Denali, in a thread on radHQ.net discussing the possible demise of non-compete agreements.

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Artificial Intelligence

Nuclear Medicine’s AI Uptake

Nuclear medicine is one of the more venerable medical imaging technologies. Artificial intelligence is one of the newest. How are the two getting on? That question is explored in new point-counterpoint articles in AJR. 

Nuclear medicine was an early adopter of computerized image processing, for tasks like image analysis, quantification, and segmentation, giving rise to a cottage industry of niche software developers.

• But this early momentum hasn’t carried over into the AI age: on the FDA’s list of 694 cleared AI medical applications through July 2023, 76% of the listed devices are classified as radiology, while just four address nuclear medicine and PET.

In the AJR articles, the position that AI in nuclear medicine is more hype than reality is taken by Eliot Siegel, MD, and Michael Morris, MD, who note that software has already been developed for most of the image analysis tasks that nuclear medicine physicians need. 

• At the same time, Siegel and Morris say the development of AI-type algorithms like convolutional neural networks and transformers has been “relatively slow” in nuclear medicine. 

Why the slow uptake? One big reason is the lack of publicly available nuclear medicine databases for algorithm training. 

• Also, nuclear medicine’s emphasis on function rather than anatomical changes means fewer tasks requiring detection of subtle changes.

On the other side of the coin, Babak Saboury, MD, and Munir Ghesani, MD, take a more optimistic view of AI in nuclear medicine, particularly thanks to the booming growth in theranostics. 

• New commercial AI applications to guide the therapeutic use of radiopharmaceuticals are being developed, and some have received FDA clearance. 

As for the data shortage, groups like SNMMI are collaborating with agencies and institutions to create registries – such as for theranostics – to help train algorithms. 

• They note that advances are already underway for AI-enhanced applications such as improving image quality, decreasing radiation dose, reducing imaging time, quantifying disease, and aiding radiation therapy planning. 

The Takeaway
The AJR articles offer a fascinating perspective on an area of medical imaging that’s often overlooked. While nuclear medicine may never have the broad impact of anatomical-based modalities like MRI and CT, growth in exciting areas like theranostics suggest that it will attract AI developers to create solutions for delivering better patient care.

Embrace the Cloud

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Artificial Intelligence for Coordinated Care

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The Wire

• No More Non-Competes? In a move that’s reverberating throughout the business world, the FTC this week banned non-compete agreements between employers and employees. The move drew praise from rank-and-file radiologists, while the American Hospital Association issued a statement panning the decision – a position that was roundly criticized on bulletin board radHQ.net. One poster noted that because radiologists don’t control patients, they are less of a threat than other physicians when leaving employers. The question is whether the FTC ruling will survive legal challenges, which have already been filed.

• Alternatives to MRI Prostate Screening? MRI is showing its value in guiding prostate cancer screening, but are blood-based biomarker tests an alternative for sites that don’t have scanners? In a paper JAMA Network Open, Swedish researchers in the STHLM3-MRI trial looked at PSA with MRI screening and compared it to the Stockholm3 risk score and systematic biopsy. In 12.7k men, Stockholm3’s detection rate was comparable to MRI (2.3% vs 2.5%) but had a higher biopsy rate (6.3% vs. 4.4%) and detected more indolent cancers (1.2% vs. 0.5%). Score one for MRI?

• Intelerad Lands Big Health System: Intelerad has landed a contract to supply its enterprise imaging solutions to a major US health system that oversees 12 hospitals in the Southeast. The deal includes Intelerad’s IntelePACS with Clario SmartWorklist software, which will enable as many as five radiology groups to read over 2M imaging studies per year over the life of the multi-year contract. The deal builds on Intelerad’s recent success with large hospital systems, such as its $50M deal in Michigan in late 2023. 

• Heart Screening with Mammography: A new study supports the idea that mammography can be leveraged for heart screening by using AI to detect breast arterial calcifications. Researchers from Solis Mammography presented results at ACC 2024 using iCAD’s ProFound Breast Health Suite to find BAC on mammograms of more than 117k women. They found overall BAC prevalence of 15%, with prevalence rising with age, from 4.2% in women <50 to 41% in women ≥ 70. Future studies will focus on tracking women with and without BAC to identify cardiovascular risk. 

• Annalise Signs on with Blackford: AI developer Annalise.ai has signed a commercial partnership with Blackford to have its solutions added to Blackford Platform. Annalise is the most established AI developer to join Platform in recent memory, and users will benefit from the wide range of pathologies that can be detected with the company’s AI tools for chest X-rays and head CT scans. Annalise joins Lucida, Radiobotics, Pixyl, Imbio, Avicenna, Bot Image, See-Mode, and Rayscape among recent additions to Blackford Platform. 

• Why Isn’t Supplemental Breast Screening Reimbursed? A recent New York Times article explored the question asked by many breast imagers and women’s health advocates: Why won’t Medicare pay for supplemental imaging for breast screening? MRI and ultrasound are indicated as supplemental screening tools, especially in women with dense breast tissue, but patients are left paying out of pocket for scans. The situation could be addressed by federal legislation in Congress, but the problem may get worse when FDA rules on density reporting go into effect in September. 

• Cancer Risk after Breast Cancer: Breast cancer survivors are at high risk of developing cancers later in life, at levels higher than previously thought. In a UK study in Lancet Regional Health – Europe, researchers tracked 580k female and 3.5k male breast cancer survivors from 1995 to 2019, finding that compared to the general population, female survivors had 2X higher risk of contralateral breast cancer, as well as higher risk for other cancers: endometrial (87%), myeloid leukemia (58%), and ovarian (25%). Previous estimates pegged non-breast cancer risk at 24-27%. 

• Us2.ai’s Echo AI Evidence: A new study out of Northwestern showed that Us2.ai’s automated echo measurements matched human expert estimates of invasively measured pulmonary capillary wedge pressure (PCWP), representing another example of how echo AI could aid in heart failure detection. Among 626 patients with HFpEF and HFmrEF, Us2.ai’s echo AI measurements of LA pressure performed as well as core lab measurements, while reservoir strain had the highest AUROCs for predicting elevated PCWP with both the core lab and Us2.ai measurements (0.69 & 0.66).

• Radiology and Climate Change: Radiology facilities can take concrete steps to reduce greenhouse gas emissions to counter climate change, and a new article in Radiology offers an action plan. University of Toronto authors say that simply powering scanners down when not in use can reduce emissions by 33% for MRI and 40% to 80% for CT. Better scanner scheduling can also help thanks to less idle time, as can shorter scanning protocols. Last week, Italian researchers presented a plan for using mobile mammography vans to reduce emissions from breast screening programs.

• AIRS Signs European Deals: South Korean AI developer AIRS Medical has expanded its presence in Europe with supply contracts in Germany and the UK. The company will supply its SwiftMR MRI enhancement software to RNZ, an imaging center operator with seven sites in Germany. It also signed a deal with Medserena, which specializes in mid-field MRI services in the UK and Germany. SwiftMR enables providers to reduce scan times, improve image quality, and enhance productivity. The company raised $20M in 2022.

• GE Adds MIM Software to Elekta Tie-Up: GE HealthCare has added radiation therapy solutions from MIM Software to its existing relationship with radiation oncology vendor Elekta. GE announced the completion of its MIM acquisition in April, and adding MIM’s vendor-neutral applications to the GE/Elekta relationship will enable the firms to offer a more comprehensive line of treatment planning offerings to hospitals and radiation therapy centers.

• Exo Launches AI for Heart Failure: Handheld ultrasound startup Exo has further expanded its AI portfolio, launching new FDA-cleared cardiac and lung applications for use with its Exo Iris POCUS device. Exo Iris was launched in 2023 and is based on the company’s pMUT technology for improved image quality and affordability. The new AI features enable Exo Iris to bring POCUS’ benefits to more patients in a wider range of healthcare settings, including rural and under-resourced locations. 

MRI Access and the Cost of Inpatient Stays

Longer inpatient stays due to delayed MRI access are a long-standing and costly issue for hospital systems. Find out how STAGE from SpinTech MRI can reduce your MRI backlog and inpatient stays by shortening brain scan times by 30%.

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.

Get to Know DeepHealth

What’s the latest from DeepHealth? In this episode of the Imaging Wire Show, we talked to COO and CTO Sham Sokka about the company’s recent launch and their take on the value AI provides to radiology, especially for screening.

The Resource Wire

• True TOF Technology Sets the Standard in PET/CT: True time-of-flight (TOF) PET/CT based on lutetium oxyorthosilicate (LSO) detectors offers numerous clinical advantages, such as better definition of small lesions and improved uniformity. Learn the other advantages in this article from Siemens Healthineers. 

• Focus on Actionable Data: Riverain Technologies’ ClearRead technology is the first FDA-cleared Clear Visual Intelligence (CVI) system that improves both detection and reading time for lung abnormalities. Learn more in this article. 

• 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. 

• Visit United Imaging at ISMRM 2024: If you’re attending ISMRM 2024 in Singapore next month, be sure to visit with United Imaging in booth A18 to explore their latest advances in MRI technology and learn how United is shaping the future of healthcare through innovation. 

• Approaches to Deploying Clinical AI: Join this April 30 educational webinar hosted by Aidoc and Merge by Merative to learn about real-world approaches to deploying AI solutions. Don’t miss this chance to learn how AI can be integrated into your workflows and help transform patient care. 

• Generating Savings by Putting Patients First: 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. 

• Joining Forces on Medical Imaging Data Standardization: Being a leader in healthcare and having to make decisions on technology purchases can be tough. Learn how Enlitic partner Blackford Analysis has made it easy, with many AI solutions all in one platform. 

• Top 5 Obstacles to Radiology AI Adoption: AI is reshaping healthcare, but some healthcare providers are encountering hurdles that demand strategic approaches for successful implementation. Learn the top 5 obstacles to radiology AI adoption – and how to avoid them – in this blog post from Blackford. 

• An Update on CARPL from HIMSS 2024: What’s the latest news from AI platform company CARPL.ai? Check out this video from HIMSS 2024 to discover how the company is making it easier than ever to deploy and use radiology AI. 

• 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. 

• AI Improves Hand and Wrist Fracture Detection: Learn how Gleamer’s BoneView AI algorithm for detecting fractures in the hand and wrist on X-ray improved radiologist performance in a recent paper in European Radiology. 

• An Integrated Approach to Radiology AI: AI automates what radiologists can’t stand, surfaces what radiologists can’t see, and identifies what radiologists can’t miss. But only if it’s implemented in the way radiologists work. See how Nuance helps radiologists achieve these results through a single, streamlined, end-to-end AI experience.

• 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. 

• Why Do Radiology Practices Choose Medality? From improving clinical quality and efficiency to reducing CME compliance costs and administrative burdens, there are many reasons why radiology practices choose Medality. Learn about some of them today.