Pallavi Prathivadi, MBBS, PhD, on how some radiologists can be intimidating to referring physicians.

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CT Scanners

Slashing CT Radiation Dose

Cutting CT radiation dose should be the goal of every medical imaging facility. A new paper in European Radiology offers a promising technique that slashed CT dose to one-tenth of conventional CT – and just twice that of a standard chest X-ray.

CT’s wide availability, excellent image quality, and relatively low cost make it an invaluable modality for many clinical applications.

• CT proved particularly useful during the COVID-19 pandemic for diagnosing lung pathology caused by the virus, and it continues to be used to track cases of long COVID.

But patient monitoring can involve multiple CT scans, leading to cumulative radiation exposure that can be concerning, especially for younger people.

• Researchers in Austria wanted to see if they could use commercially available tools to produce ultra-low-dose CT scans, and then assess how they compared to conventional CT for tracking patients with long COVID.

Using Siemens Healthineers’ Somatom Drive third-generation dual-source CT scanner, they adjusted the parameters on the system’s CAREDose automated exposure control and ADMIRE iterative reconstruction to drive down dose as much as possible.

• Other ultra-low-dose CT settings versus conventional CT included fixed tube voltage (100 kVp vs. 110 kVp), tin filtration (enabled vs. disabled), and CAREDose tube current modulation (enabled – weak vs. enabled – normal). 

They then tested the settings in a group of 153 patients with long COVID seen from 2020 to 2021; both ultra-low-dose and conventional CT scans were compared by radiologists, finding … 

• Mean entrance-dose radiation levels with ultra-low-dose CT were less than one-tenth those of conventional CT in (0.21 mSv vs. 2.24 mSv); a two-view chest X-ray is 0.1 mSv
• Image quality was rated 40% lower on a five-point scale (3.0 vs. 5.0)
• But all ultra-low-dose scans were rated as diagnostic quality
• Intra-reader agreement between the two techniques was “excellent,” at 93%

The findings led the researchers to conclude that ultra-low-dose CT could be a good option for tracking long COVID, such as in younger patients. 

The Takeaway

The study demonstrates that CT radiation dose can be driven down dramatically through existing commercially available tools. While this study covers just one niche clinical application, such tools could be applied to a wider range of uses, ensuring that the benefits of CT will continue to be made available at lower radiation doses than ever.

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.

Delivering on PACS Innovation

For over 20 years, Merge by Merative has delivered on PACS innovation. Merge PACS simplifies physicians’ reading activities, helps scale care delivery, and improves reading workflows across the enterprise. Learn more about Merge PACS and keep your eyes peeled for an update later this year.

The Wire

• Are Radiologists Scary? Believe it or not, radiologists can be frightening to some referring physicians. Reports that were unclear or requests for consultations on urgent cases drove fear into the heart of Australian general practitioner Pallavi Prathivadi, MBBS, PhD, early in her career, as she explained in an article in The Medical Republic. Prathivadi goes on to note that her interactions with radiologists these days are overwhelmingly positive; she provides some great insight into how referring physicians view radiologists and the behaviors that they find both helpful and frustrating. 

• Radiology’s Growth Slows: With spring earnings season drawing to a close, most medical imaging companies are reporting growth in the low single digits, or even down slightly. These include GE HealthCare (-1% to $4.6B), Siemens Healthineers Imaging division (+2.6% to $3.18B), Philips Diagnosis & Treatment division (+3% to $2.18B), Fujifilm’s healthcare division (-1% to $1.84B), Canon Medical Systems (+2.4% to $859M), Hologic Breast Health division (-0.2% to $384.6M), Varex (-9.6% to $206.2M), and Accuray (-14% to $101.1M). Among the exceptions on the up side were RadNet (+11% to $431.7M), United Imaging Healthcare (+6.2% to $330M), Konica Minolta healthcare business (+5.2% to $223M), and Butterfly Networks (+14% to $17.7M).

• Diversity in Radiology: A talk from last week’s ARRS 2024 revealed mixed news in radiology’s effort to diversify its workforce by attracting more women and minorities. Underrepresented groups are more likely to go unmatched when applying to diagnostic radiology residencies, but the gaps have narrowed over the last seven years. The chance of women going unmatched was 9% higher than men in 2015-2016; that narrowed to 2% in 2020-2021. Similar trends occurred for Black individuals (49% to 33%), Hispanics (48% to 19%), and Asians (31% to 4%). 

• A New Option for Blood Flow Imaging?  In another ARRS 2024 presentation, Vanderbilt researchers presented a new option for blood flow imaging using a non-contrast fluoroscopy technique. Researchers tested x-ray pulsatility index (XPI) against the gold standard of contrast pulmonary angiography in a small group of patients with suspected chronic thromboembolic pulmonary hypertension (CTEPH). XPI showed good agreement with angiography (Dice score = 0.77), indicating it could be an alternative that’s cheaper, uses no contrast, and is easier to perform. 

• 4DMedical Gets Codes for Lung Solution: The AMA notified respiratory imaging developer 4DMedical that users of its CT LVAS technology can use two existing Category III CPT codes (0721T and 0722T) for Medicare reimbursement, at a rate of $650.50 per scan. CT LVAS was cleared by the FDA last year and uses CT data to produce reports with color-coded images of regional airflow and lung ventilation to help radiologists diagnose lung diseases. The AMA’s move sets a benchmark for hospital outpatient scans that can also guide private payors.

• Low-Power MRI for the World? MRI is probably the most powerful medical imaging modality, but its technical requirements – such as power consumption – limit where it can be used. In a new paper in Science, researchers present their design for a low-power, ultra-low-field MRI scanner at 0.05T that uses just 7% of the energy of a conventional scanner. The group tested the scanner on healthy volunteers and with the help of deep learning-based image processing it produced “clear and detailed” images. 

• New MRI Supercon Factory: Speaking of making MRI more accessible, vendors have recently been launching new superconducting scanners that consume far less helium than older technology. To that end, Siemens Healthineers last week announced it’s building a new $314M UK factory for manufacturing lighter, more sustainable superconducting magnets, such as the vendor’s DryCool technology, which reduces the amount of helium required in an MRI scanner from 1.5k L to 1 L. The factory should open in 2026.

• EHR + Echo AI for HF: A new study out of Scotland showed that EHR data analytics and echocardiography AI could identify and classify patients with heart failure. The researchers used keyword searches combined with EHR filtering, and then applied Us2.ai’s echo AI solution to analyze historical echo images, before integrating analysis of routinely stored plasma samples. Out of 578 patients (236 w/ HFpEF,  156 w/ HFrEF, 186 controls), the HF patients had far more risk factors and AI-identified echo abnormalities, and unsurprisingly had worse outcomes over a three-year follow-up.

• Blackford Bolsters Lung Offerings: AI platform company Blackford has bolstered the range of AI offerings targeted at lung analysis available on Blackford Platform by adding the LungQ algorithm from Thirona. LungQ analyzes thoracic CT scans to produce quantitative measurements that help clinicians diagnose and treat pulmonary diseases. Blackford now offers over 130 AI solutions on Platform, in addition to recent deals with firms like Medcognetics. 

• inHEART Series A: Cardiovascular imaging AI company inHEART raised an $11M Series A round to fund the commercial expansion of its “digital twin” solution for cardiac ablation planning and support new product development. The funding comes just a few months after the FDA clearance of its ablation planning solution, which automates the segmentation of preprocedural CT and MR images to create 3D cardiac models. inHEART is also developing new solutions that guide heart failure treatment and predict sudden cardiac death and cardio-embolic stroke.

• Elekta Buys Philips Rad Therapy Patents: Radiation therapy vendor Elekta has acquired patents from Philips covering radiation therapy treatment planning. The companies have a long history of working together; Elekta in 1997 bought the Philips radiation therapy business including its linear accelerators, and in 2021 they announced an agreement to integrate their treatment planning systems. With the new deal, users of Philips’ Pinnacle software will be transitioned to the Elekta ONE Planning platform. Elekta also recently gained access to GE HealthCare’s MIM Software solutions. 

• GenAI with Vision for Chest X-Rays Falls Short: Generative AI tools that can understand both text and images have performed impressively under controlled conditions on generic images. But a new study in Radiology showed that one algorithm – GPT-4 with vision – fell short creating reports for 100 chest X-rays, with a PPV of 12% and true-positive rate of 5.8%. The paper sparked a debate on X/Twitter on whether clinicians really understand that generative AI is not yet ready for clinical prime time. 

Streamlining Data Migration

Efficient data management is crucial for delivering quality patient care and achieving organizational goals. But data migration when transitioning to a new PACS can be daunting. Find out how solutions from Enlitic can streamline the process.

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.

Are You Getting the Most Out of Your Image Exchange Solution?

Ask yourself these 5 questions on this page from PocketHealth to find out whether your enterprise image exchange solution is maximizing patient satisfaction and efficiency and driving revenue.

The Resource Wire

• 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. 

• 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. 

• Take the Lead in Fracture Detection: A recent review by University College London highlighted essential factors for selecting the right AI tool for fracture detection, with Gleamer’s BoneView emerging as a standout performer. Dive deeper into the article to learn more. 

• AI-Automated Heart Failure Detection from EHRs: New research shows the feasibility of using Us2.ai’s echo AI solutions to automatically identify patients with heart failure from archived echo images in the EHR. Learn how it works in this white paper. 

• Strategic Planning for Radiology Groups: The pressures on radiology groups have never been more intense. In this May 21 webinar hosted by Medality, you’ll learn why strategic planning is important, how to start doing the planning process, and how to position yourself and your group for success. 

• Go Virtual with Ease: Visage Imaging’s new Visage Ease VP solution makes it easy for you to take advantage of the unique clinical capabilities of the new Apple Vision Pro spatial computing environment. Learn how it can change your practice today. 

• 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. 

• Drivers of AI Usage in Radiology: Radiologists are being asked to read more, read faster, and with a higher degree of accuracy as imaging data grows in volume and complexity. In this video, listen to Bernardo Bizzo, MD, and Riverain CEO Steve Worrell explain how this is driving AI usage. 

• The Smooth Deployment of Lung AI: Seamless use of AI wouldn’t be possible without workflow integration, made possible in collaboration with hospital IT teams. Learn about the smooth deployment of DeepHealth’s Saige Lung solution at Portsmouth Hospitals University NHS Trust in the UK.

• Presenting Unboxing AI: Check out CARPL’s brand-new webinar series, Unboxing AI, featuring experts discussing AI and its future in radiology. The next episode on May 17 at 11 am ET features AI expert Dr. Osvaldo Landi of FIDI. 

• 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. 

• Why and How Leaders Fail – Traps to Avoid: What are the pitfalls faced by healthcare leaders, and how can you avoid them? Listen to this recording of a #RadEqual webinar featuring Anu Brixey, MD, sponsored by Intelerad and the American Association for Women in Radiology. 

• Improving Cancer Screening by Empowering Radiologists: Learn how the use of AI-based tools for cancer screening holds immense promise for addressing the lack of trained radiologists in this downloadable eBook from Bayer. 

• An End-to-End AV and AI Solution: Never buy separate AV and AI solutions again. Get in touch with TeraRecon to find out how your health system can benefit from all the Intuition clinical features you need, plus a growing list of exclusive subscription-only content that leverages the power of AI.