Rasu Shrestha, MD, in an X post on Tempus AI’s upcoming IPO.

Lunit has closed its acquisition of Volpara Health Technologies in a move that unites two leaders of AI and breast imaging software. In this episode of The Imaging Wire Show, we talked to Volpara CEO Teri Thomas and Lunit CEO Brandon Suh about the possibilities of their new alliance.

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CT Scanners

Lung Screening Narrows Disparities

New research confirms that not only does low-dose CT screening reduce lung cancer mortality, it can also narrow health disparities. Researchers found that screening’s beneficial impact was greater at lower socioeconomic levels in a new study published in Lancet Regional Health – Europe.

As we mentioned in our last issue, CT lung cancer screening is gaining momentum globally; at the same time, researchers have documented greater mortality and morbidity for a variety of diseases among racial minorities and at lower socioeconomic levels.

• This difference can be especially profound when it comes to lung disease, given higher smoking rates among some minority groups and economically disadvantaged populations.

In the original UK Lung Cancer Screening Trial (UKLS) in 2021, researchers found that a single CT screening round produced a 16% lung cancer mortality reduction. 

• The new study is a secondary analysis of UKLS to investigate whether CT lung screening’s impact differed by socioeconomic status, which is important given that smoking occurs in England at higher rates in the most deprived neighborhoods compared to wealthier ones (24% vs. 6.8%).

UKLS researchers compared lung cancer mortality rates in 4k individuals in different groups classified by a widely used socioeconomic barometer. They found that … 

• CT lung screening had the same lung cancer mortality benefit in both low and high socioeconomic groups (-19% vs. -20%)
• But there was a bigger reduction in death from COPD in lower socioeconomic groups (-34% vs. +4%)
• And fewer deaths from other lung diseases (-32% vs. +10%)
• While cardiovascular mortality was also lower (-30% vs. -13%)
• All-cause mortality was lower in lower socioeconomic groups – a benefit not seen at higher levels

Lung screening’s reduction in all-cause mortality is particularly intriguing, as this is an accomplishment that has eluded most other cancer screening tests – a point that has been repeatedly hammered home by screening skeptics.

The Takeaway

The new findings highlight how – to a greater degree than other major cancer screening tests – CT lung screening has the potential to address ongoing racial and socioeconomic healthcare disparities. It’s yet another reason to press for broader adoption of lung screening.

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The Wire

• Lunit Completes Volpara Buy: Lunit completed its acquisition of Volpara Health Technologies this week, paying AU$1.15 per share (or $193M) for the New Zealand-based company. The deal was originally announced in December 2023 and unites two companies with substantial operations in the breast imaging software segment, with Lunit offering AI for breast imaging analysis and Volpara providing breast density analysis and mammography operations software. Lunit also has a large presence outside the breast AI market, such as for chest applications.

• Tempus AI Files for IPO: Tempus AI finally filed for its long-awaited IPO. In documents filed with the SEC, the company described its various businesses, which include the Arterys operations it acquired in 2022. Much of the company’s business comes from outside radiology, however, as it provides AI to 7k physicians as well as life sciences researchers. SEC documents show Tempus AI posted a net loss of $214.1M on revenues of $531.8M for 2023; the company reportedly is looking to raise $100M, representing a small raise compared to its $1.3B in previous VC funding.

• Disparities in AI Analysis? There’s growing evidence that healthcare disparities may carry over into the AI era. In a paper in Radiology, researchers describe how an AI algorithm for breast screening performed differently based on patient race. Researchers used iCAD’s ProFound algorithm to analyze 4.9k true-negative mammograms; the AI was more likely to generate a false-positive result for Black patients compared to Whites (OR=1.5) and less likely in Asian patients (OR=0.7). False positives were also more common in older patients ages 71-80 (OR=1.9). 

• Abnormalities on Abbreviated Breast MRI: Abbreviated breast MRI has been proposed as a faster alternative to full-protocol MRI for breast cancer supplemental screening in at-risk women. Writing in a new paper AJR, UPenn researchers found that in 2.6k average-risk women with dense breasts, fewer abnormalities appeared on subsequent rounds of AB-MRI scans versus baseline exams (7.8% vs. 17%) and more earlier-stage abnormalities were found (92% vs. 83%). The findings support AB-MRI as a supplemental screening tool for these women. 

• Vapers May Need Lung Screening Too: E-cigarettes are marketed as a step toward smoking cessation, but people who vape may also be at risk for lung cancer – and thus need CT screening. In a presentation at ATS 2024, South Korean researchers presented data on 4.3M people with smoking histories, finding that long-term smokers who switched to e-cigarettes had higher risk of lung cancer incidence (HR=1.65) and lung cancer mortality over five years after quitting (HR=4.45). 

• More News from ATS 2024: Other studies presented at ATS 2024 underscored imaging’s value in diagnosing lung pathology. These included a software-based technique called CT-derived functional imaging (CTFI) for calculating lung function; a better algorithm for assessing smoking history to determine screening eligibility; a study finding that people with comorbidities might be poor candidates for lung screening; research on lung screening disparities finding that Black patients were less likely to have follow-up imaging; and a study on how changes in lung screening guidelines affected racial disparities and screening’s effectiveness. 

• Lung Screening Clears Hurdle in Germany: Meanwhile in Germany, CT lung cancer screening has cleared a regulatory hurdle and is set to begin on July 1. A German federal ministry ruled that using low-dose CT to screen smokers is admissible, a requirement under German law due to CT’s use of ionizing radiation. In a LinkedIn post, CT lung screening expert Sebastian Schmidt calls the move a “major milestone” that paves the way for broader lung screening, although reimbursement by public health insurance is still pending. 

• Teaching MRI Techs to SWiM: The shortage of experienced MRI technologists is a global problem. In a paper in JACR, authors present a pilot study of Scan With Me (SWiM), a program to upskill MRI personnel in low- and middle-income countries. In all, 43 technologists from 16 countries participated in a six-week training course on cardiac MRI that included self-paced lectures, hands-on expert-guided scanning, and protocol implementation at their sites. On completion, participants reported improvement in their CMR knowledge and skills, and 87% said they’d return to teach others.

• Risk Factors for Interval Breast Cancer: A study in JAMA Network Open investigating risk factors and mortality of interval breast cancer (cancer detected between screenings) had interesting conclusions. Researchers studied 18.2k women in South Korea to find higher breast density was associated with lower rates of interval cancers, but higher rates were found with lower BMI and HRT use after menopause. The researchers found no statistically significant difference in all-cause mortality or breast cancer-related mortality with interval cancers, although women with interval cancers had 12% higher risk of death from any cancer.  

• Hologic Recalls BioZorb Marker: The FDA announced that Hologic is recalling its BioZorb radiographic breast tissue marker due to reports of complications and adverse events from the device. The FDA said there have been 71 reported injuries from the marker, such as pain, infection, rash, and device migration; there have been no reports of patient death. The FDA issued a warning for BioZorb earlier this year. 

• AI-Powered Cardiac MRI Screening: Cardiac MRI has much potential for assessing cardiovascular disease, but it’s challenging to perform. In a paper in Nature Medicine, researchers describe a two-stage deep learning protocol for CVD pathology that starts with non-contrast cine MRI scans to screen for anomalies,  and if needed, uses cine and contrast-based late gadolinium enhancement for diagnosis. In 9.7k people, the technique had high sensitivity (97%) and specificity (90%) for detecting anomalies across 11 cardiovascular diseases. 

• UK’s AI Investment: The UK government this week announced a new $20M investment to roll out AI “to all radiography departments” in the country “in a matter of weeks.” The announcement didn’t provide many specific details about the rollout, other than to say that it’s targeted at using AI to cut waiting lists in the NHS – a persistent problem within the system. The UK government last year announced a national AI platform and the NHS AI Diagnostic Fund to jump-start AI adoption.  

• New Radiology Residency Program: A new radiology residency program has been launched by St. Luke’s University Health Network in Pennsylvania. The program will accept six diagnostic radiology and one integrated interventional/diagnostic radiology trainees each year, and when fully operational will have 28 students enrolled. The launch comes amid an ongoing shortage of radiologists in the US as imaging volume has risen dramatically while the number of residency training programs has remained static; the 170 US radiology residency programs had a 99.7% fill rate in the most recent Match.

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Two Questions about AI for Radiology Leaders

Are today’s radiology AI solutions solving the right problems? And are there other solutions available for AI of brain MRI? Read this article from SpinTech MRI to learn how its STAGE solution can optimize MRI utilization. 

The Resource Wire

• 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 on this page.

• 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 video series, Unboxing AI, featuring experts discussing AI and its future in radiology. The next episode features Ron Nag of Medcognetics on May 24 – reserve your seat today. 

• Reinventing How Medical Imaging is Done: Explore how United Imaging is reinventing the medical imaging business, including downtime rebates, lifetime upgrades, and making sure their customers truly are successful.

• Give Your Patients the Experience They Want: Empower patients to take control of their healthcare journey by giving them mobile access to their records and images with Clearpath, the world’s first digital fulfillment platform for records and films. Book a demo today. 

• Healthcare Network Uses PocketHealth with Legacy Image Exchange: Valley View Hospital in Colorado wanted to share images and records with patients while continuing to use its legacy image exchange for providers. Find out how PocketHealth helped them in this article. 

• Enterprise Imaging on Your Terms: Meet your radiology, cardiology and all other imaging needs – on your own terms – with imaging solutions from Merge by Merative. Learn more about their award-winning solutions and request a demo today. 

• AI for Incidental Osteoporosis Findings: Looking to learn more about how AI is used for incidental osteoporosis findings? Watch this on-demand webinar from Blackford in which clinical leaders discuss the benefits of preventive care and share their real-life experiences.

• Understanding PET/CT’s Expansion: If your work is impacted by PET/CT, you should be aware of the rapid growth that’s predicted for this imaging exam. Learn more on this page from Siemens Healthineers about the exciting clinical applications fueling the technology. 

• Image Sharing to Improve Patient Outcomes: In this case study, learn how AdventHealth improved treatment planning and delivery because of Nuance PowerShare’s immediate connection to other sites in the network for medical image sharing.

• The Journey to Cloud-Based PACS: Radiology is looking closely at cloud-based PACS as an alternative to on-premises digital image management. Learn about providers who have made the switch with Visage Imaging in this white paper from Signify Research. 

• Learn a New Subspecialty in 5 Minutes per Day: Gain confidence in your diagnosis and improve turnaround times with Medality’s expert-led video courses and the largest collection of curated, scrollable DICOM cases available anywhere. 

• Fully Automated AI LV Assessment: Read how a new study showed that Us2.ai’s echo AI solution had good to excellent agreement between AI and experts’ assessments of LV volumes and ejection fraction in contrast echocardiograms.

• 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 on this page.

• Prioritizing Efficiency in Healthcare IT: Health IT teams are bombarded with projects and initiatives aimed at improving patient care, and prioritizing projects can be a challenge. In this white paper from Enlitic, learn more about how to efficiently manage and prioritize the introduction of new technologies.