Philippe Grenier, MD, of Foch Hospital in France in a commentary in Radiology on the I-ELCAP study.

At RSNA 2023, United Imaging will be celebrating its fifth anniversary of commercial operations in the US. In this Imaging Wire Show, we discuss the company’s RSNA highlights with Michael Coulter, senior vice president of modality business management and market strategy. 

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CT Scanners

Lung Screening’s Long-Term Benefits

CT lung cancer screening produced lung cancer-specific survival over 80% in the most recent data from the landmark I-ELCAP study, a remarkable testament to the effectiveness of screening. 

The findings were published this week in Radiology from I-ELCAP, one of the first large-scale CT lung screening trials, and are the latest in a series of studies pointing to lung screening’s benefits. The findings were originally presented at RSNA 2022. 

The I-ELCAP study is ongoing and has enrolled 89k participants at over 80 sites worldwide from 1992-2022 who have been exposed to tobacco smoke and who received annual low-dose CT (≤ 3mGy) scans. Periodic I-ELCAP follow-up studies have documented the survival rates of those whose cancers were detected with LDCT, and the new numbers offer a 20-year follow-up, finding: 

• Primary lung cancers were detected on LDCT in 1,257 individuals who had lung cancer-specific survival of 81%, matching the 10-year survival rate of 81%
• 1,017 patients with clinical stage I lung cancer underwent surgical resection and saw a lung cancer-specific survival rate of 87%
• The I-ELCAP survival rate is much higher than another landmark screening study, NLST, in which it was 73% for stage I cancer at 10 years
• Lung cancer-specific survival hit a plateau after 10 years of follow-up, at a cure rate of about 80%

I-ELCAP is unique for a variety of reasons, one of which is that it continues to screen people beyond a baseline scan and 2-3 annual follow-up rounds – perhaps the reason for its higher survival rate relative to NLST. 

• It also has included people who were exposed to tobacco smoke but who weren’t necessarily smokers – an important distinction in the debate over how broad to expand lung screening criteria.  

The findings come as CT lung cancer screening is generating growing momentum. Studies this year from Germany, Taiwan, and Hungary have demonstrated screening’s value, and several countries are ramping up national population-based screening programs. 

The Takeaway

The 20-year I-ELCAP data show that CT lung cancer screening works if you can get people to do it. But achieving survival rates over 80% also requires work on the part of healthcare providers, in terms of defined protocols for working up findings, data management for screening programs, and patient outreach to ensure adherence to annual screening. Fortunately, I-ELCAP offers a model for how it’s done.

Building a Successful Radiology Team in a Hyper-Competitive Market

In today’s hyper-competitive job market, radiologist recruiting and retention is more important than ever. Learn from industry experts and practice leaders in this on-demand Medality webinar as they reveal how to overcome hiring challenges and keep your team engaged.

Us2.ai AI Echo for Cardiac Amyloidosis

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 echo AI technology was used to assess ATTR.

The Wire

• ChatGPT Gets Upgrades: Generative AI developer OpenAI announced upgrades for its ChatGPT large language model this week. The company released a new GPT-4 Turbo version that operates faster and supports longer prompts, and it has also updated the model’s knowledge base to April 2023 from its previous cutoff of September 2021. OpenAI also gave developers the ability to create customized versions called GPTs for specific tasks. Finally, the company created GPT Store, a digital store that will allow developers to share their customized models publicly.

• National Lung Cancer Screening Day on November 11: Recent positive studies on CT lung cancer screening are being published as National Lung Cancer Screening Day approaches on Saturday November 11. Screening facilities are encouraged to open their doors in the second annual edition of this event, which in 2022 drew 400 participating sites. The day is designed to make screening possible for eligible individuals who can’t take time off work for an exam, with a particular focus on underserved communities and high-risk populations. 

• Siemens to Launch New Somatom CT: Siemens Healthineers is planning to launch a new scanner in its Somatom CT lineup on November 16. The company hasn’t released details of the launch, but it’s most likely to be a new dual-source scanner based on conventional energy-integrating detectors rather than photon-counting CT. The company’s published materials indicate the new system will make dual-source technology “available to a wider range of clinical institutions.”

• Image-Based AI Better Predicts Breast Cancer Risk: AI algorithms based only on image data provided more accurate prediction of breast cancer risk than traditional clinical risk factors. In a meta-analysis in JACR, researchers analyzed 14 studies, finding that AI image-only models had a higher median AUC than predictions based on clinical risk factors like breast density (0.72 vs. 0.61). Adding clinical risk factors to AI slightly boosted median AUC to 0.73. AI-driven risk prediction could lead to more personalized mammography screening.

• HAP Analyzes 2024 MPFS: Revenue cycle management firm Healthcare Administrative Partners (HAP) has published an analysis of CMS’ final rule for the 2024 Medicare Physician Fee Schedule (MPFS), noting that the 2024 MPFS conversion factor is 3.37% lower than in 2023. Medicare’s budget-neutral requirement has forced CMS to cut the conversion factor to pay for higher evaluation and management (E/M) payments to primary care physicians, but a bill in Congress (H.R. 2474) could break the cycle by improving the conversion factor methodology.

• MRI Best for Stroke Evaluation in ED: If it’s available, MRI is more cost-effective than CT for evaluating stroke in the emergency department, especially with specialized protocols like diffusion-weighted imaging (DWI). In AJR, researchers found that while specialized MRI was $13,477 more expensive in the short term compared to non-contrast CT, lower costs of subsequent care gave MRI the QALY edge (0.48 greater QALY). Specialized MRI had an incremental cost-effectiveness ratio (ICER) of $28,118/QALY, far below the willingness to pay of $100,000/QALY. 

• Toy MRI Sets Calm Kids before Scans: Giving kids scheduled for MRI scans build-a-scanner playsets that include a virtual reality component helped calm them before exams. A paper in BMJ Innovations describes how kids build the scanner from a cardboard flatpack, then insert a smartphone to perform scans and view images of their favorite toys. Kids can even view images and hear scanner noises via virtual reality. Interviews with families indicated the playsets helped prepare them for the scans, and researchers theorize if implemented widely the sets could reduce use of general anesthesia.

• High-Temp Supercon Paper Retracted: A controversial paper in Nature that claimed to have discovered high-temperature superconductivity was retracted this week. Nature investigators found problems with the paper’s claims, and the senior author on the paper, physicist Ranga Dias, PhD, is also under investigation by his institution, the University of Rochester. The paper was published in March 2023 and was one of two high-temperature superconductivity papers that made waves during the year, the other coming from South Korean researchers whose claims were also disproved. 

• X-Ray AI Improves Hand Fracture Detection: Gleamer’s BoneView AI algorithm improved radiologists’ ability to detect hand and wrist fractures on X-ray. In European Radiology, French researchers used BoneView to assist radiologists in analyzing X-rays of 296 cases and compared their performance to the gold standard of CT. With BoneView, radiologists saw improvements in sensitivity (0.70 vs. 0.66) and negative predictive value (0.62 vs. 0.59). There was no statistically significant change in specificity or positive predictive value. 

• Philips to Expand AI-Powered POCUS: Philips has received another round of funding from the Bill & Melinda Gates Foundation to expand its AI-powered POCUS technology globally. The project began in 2021 in Kenya, where the foundation granted $15.4M to test the use of AI with the company’s Lumify handheld scanner for guiding obstetric care; the new grant will expand the project globally and brings the total funding to $60M. Lumify will help non-experts perform early fetal scans by automating image acquisition and/or image interpretation.

• COVID Link to Situs Inversus? Researchers in China saw a surge of fetal situs inversus cases – a rare condition in which a fetus’ internal organs are reversed – that corresponded to rising SARS-CoV-2 infections during the COVID-19 pandemic. In NEJM, they tracked fetal situs inversus cases detected on routine ultrasound at a gestational age of 20-24 weeks, finding 4X higher incidence in the first seven months of 2023 compared to mean annual incidence from 2014-2022. The period followed the loosening of China’s zero-COVID policy in December 2022, but the authors refrained from claiming a connection.

Making a Difference in Scoliosis Detection

Did you know scoliosis affects about 2-3% of the population? That’s millions of lives, and Gleamer is on a mission to make a difference with its BoneMetrics solution for automatically detecting and quantifying spinal measurements. Get a demo today.

Solutions to Solve Radiology’s Workflow Challenges

Radiology faces numerous challenges to more efficient workflow, from the siloed nature of healthcare enterprises to mundane tasks that are ripe for automation. In this Imaging Wire Show, we talked to Dr. Matthew Lungren and Calum Cunningham of Nuance Communications.

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.

The Resource Wire

• 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.

• Stories of Success in Cloud and AI: Join Merge by Merative at RSNA 2023 for a symposium at 9:30 am on Monday November 27 to hear stories of innovation, success, and best practices from Alex Towbin, MD, associate CMIO of Cincinnati Children’s Hospital, and Randy Hicks, MD, CEO of Regional Medical Imaging.

• Join Industry Leaders for a Lunch & Learn at RSNA: In this Lunch & Learn presentation at RSNA sponsored by PocketHealth, learn how industry leaders have improved population health, patient experiences, and operational efficiencies. Register for free!

• 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. 

• 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 pm ET to meet the company’s new Somatom CT family member. 

• 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. 

• 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. 

• 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 World Where Healthcare Has No Limits: Join GE HealthCare at RSNA 2023 at Booth #7326 in the North Hall at McCormick Place. Come see what’s new in the Innovation Theater, or drop in virtually and watch a livestream. GE looks forward to connecting with you!

• Delighting Patients with Medical Image Sharing: 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. 

• Purpose-Built for the Cloud: 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.

• What to Expect from United Imaging at RSNA 2023: At RSNA 2023, United Imaging will be celebrating its fifth anniversary of commercial operations in the US. In this Imaging Wire Show, we discuss the company’s RSNA highlights with Michael Coulter, senior vice president of modality business management and market strategy. 

• Let’s Meet 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. 

• 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.