Melinda Aldrich, PhD, of Vanderbilt University, in an article in Undark about racial disparities in lung cancer screening.

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Cardiac Imaging

CT First for Chest Pain

CT should be used first to evaluate patients with stable chest pain who are suspected of having a heart attack. That’s the message of a paper being presented this week at the American College of Cardiology Cardiovascular Summit in Washington, DC.

CT is proving itself useful for a variety of applications in cardiac imaging, from predicting heart disease risk through coronary calcium scores to assessing whether people with chest pain need treatment like invasive angiography – or can be sent home and monitored.

• But cardiac CT often runs up against decades of clinical practice that relies on tools like stress testing or diagnostic invasive coronary angiography for evaluating patients, with the CT-first strategy reserved for a limited number of people, such as those with unestablished coronary artery disease. 

But the new study suggests that the CT-first approach could be used for the vast majority of patients presenting with stable chest pain. 

• A research team led by senior author Markus Scherer, MD, of Atrium Health-Sanger Heart & Vascular Institute in Charlotte, North Carolina tested the strategy in 786 patients seen from October 2022 to June 2023 who had no prior diagnosis of coronary artery disease and underwent elective invasive angiography to evaluate suspected angina.

The CT-first strategy compared CT angiography with provisional FFRCT testing to traditional evaluation pathways, which included stress echo, stress myocardial perfusion imaging, stress MRI, or no invasive testing before direct referral to angiography. Revascularization rates by strategy were as follows … 

• 62% for CT-first
• 50% for stress MRI
• 40% for stress echo
• 34% for no prior test
• 31% for stress MPI

The Takeaway

The results presented this week offer real-world evidence that support recent clinical studies backing broader use of CT for patients with chest pain. Given CT’s advantages in terms of cost and noninvasiveness, the findings raise the question of whether more can be done to get clinicians to adhere to established guidelines calling for a CT-first protocol. 

Maximize Your Return on Investment

Looking for ways to maximize your return on investment in healthcare IT? Check out this white paper from Enlitic to learn how the company’s intelligent healthcare solutions can help you harness the power of AI and deep learning to unlock ROI. 

AI Platform’s Benefits Beyond Stroke Triage

How did the VA’s National Teleradiology Program (NTP) use Blackford Platform to respond to stat reads for intracranial hemorrhage from 120 facilities across the US — enabling AI to deliver benefits beyond stroke triage? Find out in this case study.

The Wire

• Race and Lung Screening: Recent changes in the USPSTF’s guidelines for CT lung cancer screening are capturing more at-risk Black people, but they haven’t eliminated racial disparities in screening. That’s the message of an article this week in Undark that takes a deep dive into healthcare’s racial disparities, particularly as they apply to lung screening. The solution? Perhaps screening guidelines should be driven by more personalized evaluations of cancer risk that incorporate genetics, race, and other factors rather than one-size-fits-all criteria. 

• Biogen Shuts Down Aduhelm: Pharmaceutical developer Biogen said it is shutting down its commercialization efforts for the Alzheimer’s drug Aduhelm in favor of its Leqembi therapy. The move is a stunning comedown for Aduhelm, which was approved in 2021 but was dogged by questions about its effectiveness due to lackluster clinical evidence. Leqembi was approved in January 2023 and has mostly escaped controversy. Both drugs aim to reduce amyloid buildup in the brain, with PET a necessary technology for selecting patients while both PET and MRI are indicated for monitoring treatment. 

• UAE Lab to Buy United Total-Body PET: Research center Prepaire Labs has signed an MOU to buy United Imaging’s uExplorer total-body PET/CT scanner for a research facility the company is building in the United Arab Emirates. Prepaire will use the scanner for research into drug discovery and precision medicine, such as better understanding of disease presentation and drug response. The deal was announced at this week’s Arab Health meeting and the scanner will be United’s first uExplorer installation in the Middle East. 

• Esaote Debuts US Scanners: In other news from Arab Health, Esaote launched two new ultrasound scanners, MyLab A50 and MyLab A70. The scanners are the first to be launched in the company’s new A-series line, designed to be agile systems with a compact footprint, battery operation, and lightweight design. A-series buyers have a choice of interfaces, either a conventional control panel or touchscreen, and clinical applications include elastography and attenuation imaging as well as liver multi-parametric analysis. The scanners are pending 510(k) clearance.

• AI Helps Novices Read Chest X-Rays: An AI algorithm that analyzed chest X-rays for signs of pathology sharply improved diagnostic performance of non-radiologist resident physicians in a new study in Chest. When reading 563 emergency chest X-rays, non-radiology residents who were aided by AI Rad-Companion VA40 from Siemens Healthineers saw their AUC go up for pathologies like lung nodules (0.89 vs. 0.72) and pneumothorax (0.97 vs. 0.85). Researchers concluded AI could help non-radiologist physicians in the emergency setting at times when 24/7 radiologist coverage isn’t available. 

• Intelerad Fills Out C-Suite: Intelerad made additions to its C-suite this week with appointments of three executives. Pete Srejovic has been named chief technology officer, coming to Intelerad after serving as CTO of treasury and risk management firm GTreasury. Named as chief customer officer is Vivek Rao, who joins Intelerad from Cloud Software Group. Finally, Erikka Buracchio was named chief people officer after serving in positions at Brightly and Allscripts Healthcare Solutions. 

• Foundation Model for Chest X-Rays: Researchers from Stanford University have launched a foundation model for training AI algorithms to analyze chest X-rays. In a paper posted to arXiv, they describe CheXinstruct, a large-scale instruction-tuning dataset curated from 28 publicly available datasets, as well as CheXagent, a foundation model for analyzing and summarizing chest X-rays. Foundation models have been proposed as a solution for the challenge of building datasets large enough to adequately train AI algorithms. 

• DCIS and Breast Cancer Risk: Women whose DCIS was detected outside the UK’s national breast screening program had 4X the risk of developing invasive breast cancer than national averages, and almost 4X the mortality rate. In a study in BMJ of 27.5k women from 1990 to 2018, women diagnosed with DCIS that wasn’t detected on screening developed invasive cancer at a rate of 13 per 1,000 per year and died at a rate of 3 per 1,000 per year, more than four times higher than expected from national cancer incidence rates. 

• Philips Launches Mini-3D TEE: Philips is launching a new miniaturized 3D transesophageal echocardiography ultrasound transducer designed for use in settings where larger probes aren’t appropriate, like children or ICU cases. The FDA-cleared X11-4t Mini 3D TEE transducer delivers the value of high-quality 3D cardiac imaging for more-fragile patients and can reduce complications from prolonged transesophageal imaging during structural heart procedures, as well as the need for anesthesia.

• RT Shortage Leads to Scan Delays: The US shortage of radiologic technologists is having a major impact on patient care, leading to scan delays in some areas. The problem is particularly acute in the Las Vegas area, where a new article describes how what used to be a three-day wait for imaging tests has stretched into two months. Imaging providers in the area are having to conduct national searches for RTs, and the state medical association is looking into the problem. 

• RadNet Buys Ariz. Centers: RadNet’s Arizona Diagnostic Radiology Group joint venture has acquired seven outpatient imaging centers in Phoenix, Arizona from Evernorth Care Group. The radiology group has provided imaging services to Evernorth since 2022, and the deal gives Evernorth patients access to the existing centers as well as the nine additional facilities RadNet operates in the Phoenix area. RadNet will also be able to roll out its imaging IT and DeepHealth AI solutions to the new centers. RadNet first entered the Arizona market in 2020. 

• b-rayZ Secures CE Mark: Swiss AI developer b-rayZ has received the CE Mark for its DANAI solution, an AI algorithm designed to integrate easily into different diagnostic environments. DANAI integrates with the company’s b-box plus breast diagnostic suite, which includes features for standardizing and automating mammography findings. b-rayZ is planning to officially launch DANAI at ECR 2024 later this month.

Simplifying Patient Access to Imaging

A major U.S. healthcare provider faced challenges in simplifying imaging workflows while ensuring cost-effectiveness. Learn how PocketHealth improved patient experience and efficiency, and saved $130,000 in annual costs.

The Importance of Workflow in SPECT/CT

SPECT/CT can impact everything from patient satisfaction to exam efficiency. In this video, learn from two technologists and a physician how Siemens Healthineers’ Symbia Pro.specta SPECT/CT system impacts their daily work, their patients, and their department’s efficiency.

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 Resource Wire

• The Right Approach to AI Adoption: Discover the right approach to AI adoption and the transformative impact of CARPL.ai in accelerating the clinical implementation of AI, driving ROI, and revolutionizing patient care in this video featuring leaders from Radiology Partners and University Hospitals, Cleveland. 

• From NASA Engineer to Radiology Leader: Join Medality founder and CEO Daniel Arnold on The Radiology Report Podcast for a discussion with John Stewart, MD, PhD, radiologist and CEO of Scriptor Software. Hear him describe his journey from aerospace engineer to radiologist to health IT entrepreneur. 

• Learn about the Benefits of CloudPACS: CloudPACS has finally arrived. Learn more about the benefits that cloud-based PACS can have for your radiology practice and how Visage Imaging’s Visage 7 was built from the ground up to ensure maximum performance, security, and scale. 

• Effectiveness of AI for Fracture Detection: How effective is AI for detecting fractures on X-ray in the trauma environment? In this case study, read about the experiences of Riga Hospital in Latvia and how they implemented Gleamer’s BoneView solution for fracture detection. 

• Clearly Superior Chest X-Ray Imaging: Chest X-rays can help identify many abnormalities, but interpretation is often difficult due to obstructing bone, patient positioning, and image quality. Book a demo to see how Riverain’s ClearRead Xray with Clear Visual Intelligence provides a clearly superior view of the chest.

• How to Help Radiologists Thrive: With burnout and staffing shortages on the rise, and the increasing volume of imaging, radiology teams are searching for solutions. This interactive guide from Nuance can help you create an environment where radiologists thrive by building a powerful imaging strategy with AI-driven, real-time intelligence.

• Modern Technology for Better Patient Outcomes: United Imaging is developing modern medical imaging technology for better patient outcomes. CEO Jeffrey Bundy, PhD, explains the company’s unique philosophy in this interview with Healthcare Tech Outlook. 

• Lessons of Cloud Image Management: What has radiology learned so far as it adopts wider use of cloud-based medical image management? In this Imaging Wire Show, we talked to Ran Rumianek of Change Healthcare about how now is the right time to begin moving imaging data to the cloud.

• White Paper on Structural Heart Imaging: How can AI help improve care for patients with structural heart issues? Learn more about new enhancements for procedures like TAVR and TMVR, as well as LAA closure, in this downloadable white paper from TeraRecon.

• Gain Clarity at Speed in MRI: Acquire images faster per MRI machine per day with STAGE from SpinTech MRI. STAGE reduces the time for MRI brain protocols by 30% for your most common exams. 

• AI Applications in Neuroradiology: What are the most common AI applications in neuroradiology? This downloadable e-book from Bayer and Calantic Digital Solutions reviews the most common AI applications for brain imaging and the evidence behind them.  

• Navigating Breast Cancer with Empathy and Technology: How can cancer patients appreciate the benefits and value of innovation during their care journey? Join GE HealthCare at 10 am EST on February 6 for a live discussion with breast cancer survivor and patient advocate Ellyn Winters-Robinson.

• A New Solution for Cardiac MR Programs: Intelerad is making advanced cardiac solutions available whenever you want them. Learn more about the company’s new Precession application, which enables you to view, analyze, and report cardiac MR exams – all within a standard web browser. 

• 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. 

• Home-Based Cardiac Ultrasound: How is home-based AI-aided cardiac ultrasound poised to change global healthcare? In this article from Us2.ai, hear from Izabella Uchmanowicz, RN, on how the CUMIN study is empowering nurses to perform AI-POCUS.