Health AI Register, in a LinkedIn post on the hacking that occurred around the site’s AI vendor poll during ECR 2024.

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Cardiac Imaging

More Support for Cardiac CT’s Value

A new study in Radiology offers more support for the value of CT-based coronary artery calcium scoring, finding that people with higher CAC scores had worse outcomes, and suggesting that those with scores of 0 could potentially avoid invasive coronary angiography. 

Evidence has been building that by measuring calcium buildup in the heart, CAC scores can predict clinical outcomes, in particular major adverse cardiac events, particularly in patients with stable chest. 

• Studies ranging from MESA to SCOT-HEART to PROMISE have found that patients with CAC scores of 0 have MACE risk that’s lower than 2% – meaning they could be discharged without further invasive workup. 

The new study is an update to the DISCHARGE trial, which in 2022 published results comparing a CT-first evaluation strategy to one with invasive coronary angiography. The new study investigates the value of CAC scoring by analyzing its prognostic power in patients with stable chest pain who were referred for invasive coronary angiography. 

• The DISCHARGE study is notable for its diversity – 26 clinical centers in 16 European countries – as well as its use of 13 different models of CT scanners from all four major CT OEMs from 2015 to 2019. 

In all, 1.7k patients were studied, and CAC scores were generated based on CT scans and used to stratify patients into one of three groups; they were then followed for 3.5 years and rates of MACE were correlated to CAC levels, finding … 

• Patients with CAC scores of 0 had the lowest rates of MACE compared to those with scores of 1-399 and ≥400 (0.5% vs. 1.9% & 6.8%)
• Rising CAC scores corresponded to higher prevalence of obstructive coronary artery disease (0=4.1% vs. 1-399=29.7% & ≥400=76%)
• Revascularization rates rose with CAC scores (0=1.7% vs. ≥400=46.2%)

While the authors steered away from commenting on the study’s impact on clinical management, the findings – if confirmed with additional studies – suggest that stable chest pain patients may not need invasive coronary angiography.

• And in another interesting wrinkle to the study, the researchers pointed out that 57% of the DISCHARGE study’s patient population were women, a fact that addresses sex bias in previous research. 

The Takeaway

The DISCHARGE study’s findings are yet another feather in the cap for cardiac CT, with higher CAC scores indicating the long-term presence of atherosclerosis. Should they be confirmed, individuals with stable chest pain in the future will benefit from less invasive – and less expensive – management.

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.

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The Wire

• AI Firms Try to Hack ECR Poll: An informal poll by Health AI Register (formerly AIforRadiology) designed to measure attendee interest in AI firms exhibiting at ECR 2024 instead turned into a hackathon as AI developers “got creative” and tried to influence the results. AI firms solicited friends and family to vote, and some even wrote hacks and bots to pump up their votes, prompting Health AI Register engineers to counter with patches to remove “fraudulent” votes. The lesson? Regulation and monitoring of AI are crucial to ensure trust.

• Herman O’s Overview of AI at ECR: If you’re looking for an overview of AI at ECR 2024 that you can definitely trust, look no further than consultant Herman Oosterwijk’s overview on LinkedIn. Herman addresses many of the issues holding back broader adoption of AI in radiology, including workflow and infrastructure integration, challenges that AI developers are having in onboarding with PACS vendors, and technical issues like “dirty” DICOM metadata. A must-read for anyone in the AI space.

• Singapore Audits AI Performance: Singapore has taken the lead in implementing healthcare AI nationwide with its AimSG platform, and researchers at ECR 2024 showed how the platform can help audit AI algorithm performance. Using monitoring tools from CARPL.ai, researchers found that Lunit’s Insight CXR algorithm turned in an AUROC of between 0.95 and 0.99 in analyzing 300 chest X-rays performed for acute respiratory and thoracic symptoms. The study offers a good example of how AI algorithms can be monitored on a national scale. 

• Healthcare Burnout Edges Down: A new survey of burnout among healthcare providers found that burnout levels have actually edged down compared to last year. Apollo Intelligence surveyed 253 US physicians in January 2024, finding that fewer reported feeling frustrated by work pressure compared to 2022 (64% vs. 70%), but the numbers are still higher than in 2021 (47%). Other recent surveys have also found burnout levels to be easing. Only 28% said they thought AI could help alleviate burnout by taking over administrative tasks.

• HHS Offers Aid to Cyberattack Sites: The US Department of Health and Human Services is taking steps to mitigate the impact on healthcare providers of the recent cyberattack on Change Healthcare, a unit of UnitedHealth’s Optum business. The attack has crippled healthcare claims processing, and HHS announced a number of steps designed to speed up claims, such as relaxing prior authorization rules. While the attack has had a major impact on claims processing, anecdotal reports indicate that Change’s enterprise imaging business remains operational. 

• PET/CT’s Incidental Cascade: Using whole-body PET/CT to work up pulmonary incidental findings discovered on other modalities could lead to a cascade of even more incidental findings. Researchers in Clinical Imaging analyzed costs and clinical outcomes in 70 patients, 23 of whom had incidental findings that were not FDG-avid; in 12 cases a new incidental was found, only one of which proved to be malignant. Workup caused permanent nerve damage in one patient, and total costs were $11k or $160 per case. 

• Siemens Launches App for Apple Vision Pro: Interest is growing among radiology vendors in the new Apple Vision Pro 3D spatial computing headset. Siemens Healthineers is the latest imaging vendor to develop software for the headset with its Cinematic Reality app. The app enables users to view photorealistic cinematic-rendered images in a virtual environment, and could be used for surgical planning or patient education. It’s available in the Apple App Store, and visitors to Siemens’ booth at HIMSS 2024 can experience Cinematic Reality in person. 

• Low-field Vs. High-Field MRI for Back Pain: Low-field MRI at 0.55T is an acceptable alternative to high-field MRI for imaging back pain and could make MRI more accessible in resource-challenged areas. In European Radiology, researchers had two neuroradiologists use a four-point scale to rate the quality of 665 image series across 70 lumbar spine studies at 0.55T and 1.5/3T. All 0.55T sequences were graded as acceptable (≥2) for diagnostic use despite significantly lower scores for some sequences compared to 1.5/3T.

• Sectra Scores Contracts Worth $36M: Swedish enterprise imaging developer Sectra landed two contracts valued at a combined $36M to install its software at US healthcare systems. In a $16M deal, Sectra will install its radiology module on-premises at a healthcare system in the Midwest with 20 sites producing about 2M images a year. In a $20M deal, the company will provide its Sectra One Cloud SaaS subscription service over six years to a university health network with 10 hospitals. The identities of the systems were not disclosed. 

• AI Boosts Tomosynthesis Reading: DeepHealth’s Saige-Dx algorithm helped radiologists read DBT mammograms in a new study in Radiology: Artificial Intelligence.  For the study, 18 radiologists read 240 DBT studies with and without Saige-Dx V.2.0.0, which classifies exams into one of four suspicion levels. The AUC performance for all radiologists improved (0.93 vs. 0.87), and general radiologists saw a bigger improvement in AUC compared to breast imaging specialists (0.08 vs. 0.05). Saige-Dx could help general radiologists read at the level of specialists.

• Cleerly’s CAD Breakthrough: Cleerly’s high-priority Coronary Artery Disease Staging System landed FDA Breakthrough Device Designation and was accepted into FDA’s Total Product Life Cycle Advisory Program (TAP) Pilot. The Cleerly CAD Staging System analyzes atherosclerosis, stenosis, and ischemia in CT scans, with the goal of providing physicians with more accurate and personalized risk assessments. The CAD Staging System is also the focus of Cleerly’s ambitious new TRANSFORM trial, investigating whether patients who receive cardiovascular treatments based on Cleerly results have better outcomes.

• UltraLinQ ECG: UltraLinQ is best known as a cloud PACS company, but it just took a big step beyond image viewing, launching its new Holter Program. The UltraLinQ Holter Program combines its wearable UbiqVue ECG Holter and ECG Interpretation Software, allowing users to capture ECG data for up to 5 days, which is then uploaded for ECG viewing, analysis, and reporting.

Solutions to Transform Medical Image Delivery

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What’s the Latest News from United Imaging?

Driven by a focus on R&D, United Imaging has increased its brand influence and market share worldwide. Get the details in the company’s first annual report since going public.

The Resource Wire

• Overcoming Challenges to Achieving Quadruple Aim Goals: Watch a highlight from RSNA explaining how to overcome barriers to improving population health, patient experience, avoiding revenue loss and increasing staff wellness. Presented by PocketHealth Co-Founder and CEO Rishi Nayyar.

• Calantic by Bayer’s ECR Highlights: What were the hot topics in the booth of Calantic by Bayer at ECR 2024? AI was definitely a highlight in this video interview with Calantic executives Lucía Fernández and Juan Gutiérrez, MD.

• Clearer MRI for Alzheimer’s Disease: Clinicians and patients are encouraged by new drugs available to slow or reduce cognitive decline and Alzheimer’s disease. Learn how 30% faster MRI scans and clearer images enabled by SpinTech MRI’s STAGE software can help address imaging challenges. 

• Lunch & Learn with Intelerad at HIMSS 2024: HIMSS 2024 is right around the corner, and Intelerad is hosting a Lunch & Learn session March 12 in Orlando that you won’t want to miss! Discover insights on improving health equity and ensuring patient access – reserve your spot today.

• Get to Know DeepHealth: DeepHealth offers a portfolio of AI solutions for clinical applications ranging from lung to prostate to brain indications. Learn more about DeepHealth and its AI-driven breakthroughs in care delivery.

• Circulation on the Run: Looking for a weekly summary of hot cardiovascular topics in the journal Circulation? Check out Circulation on the Run, a podcast series featuring Carolyn Lam, MD, of echo AI developer Us2.ai. 

• 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.

• Nuance’s PIN Helps Identifies Emphysema: Emphysema is often underdiagnosed, and this can make treatment more difficult. FirstHealth of the Carolinas was able to improve its diagnosis of emphysema and enhance its CT lung screening service with AI algorithms available through Nuance Precision Imaging Network (PIN).

• Innovating Along Your Imaging Value Chain: Join Siemens Healthineers at HIMSS 2024 to find out how they are leveraging digitization and automation at scale in healthcare, featuring a talk on outcome-driven software on Wednesday March 13 at 11:45 am ET.

• Create Better Experiences for Staff and Patients: Visit Merge by Merative at HIMSS 2024 to learn how their solutions, built on a cloud-native foundation, are helping imaging organizations create better experiences for staff and patients alike. Book a meeting today.

• Unlock Your Data’s Potential: At HIMSS 2024, learn how Enlitic can improve data quality within medical imaging and unlock the potential of your organization’s healthcare data. Book a demo today.

• Why AI in Radiology is a Game Changer: What are the benefits of AI in radiology? Quite simply, they are game-changing and will drive improved hospital efficiency, according to this article that features Blackford Analysis CEO Ben Panter. 

• Blazing the Trail to the Cloud: Come for the hottest imaging technology, stay for the homemade nitro ice cream! Visit Visage Imaging at HIMSS 2024 and learn how they are trailblazing imaging’s SaaS move to the cloud. Schedule a demo today. 

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

• 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.

• Unlocking the Potential of Radiology AI: How is AI revolutionizing radiology to enhance patient outcomes and streamline workflow? Find out in this video discussion between CARPL.ai CEO Vidur Mahajan and Mitchell Goldburgh of NTT Data USA.