757 for an espresso and a chance to win Apple Airpod Pros or an Apple iPad Pro, and learn about the latest ClearRead updates and news. Schedule an appointment today.

Learn About AI Adoption at RSNA 2023

Learn about the right approach to AI adoption at RSNA 2023. Discover how CARPL.ai and the platform approach enable seamless integration of radiology AI, create true clinical impact, and drive ROI. Join us at the AI Theater on November 27 at 1:30 pm.

The Resource Wire

• Democratizing Echocardiography with AI: We talk a lot about AI’s potential to expand echo access, and this Imaging Wire Show reveals that ultrasound’s AI-driven expansion might go far beyond what many of us had in mind. Check out our discussion with Duke Health’s Madhav Swaminathan, MBBS, MD, and Us2.ai’s Carolyn Lam, MBBS, PhD, and James Hare, to see how AI is democratizing echo exams.

• Get a Sneak Peak at RSNA 2023: Join Intelerad on November 14 at 2 pm ET for a behind-the-scenes webinar on the latest innovations at RSNA 2023. Learn how the company’s technology can help support your enterprise imaging goals. 

• Theranostics – The Future of Personalized Care: Join your peers and leadership from GE HealthCare to hear how advances in precise diagnostics and therapies are evolving to deliver Theranostics. GE HealthCare’s comprehensive solutions connect every step in molecular medicine, helping to create a world where healthcare has no limits.

• 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.

• Efficiency Unleashed with Image Acceleration: Discover unrivaled acceleration in image acquisition and the latest synthetic imaging innovation by Subtle Medical in this presentation at RSNA 2023 by Suzie Bash, MD, at the AI Theater at 11 am Sunday November 26.

• A Comprehensive AI Copilot: Gleamer is dedicated to pioneering the future of medical imaging by building a comprehensive AI copilot that will pave the way for precision medicine. Learn more about the company and its solutions.

• How to Revamp Patient Engagement: 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.

• Clarity, Speed, and Confidence in MRI: Don’t miss SpinTech MRI’s RSNA 2023 session at 2 pm November 27 with James Backstrom, MD, who will share how he drove MRI efficiency for a busy radiology department by utilizing the company’s Stage platform.

• 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.

• Get Prepared for RSNA 2023: Enlitic is bringing its latest innovations in data standardization, deidentification and anonymization and coding discrepancy detection to the show floor at RSNA 2023. Prepare for your conference by scheduling a time with Enlitic today. 

• Learn How AI Can Help at RSNA 2023: AI can help your radiology practice in a variety of applications, from detecting pulmonary nodules on chest CT to improving echocardiography readings. Learn more from AI developers on the Blackford Platform at RSNA 2023. 

• Improving Access and Efficiency at William Osler Health: Watch how PocketHealth helped William Osler Health System improve access and efficiency through patient-driven image exchange in this video interview with Aimee Langan, Director, Diagnostic Imaging, Laboratory, Neurodiagnostics. 

• Reimagine the Imaging Worklist: Learn how Merge Workflow Orchestrator from Merge by Merative can help redefine your imaging experience in this article. All worklists are visible and accessible from one view – helping radiologists as well as staff.

• Expanding Your Talent Pool with Teleradiology: Teleradiology can be a force multiplier in radiology. Watch this Medality webinar recording with Daniel Corbett of Radiology Business Solutions to learn the pros, cons, and essential factors for private practice leaders considering teleradiology integration.

• The Journey to Cloud-Based PACS: Radiology is looking closely at cloud-based PACS as an alternative to on-premises digital image management. We discuss this emerging trend with key opinion leaders who have made the switch with Visage Imaging in the latest edition of The Imaging Wire Show.