Lu N et al, writing in STAT on their vision for a future of easy access to portable brain MRI.

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CT Scanners

CT Lung Screening Shows Progress at ATS 2024

Making CT lung cancer screening more effective has been a hot topic at the American Thoracic Society meeting, which convened this weekend in San Diego. Presentations at ATS 2024 have ranged from improving screening compliance rates to eliminating racial disparities in screening attendance.

After years of fits and starts, low-dose CT lung cancer screening appears to be finally making progress. 

• While the US still struggles with overly restrictive screening criteria and convoluted reimbursement rules, the rest of the world – including Australia, Germany, and Taiwan – is moving ahead with population-based screening programs designed to counter the tobacco epidemic’s deadly scourge.

At ATS 2024, investigators are presenting research to ensure that the benefits of CT lung cancer screening are delivered to those who need it, with the following highlights …

• Researchers at the University of Minnesota saw a 7.2% completion rate for screening-specific low-dose CT among 91k eligible individuals – an indication of “overall poor uptake of screening” 
• To improve uptake, another group implemented a centralized nurse coordinator for lung screening, resulting in a 23-day reduction in time from initial consultation to report delivery as well as better adherence to eligibility criteria
• Patients who self-identify as Black are more likely to miss a scheduled CT screening appointment (OR=2.05), while Hispanic patients also have high miss rates (OR=1.92) as do those with limited English proficiency (OR=1.72). The numbers highlight the need for patient conversations to boost completion rates
• Incidence rates of lung and bronchus cancer dropped from 2007-2019 compared to 1999-2006, underscoring the importance of smoking cessation and supporting current USPSTF age criteria for lung screening
• Pulmonary physicians significantly overestimated their patients’ lung screening completion rates, with almost half thinking the rate was higher than 60% when it was actually 17%. Researchers suggested interventions for improving completion rates

The Takeaway

The fact that ATS 2024 has seen so many presentations on CT lung cancer screening – the vast majority presented by US authors – indicates that low screening rates haven’t discouraged American researchers and clinicians. The presentations underscore the progress being made toward making the benefits of lung screening available to Americans who would benefit from it.

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The Wire

• A ‘Massive Increase in Brain Scans’: Will the proliferation of affordable, portable MRI scanners lead to a “massive increase in brain scans,” creating new challenges for providers? In a new opinion essay in STAT, a trio of Harvard authors with backgrounds in neurology and psychiatry speculate on how easier access to portable neuro MRI in locations like homes and high school gyms could create the need for a new field – “neuroimaging counseling” – to help consumers interpret what could become regular brain-health “check-ups.” We’ll believe it when we see it.

• AI Spots Normal Chest X-Rays: Lunit’s Insight CXR AI algorithm for chest radiography identified normal chest X-rays and could reduce 15% of radiologists’ workload in a new study in European Radiology. Dutch researchers used version 3 of the algorithm to analyze 1.7k chest radiographs for 10 abnormalities; compared to three expert radiologists the AI achieved an AUC for normal cases of 0.92 and identified 53% of normal radiographs with an NPV of 98% for urgent findings, possibly eliminating the need for radiologist review.

• Eye Doc Gets Jail Time in Kickback Case: A Connecticut ophthalmologist was sentenced to a year and a day in prison for ordering medically unnecessary transcranial Doppler ultrasound brain scans in exchange for kickbacks. Donald Salzberg, MD, pleaded guilty in 2022 to kickback and healthcare fraud charges in a case in which he was accused of getting $100-$125 per referral, netting a total of over $3M in fraudulent bills. Separately, a guide to avoiding running afoul of kickback rules in radiology was just published in Current Problems in Diagnostic Radiology. 

• Google Debuts Med-Gemini: Google continues to add to its family of generative AI models for healthcare with the debut last week of Med-Gemini. The new model is based on the Gemini family Google introduced in December 2023, with multimodal capabilities for use in radiology, pathology, dermatology, and other applications, and is believed to be the most advanced medical AI model from the company. AI expert Woojin Kim, MD, offers a great explanation of Med-Gemini and other large language models/vision language models in a LinkedIn post. 

• Wellness Program Reduces Resident Burnout: Burnout of residents was lower than national averages at a radiologist training program that implemented a wellness program. In a paper in Clinical Imaging, researchers from Weill Cornell Medicine describe their program that includes annual resident retreats, social activities, and unlimited access to gyms and exercise classes. After a three-year review, burnout rates were lower than averages for emotion exhaustion (17% vs. 25%) and depersonalization (6% vs. 10%), while ratings of personal accomplishment were higher (38% vs. 33%). 

• Gleamer Builds Foundation Model: French AI developer Gleamer is developing its own foundation model and generative AI capability, based on an internal dataset of 10M anonymized exams and associated reports. The model covers all 2D and 3D imaging modalities and will power Gleamer’s current/upcoming solutions and “pave the way toward report generation.” The company’s AI point solutions include BoneView for fracture detection, ChestView for urgent findings on chest X-ray images, and BoneMetrics for automated MSK measurements on radiography images. BoneView received FDA clearance in 2022. 

• Brainomix Gets Lung Clearance: Stroke AI software developer Brainomix is expanding into lung imaging after getting FDA clearance for its Brainomix 360 e-Lung application. The firm already offers Brainomix 360 Stroke in the US and Europe through channels like Blackford, and said it will build on the clearance with research collaborations in pulmonology. Brainomix is highlighting e-Lung at this week’s American Thoracic Society conference in San Diego. 

• ConcertAI Taps TeraRecon GM: The parent company of TeraRecon has named imaging veteran Dhiraj Carumbaya as general manager of the business. ConcertAI said Carumbaya would lead TeraRecon as well as a new product group focused on imaging data solutions and a new business concentrating on generative AI solutions for imaging interpretation and clinical research. Carumbaya began his career in medical physics and went on to serve stints at RadNet, Philips, GE Healthcare, Fujifilm, and Amazon AWS.

• FFRCT Guides PAD Surgery: Adding FFRCT assessments to patient workups prior to peripheral artery disease surgery has a massive impact on coronary artery disease detection, treatments, and long-term outcomes. In a paper in Journal of Vascular Surgery, researchers used HeartFlow’s FFRCT solution in 522 surgical PAD patients; those who got FFRCT had lower rates of all-cause mortality (16% vs. 36%), cardiovascular deaths (4% vs. 21%), myocardial infarction (4% vs. 24%), and MACE (27% vs. 47%). Check out a complete analysis on our CardiacWire sister site. 

• Circle CVI Adds inHEART: Circle Cardiovascular Imaging and inHEART announced a global distribution alliance that will make inHEART’s AI-enabled “digital twin” cardiac ablation planning solution available through Circle CVI’s sales network. The partnership further expands Circle CVI’s already broad cardiovascular imaging solutions portfolio, while continuing inHEART’s busy few months, following its FDA clearance and Series A round.

• deepc’s US Expansion: AI platform developer deepc continues to expand its presence in the US. Following its establishment of a US headquarters in 2023, the company last week announced a partnership with medical billing and revenue cycle management software developer ImagineSoftware. The alliance gives deepc access to ImagineSoftware’s customer network in the US in radiology as well as other medical specialties. deepc recently expanded its UK presence and acquired Osimis Platform earlier this year. 

• Exo’s POCUS Package: Point-of-care ultrasound developer Exo rolled out a new package designed to help healthcare facilities implement POCUS more quickly. Called Exo Works Connect, the package includes features like exam documentation, real-time collaboration and feedback, and easier quality assurance, while also tracking user proficiency. It also enables POCUS devices to be connected to a hospital’s IT infrastructure to enable images to be stored directly to a PACS, VNA, or cloud archive – addressing the challenge of POCUS image management.

• Early Preeclampsia Risk Screening: A Fetal Medicine Foundation (FMF) screening algorithm that combines biophysical, biochemical, and ultrasound markers successfully detected preeclampsia risk in early pregnancy. In the PREDICTION study of 7.6k participants in the first trimester and who had never given birth, the FMF algorithm’s detention rates were about 63% for preterm preeclampsia and 77% for early-onset preeclampsia, with 16% false positives.

• InVision LVEF FDA: The echo AI arena welcomed a new competitor last week, following the FDA clearance of InVision Medical Technology’s InVision Precision LVEF solution, which as its name suggests supports the analysis and reporting of echo-based left ventricular ejection fraction exams. InVision highlighted the new solution’s training and testing in its announcement, noting that it was trained on more echo videos than any other FDA-cleared echo AI model and is the only echo AI product tested in a blinded RCT.

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The Resource Wire

• Starting a CT Lung Cancer Screening Program: There’s no doubt CT lung cancer screening reduces lung cancer mortality. In this Imaging Wire Show, we discuss how to set up CT lung screening and the technologies available to help with Chip Gilkeson, MD, of University Hospitals Cleveland Medical Center and Steve Worrell of Riverain Technologies.

• From CPACS to CVIS for Comprehensive Cardiac Care: In cardiology, two prominent IT systems, CPACS and CVIS, have emerged as pivotal tools for managing the vast array of cardiology-related data. Learn the key differences between them in this Intelerad article.

• Best in KLAS for Cardiovascular Imaging: The Merge Cardio and Merge Hemo solutions from Merge by Merative have been named Best in KLAS 2024 for Cardiology and Hemodynamics. Learn more about the solutions that have dominated both KLAS categories since 2007.

• Building a Mobile Lung Cancer CT Screening Program: The number of patients eligible for low-dose CT lung cancer screening has expanded, and so has the need to reach at-risk patients closer to where they live. That’s why Siemens Healthineers’ Mobile Lung Screening Solution combines the quality, ease of use, and flexibility needed to create a program that meets the real-life needs of your community.

• 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%.

• 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. 

• Demystifying Data Monetization in Healthcare: Some healthcare providers are reluctant to fully embrace data monetization. But done right, it can be a force for good. Learn how data monetization can enhance clinical decision-making, optimize workflows, and improve patient outcomes in this article from Enlitic. 

• 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.

• The Present and Future of Lung Cancer Screening: What is the latest evidence to support lung cancer screening, and what role will AI play? Watch this on-demand Bayer webinar to learn about evidence-based recommendations for the diagnosis and management of lung cancer. 

• Simplifying Patient Access to Imaging: A major U.S. healthcare provider faced challenges in simplifying imaging workflows while ensuring cost-effectiveness. Discover how PocketHealth improved patient care and drove annual cost savings of $130,000.

• Improving the Patient Experience: How is Clearpath improving the healthcare experience for patients? Learn more about the company and its solutions for ditching the disc when sharing images and records with patients. 

• The UK’s Lung Cancer Screening Rollout: The UK has launched a targeted lung cancer screening program to improve lung cancer outcomes through earlier detection. Learn how DeepHealth’s Saige Lung is the preferred AI solution in this case study. 

• Memorial MRI’s Choice for Patient Comfort: Texas has one of the highest obesity rates in the US. So to best serve its patients, Memorial MRI & Diagnostic in Houston turned to United Imaging and its 3.0T uMR OMEGA MRI scanner with 75cm ultra-wide-bore. Learn more about their story. 

• Radiology Automation Simplified: A recent statement by top radiology societies states that there should be close collaboration between the developers and users of AI. Find out in this video how CARPL.ai worked with University Hospitals, Cleveland for AI testing, deployment, and monitoring.