Kwee T et al, in a new article in European Journal of Radiology that ponders radiology without images.

Of the technologies with the most potential to change breast screening, AI is the most intriguing. One exciting new clinical application for AI is the detection of breast arterial calcification (BAC), which could indicate heart disease. Learn more about how BAC can reshape mammography in this Imaging Wire Show interview with Chirag Parghi, MD, chief medical officer at Solis Mammography.

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Breast Imaging

Why Has Breast Cancer Mortality Fallen?

There’s no question that breast cancer mortality has fallen dramatically over the last several decades. The question is why. 

Proponents of cancer screening believe that early detection has played a major role by finding cancer and enabling treatment to start before it spreads. 

• But that position is disputed by a vocal minority of skeptics who believe that better cancer treatments deserve most of the credit. 

A case in point was the Bretthauer et al study published in 2023, which claimed that there was no evidence to support screening’s beneficial impact on all-cause mortality. 

• This despite a demonstrated long-term decline in mortality for the cancers targeted by the four major population-based screening programs: breast, cervical, prostate, and lung. 

A new study in JAMA offers clarity in the debate by placing a numeric value on the tools that have contributed to lower breast cancer mortality. Researchers led by Jennifer Caswell-Jin, MD, of Stanford University used simulation models based on CISNET data to analyze breast cancer mortality from 1975 to 2019, drawing the following conclusions:

• Screening and treatment together produced a 58% decline in breast cancer mortality, from a death rate of 48/100,000 women to 27/100,000
• 47% of the reduction was due to treatment of stage I to III cancer 
• 29% was due to treatment for metastatic breast cancer 
• 25% was associated with mammography screening 

The authors also discovered that the biggest improvement in breast cancer survival after metastatic recurrence (3.2 vs. 1.9 years) happened between 2000-2019. 

The Takeaway

The new results in Caswell-Jin et al should be seen as another victory for the screening community. In addition to setting a numeric figure for screening’s value, they also demonstrate the synergistic effect when screening and treatment work together to target breast cancer before it has a chance to spread. Efforts to separate the two are quixotic at best and dangerous to women at worst. 

Looking to Get Started with AI?

Learn how Milton Keynes University Hospital adopted a successful AI strategy in this on-demand webinar from Blackford. You’ll discover how to evaluate and select the best AI solutions for your facility, tips for getting started with AI, and more. 

Benefits of Cloud and AI for Medical Imaging

Check out this white paper from Merge by Merative to learn how a cloud-first approach for modern imaging solutions can ensure accessibility and efficiency, addressing the pressing need for change in radiology.

The Wire

• Radiology without Images? Is it possible to visualize a future for radiology in which – thanks to the growing power of AI – images are never reconstructed for human interpretation? A team led by Thomas Kwee, MD, of the Netherlands takes a crack at this concept in European Journal of Radiology. They posit a future in which powerful AI algorithms work on raw, unreconstructed data, with no need to create images for human visual evaluation. There are obvious pros and cons to this approach, which Kwee et al investigate.

• Cancer Incidence Grows:  A new American Cancer Society report shows that while cancer mortality has fallen – averting 4M deaths since 1991 – incidence is growing for 6 of the top 10 cancers. Less smoking and earlier detection have led to lower overall cancer mortality, but incidence is rising for cancers like breast (+0.6% ), prostate (+3%), and cervical (+1.7%). In particular, rising incidence is being seen in people under 50, with breast cancer killing 2.3k women under 50 in 2021, leading ACS to support earlier screening.

• SpinTech MRI Partners with Canon: SpinTech MRI and Canon Medical Systems USA have joined forces to speed up reconstruction of 3D MRI brain images. The companies have combined Canon’s AiCE deep learning reconstruction technology with SpinTech MRI’s STAGE software platform to produce a quantitative fast MRI solution for clinical use that provides multiparametric maps to measure tissue properties. In testing on a 1.5T Canon MRI scanner, AiCE DLR-STAGE acquired brain images in shorter exam times with higher SNR while also providing quantitative data. 

• Out-of-Network Billing Surprise: The US government’s independent dispute resolution process for out-of-network billing under the No Surprises Act could lead to financial surprises for radiology practices. In a new study in AJR, researchers analyzed 76M claims for in-network ED visits or inpatient stays, of which 1.9% were out of network. Due to fees required under the IDR process, radiologists would break even for only 11-27% of claims, and among the lowest break-even rate for hospital-based specialists. 

• FDA Clears Alzheimer’s Prediction Tool: The FDA has cleared Darmiyan’s BrainSee software for predicting progression to Alzheimer’s disease from amnestic mild cognitive impairment. BrainSee generates a score from brain MRI scans to predict progression to Alzheimer’s within five years, and the application navigated the FDA’s de novo regulatory pathway after getting “breakthrough” designation in 2021. Darmiyan believes BrainSee will shift Alzheimer’s diagnosis from biomarker-based methods that can be expensive and invasive to more noninvasive tools with prognostic value. 

• Blackford Adds See-Mode: Blackford is expanding the AI offerings on its Blackford Platform through a deal with See-Mode to include that company’s solutions for breast lesion and thyroid nodule detection and classification on ultrasound scans. See-Mode joins other recent additions to Blackford Platform, including Rayscape, Nurea, AIQ Solutions, and contextflow. 

• Lung Cancer on COVID CT Scans: French researchers found that chest CT scans for patients with suspected COVID-19 infection can also reveal lung cancer. In Respiratory Medicine and Research, they found that in scans of 24.4k COVID-19 patients, 72 lung cancer diagnoses were made – half in patients who didn’t meet lung screening guidelines. The 0.3% incidence rate was lower than after the first round of screening studies like NLST and NELSON (1% and 0.9% respectively), but the findings highlight the potential of opportunistic screening.

• Better Breast Incidental Follow-Up: The challenge with incidental findings like those in the French study above is making sure they get followed up. To that end, researchers in JACR describe their closed-loop imaging program (CLIP) to follow patients who missed recommendations for breast imaging workup based on CT scans. Of 311 cases, 147 were not followed up within six months, and the CLIP team intervened in 19%, but most patients got follow-up without CLIP intervention. Incidental breast cancer was diagnosed in 13% of patients who got follow-up imaging. 

• Echo AI’s RHD Impact: The Washington Post put a spotlight on how handheld ultrasound systems and AI algorithms might significantly improve early detection of rheumatic heart disease, especially in developing countries. The article detailed a new echo AI solution developed by Children’s National and Us2.ai that could help detect pediatric RHD while it’s still easily treatable with penicillin (currently 90% accuracy), potentially avoiding thousands of heart surgeries and RHD deaths. The researchers will initially deploy the echo AI solution in a Ugandan screening program that will also be used to further train the algorithm.

• DASI’s TAVR Planning Code: Ohio State spin-out DASI Simulations announced that CMS added an outpatient code that would provide $1k reimbursements for the use of its PrecisionTAVI solution (HCPCS code: C9793). PrecisionTAVI leverages AI and computer modeling to analyze CCTA exams and generate 3D predictive models for TAVR pre-planning, and is currently the only solution in its class.

• Lunit Signs Samsung: Lunit signed a three-year deal to integrate its AI software with Samsung Healthcare’s X-ray systems, supplying its Insight CXR and Insight CXR Triage applications. Insight CXR detects 10 of the most common lung abnormalities like lung cancer and pneumonia, while Insight CXR Triage identifies critical findings like pleural effusion or pneumothorax. The deal initially covers the US, Canada, and Europe. Separately, Lunit touted its performance in a recent study in Radiology comparing AI algorithms head-to-head.

• RadAI Inks Deal with Google: Rad AI landed a big fish this week, signing a partnership with Google to use its Google Cloud platform and AI tools like MedLM foundation models. Rad AI will integrate Google technology into its Rad AI Omni Impressions and Rad AI Reporting solutions, enhancing their ability to automatically generate more content for radiology reports to save radiologists’ time. And by leveraging Google Cloud, Rad AI will be able to increase the size and complexity of both offerings. Rad AI launched Rad AI Reporting in September 2023. 

• Google’s Deep Thoughts on Health AI: While we’re on the subject of Google, the company’s Chief Clinical Officer Michael Howell, MD, and co-authors shared their worldview of AI in healthcare in a new article in JAMA. Howell et al separate healthcare AI into three epochs: traditional point-source AI applications for uses like breast and lung cancer screening dominated during AI 2.0, but the rise of foundation models and generative AI mark the transition to AI 3.0. Google launched its MedLM and Gemini generative AI algorithms in December.

A Major US Health System Optimizes Image Exchange

A major US healthcare organization streamlined their image exchange, saving them $100,000 while improving their patient experience and eliminating administrative work. Find out how in this case study from PocketHealth.

3 Good Reasons to Add Mammography

There are three good reasons to add mammography services at your imaging site as providers expect higher demand for breast imaging services. Get the facts about mammography on this resource page from Siemens Healthineers.

How Your Imaging Tech Affects the Entire Enterprise

Join Konfidi Healthcare President Brandon Taggart and Enlitic’s Dave Wilson in a conversation about medical imaging technology. Dive into the key points and get your questions answered during this 30-minute webinar on January 25.

The Resource Wire

• 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.

• 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. 

• AMRIC’s Multimodality Approach to Medical Imaging: AMRIC is a new premium imaging clinic on Manhattan’s Upper East Side. Learn about their multimodality approach to medical imaging and why they turned to United Imaging for cutting-edge CT, MRI, and molecular imaging technology. 

• AI-Powered Home Ultrasound: The recently published CUMIN study shows the technical feasibility of AI-POCUS in the hands of novice nurses and opens new possibilities for redefining how we approach cardiac care. Learn more on this page from Us2.ai. 

• Stop Shipping Discs! By pivoting to a 100% digital fulfillment model for patient images and records, you can improve their experience while significantly reducing labor and shipping costs. Find out how on this page from Clearpath. 

• The Benefits of an AI Accelerator: What is an AI accelerator, and how can it impact your practice? Learn about the Visage AI Accelerator program and its impact on research and clinical practice in this video from Visage Imaging. 

• A Global Standard for Bone Trauma X-Ray Interpretation: Gleamer’s BoneView has become a global standard for bone trauma X-ray interpretation. Learn more about the rigorous science backing this FDA-cleared clinical application on this page.

• Conversations with the Leaders Transforming Radiology: Join Medality founder and CEO Daniel Arnold for the Radiology Report, a podcast that addresses the opportunities and challenges facing the imaging profession head on to ultimately improve practice and patient outcomes everywhere.

• The Power of the Platform at RSNA 2023: How can radiologists get easy access to AI solutions? Watch this video interview at RSNA 2023 with CARPL.ai CEO Vidur Mahajan and Chief Architect Rohit Takhar to learn how the power of the platform is making AI for radiology a reality. 

• Clarity, Speed, and Confidence for MRI Efficiency: Radiologists have used a variety of methods to improve efficiency, but many of these methods come with drawbacks. Find out in this article how SpinTech MRI takes on the challenge of MRI efficiency with its STAGE software.

• AI in Radiology and the Considerations for Regulation: AI in healthcare has grown quickly, as have discussions about AI regulation. Listen to this on-demand webinar from Bayer and Calantic Digital Solutions to hear expert perspectives on the current and future state of AI governance in healthcare and radiology.

• Real patients. Real stories: 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.

• Solutions to Support Breast Density Reporting: 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. 

• Artificial Intelligence for Coordinated Care: TeraRecon’s Eureka AI platform is a vendor-agnostic hosting platform that can help execute clinical and non-clinical AI algorithms to improve outcomes, reduce burnout, and streamline radiology workflow. Learn how it works on this page.

• Revolutionizing Radiology with Clear Visual Intelligence: The University of New Mexico Hospital is partnering with Riverain Technologies to revolutionize radiology with the use of ClearRead CT with Clear Visual Intelligence for chest CT scans. Get details about the partnership on this page.