Wu K et al, in a new paper in NEJM AI on CPT codes and AI usage.

Radiology is continually getting more sub-specialized — but is that contributing to the specialty’s growing workforce shortage? And how can sub-specialized radiologists get the training they need to match workforce requirements? We talked about these developments with Daniel Arnold, founder and CEO of Medality, in this episode of The Imaging Wire Show.

Want to take a deeper dive into radiologist education, and have fun in the process? If you’re a radiologist at RSNA 2023, drop by and meet the teams from Medality and The Imaging Wire at Flight Club at 111 W. Wacker Dr. on Tuesday, November 28 from 6:15 – 8:15 pm. RSVP today. 

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Artificial Intelligence

Reimbursement Drives AI Adoption

It’s no secret that insurance reimbursement drives adoption of new medical technology. But a new analysis in NEJM AI shows exactly how reimbursement is affecting the diffusion into clinical practice of perhaps the newest medical technology – artificial intelligence. 

Researchers analyzed a database of over 11B CPT claims from January 2018 to June 2023 to find out how often reimbursement claims are being submitted for the use of the over 500 AI devices that had been approved by the FDA at the time the paper was finalized. 

• The authors chose to focus on CPT claims rather than claims under the NTAP program for new technologies because CPT codes are used by both public and private payors in inpatient and outpatient settings, while NTAP only applies to Medicare inpatient payments. 

They found 16 medical AI procedures billable under CPT codes; of these, 15 codes were created since 2021 and the median age of a CPT code was about 374 days, indicating the novelty of medical AI.

• Also, only four of the 16 had more than 1k claims submitted, leading the authors to state “overall utilization of medical AI products is still limited and focused on a few leading procedures,” such as coronary artery disease and diabetic retinopathy.

The top 10 AI products and number of CPT claims submitted are as follows:

1. HeartFlow Analysis for coronary artery disease (67,306)
2. LumineticsCore for diabetic retinopathy (15,097)
3. Cleerly for coronary atherosclerosis (4,459)
4. Perspectum LiverMultiScan for liver MRI (2,428)
5. Perspectum CoverScan for multiorgan MRI (591)
6. Koios DS for breast ultrasound (552)
7. Anumana for ECG cardiac dysfunction (435)
8. CADScor for cardiac acoustic waveform recording (331)
9. Perspectum MRCP for quantitative MR cholangiopancreatography (237)
10. CompuFlo for epidural infusion (67)

While radiology may rule in terms of the sheer number of FDA-approved AI products (79% in a recent analysis), the list shows that cardiology is king when it comes to paying the bills. 

The Takeaway

Amid the breathless hype around medical AI, the NEJM AI study comes as a bit of a wake-up call, showing how the cold reality of healthcare economics can limit technology diffusion – a finding also indicated in other studies of economic barriers to AI. 

On the positive side, it shows that a rosy future lies ahead for those AI algorithms – like HeartFlow Analysis – that can make the leap.

Meet Merge at RSNA 2023

Merge by Merative is an innovative provider of proven radiology technology solutions and is a committed transformation partner to imaging organizations, enabling user and patient satisfaction across the enterprise. Explore Merge’s presence at RSNA 2023.

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. 

The Wire

• Lung Cancer Survival Rises: In good news in the battle against lung cancer, an American Lung Association report found that the US five-year lung cancer survival rate rose from 2015 to 2019 (22% to 27%). But compliance with CT lung cancer screening remains low, at just 4.5% in 2022. Some states saw extremely low compliance rates, like California (0.7%) and Wyoming (1%), while Massachusetts had the highest rate (12%). For an excellent analysis of the report check out a LinkedIn post by Siemens Healthineers executive Sebastian Schmidt. 

• 4DMedical Gets Medicare Payment Rate: 4DMedical says its XV LVAS respiratory imaging technology has been assigned a Medicare payment rate of $299 from CMS in its proposed rule for the 2024 Hospital Outpatient Prospective Payment System. The payment rate should help spur adoption of XV LVAS in US hospitals, and will serve as a stepping stone to a permanent Category I CPT code. 4DMedical showed the technology at RSNA 2022 and has been rolling it out globally. 

• Sirona Launches Unified Software: Sirona Medical this week followed through on its promise to unveil its new cloud-native radiology IT platform, including Unify, which unites image review, reporting, and worklist. The platform is based on Google Chrome and enables radiologists to work from practically any location via a single URL and sign-in. Other highlights of the event included a new Sirona Archive workflow service that archives images for $0.33 per exam, and Amplify SDK ecosystem that will enable developers to create applications to run on the platform. 

• Coronary Calcium Linked to Heart Attacks: CT measurements of coronary artery calcium (CAC) could find people at risk of a heart attack but who don’t have symptoms or risk factors. In a study at AHA 2023, researchers looked at risk factors and CT-derived CAC scores in 429 patients who had myocardial infarctions, finding that patients without risk factors still had high CAC scores (82% ≥ 50), and 77% met criteria for preventive therapy like statins or aspirin. The findings support broader use of CAC scoring.

• Intelerad to Unify Sharing Platforms: Intelerad Medical Systems is planning to showcase new technologies at the upcoming RSNA 2023 meeting, including unification of the company’s Life Image and Ambra image sharing platforms. Intelerad acquired Life Image in 2022, and Life Image and Ambra clients can now natively connect with each other. Intelerad also plans to show updates to its AI-enhanced solutions like Clario SmartWorklist, as well as improvements to its cloud technology that enable users of its Intelerad Cloud Long-term Archive to stream images at rates comparable to on-premises PACS.

• PocketHealth Unveils MyCare Navigator Software: PocketHealth is launching MyCare Navigator, a new personalized tool within its PocketHealth platform to give patients a deeper understanding of their healthcare. MyCare Navigator shows up within a patient’s PocketHealth account when they view their imaging exams or reports, and encourages adherence to follow-ups, improves communication, and offers health screening tools to keep patients engaged and involved. PocketHealth earlier this year launched Follow-Up Navigator to help patients comply with follow-up instructions. 

• CEM Measures Up to Breast MRI: In a new study in Radiology, contrast-enhanced mammography (CEM) had performance comparable to full breast MRI and abbreviated breast MRI in a set of 132 of asymptomatic women who needed workup after screening mammography. With an AUC of 0.91, CEM was superior to digital mammography (AUC=0.79), and there was no statistically significant difference versus breast MRI or abbreviated breast MRI (AUC=0.89 & 0.91). CEM’s advantage over breast MRI is its wide availability at breast health practices.  

• Patients Give CEM High Marks: In a related study on contrast-enhanced mammography (CEM), patients gave the exam high marks in a survey of 410 women published in JACR. On a scale of 0 to 100 (with 0 representing the worst possible experience), women gave CEM an overall mean score of 93. The findings indicate that CEM’s value as a tool for working up suspicious breast lesions did not come at the expense of putting an additional testing burden on patients. 

• Lunit Gets FDA Nod, Raises Funds: The FDA has cleared Lunit’s Insight DBT software for AI analysis of 3D DBT exams. The company said the clearance paves the way for its entry into the US breast screening market, which has largely converted to DBT from conventional 2D digital mammography (88% adoption according to FDA as of November 2023). Separately, Lunit raised $150M in a public stock offering, with the cash to be used for product development and entering new markets like the US and Europe, among other purposes.

• RefleXion Raises $105M: Radiation therapy firm RefleXion Medical announced a big funding round, raising $105M. The company is ramping up sales of its RefleXion X1 system after getting FDA clearance earlier this year for its Scintix biology-guided radiation therapy technology, which enables X1 to use signals from an injected radiotracer to guide treatment in real time. 

• GE Teams with BAMF for Theranostics: GE HealthCare and radiopharmacy operator BAMF Health have signed a partnership designed to make theranostics more accessible. Under the deal, BAMF will be able to offer a turnkey theranostics package to health systems that includes GE technologies and services. Both GE and BAMF see theranostics – which combines diagnostic and therapeutic radiotracers – as a major step toward precision medicine. 

• TeraRecon Adds AI Platform Partners: TeraRecon continues to add partners to its Eureka Clinical AI Platform. The company most recently added the Pi machine learning software from Lucida Medical for detecting prostate cancer lesions on MRI scans. Lucida joins another recent addition to Eureka, Avicenna.AI, which is contributing its algorithms for detection of pulmonary embolism and aortic dissection. TeraRecon has also signed an agreement to supply its Eureka Life Science AI Platform to Memorial Sloan Kettering Cancer Center for developing cancer detection and classification models.

• Samsung Launches V6 Ultrasound: Samsung’s Boston Imaging US headquarters is launching the V6 value-based ultrasound scanner targeted at women’s imaging and urology applications. The scanner supports 2D, 3D, and color imaging, and is based on Samsung’s Crystal Architecture core imaging platform. The scanner also includes Samsung’s AI-based assistive technologies, such as ViewAssist, BiometryAssist, and UterineAssist. V6 has received FDA 510(k) clearance.

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. 

Rethinking Image Exchange to Deliver the Quadruple Aim

Join this RSNA Lunch & Learn and hear how industry leaders have improved patient experiences, retention, and operational efficiencies. Register for free!

A New Duality in Medical Imaging

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.

The Resource Wire

• 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.

• Monitoring AI Solutions in Healthcare: Clinical applications for healthcare AI are rapidly expanding, but many barriers are still preventing widespread adoption. This Nuance post explores a critical set of questions: what happens after an AI model goes into production, and how to know if it continues to perform as expected?

• A Commitment to Innovation in Digital Health: Gleamer is now featured in the AlbionVC European HealthTech Market Map 2023! This showcases Gleamer’s commitment to innovation in digital health and pharma across Europe.

• Unwind at RSNA 2023 with Medality: Unwind at RSNA 2023 with Medality at booth #3139 in the South Hall. Network with their esteemed faculty, experience new courses and fellowships, and savor drinks and mini-bites from 2-5 pm on Tuesday November 28. RSVP today.

• What Can We Do About Physician Burnout? 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.

• The Journey to Cloud-Based PACS: Radiology is looking closely at cloud-based PACS as an alternative to on-premises digital image management. Learn about providers who have made the switch with Visage Imaging in this white paper from Signify Research. 

• New Guidelines on Heart Failure Management: The ESC has updated its heart failure guidelines, for the first time including a guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). Learn how to trust echo AI to find these cases earlier in this video from Us2.ai. 

• 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. 

• Visit Intelerad at RSNA 2023: Join Intelerad at RSNA 2023 for a Lunch & Learn educational panel at 12 pm Monday November 27 in Room S501 where we will explore why health equity is in radiology’s lane, moderated by Geraldine McGinty, MD. Register today.

• 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 talked about the company’s RSNA highlights with Michael Coulter, senior vice president of modality business management and market strategy. 

• Clarity, Speed, and Confidence in MRI: Don’t miss SpinTech MRI’s RSNA 2023 session at 2 pm Monday 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.

• Let’s Meet at RSNA 2023: Stop by Riverain Technologies at booth #4757 at RSNA 2023 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.

• A New Era for fMRI: Reducing acoustic noise from MRI scanners is particularly important in rapid functional MRI exams of the brain. Learn what GE HealthCare is doing with Looping Star, a novel noise reduction method for whole-brain fMRI scanning.

• Improving the Patient Experience: How is Clearpath improving the healthcare experience for patients? Learn more about the company and its solutions for ditching the disc when sharing images and records with patients. 

• Ignite Your AI Strategy at RSNA 2023: Visit the Bayer AI Visionary Theater at booth #4747 at RSNA 2023 to hear from Calantic Digital Solutions and Blackford Analysis teams on how to ignite your AI imaging strategy. Reserve your spot today.