Dense Breasts Canada, commenting on the Canadian Task Force on Preventive Health Care’s failure to recommend mammography screening for women in their 40s.

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Cardiac Imaging

AI of Cardiac CT Predicts Risk

In a landmark study of 40k patients from the UK published in The Lancet, an AI-derived score that analyzed coronary arterial inflammation on coronary CT angiography scans was effective in predicting future cardiac risk in people regardless of whether they had obstructive coronary artery disease.

CCTA’s power for predicting heart problems has been demonstrated in multiple studies, and it’s now considered a first-line test for individuals with chest pain. 

• But the situation is trickier in those without obstructive disease – prompting researchers to ask whether CCTA’s ability to visualize subtle changes in cardiac structure and function could be leveraged – such as with AI – to deliver even more prognostic power. 

The Oxford Risk Factors And Noninvasive imaging (ORFAN) study in the UK is addressing that question by conducting CCTA scans in 40k patients as part of routine clinical care at eight hospitals. 

• Researchers analyzed outcomes in the entire ORFAN population of 40k patients, then followed a subset of 3.4k higher-risk patients for 7.7 years to study the value of a perivascular fat attenuation index (FAI) score. 

FAI scores measure heart inflammation in coronary arteries and are calculated using Caristo Diagnostics’ CaRi-Heart AI software.

• The scores are combined with other traditional risk factors to create an AI-Risk classification that predicts the likelihood of an adverse event.  

Researchers found that … 

• Across the entire 40k cohort, patients without obstructive CAD accounted for 64% of cardiac deaths and 66% of MACE – twice as many as those with obstructive CAD
• In the smaller higher-risk cohort, patients with an elevated FAI score in all three coronary arteries had a higher risk of cardiac mortality (HR=29.8) or MACE (HR=12.6)
• Elevated FAI scores in any coronary artery also predicted cardiac mortality
• AI-Risk scores were associated with cardiac mortality (HR=6.75) and MACE (HR=4.68) when comparing very-high-risk versus low- or medium-risk patients 

The first data point is worth noting, as it illustrates the need to improve risk stratification and management in people without obstructive CAD.

The Takeaway
The ORFAN results are an exciting development for cardiac CT AI (in addition to being a major coup for Caristo, which raised $16.3M last year to commercialize CaRi-Heart globally). Measurements of coronary inflammation could give clinicians another tool – in addition to plaque measurements and calcium scoring – to predict cardiac events.

Redefining Excellence in Molecular Imaging

United Imaging is set to disrupt molecular imaging once again at SNMMI 2024. Join the company for a product launch on June 9, or reserve your spot today for their June 9 evening event or June 10 satellite symposium.

Focus on Actionable Data for Lung Abnormalities

The volume and complexity of imaging interpretation are exploding. Find out how ClearRead CT with Clear Visual Intelligence from Riverain Technologies can help you focus on actionable data for lung abnormalities in this article.

The Wire

• Canadian Comedown on Breast Screening: As expected, the Canadian Task Force on Preventive Health Care last week declined to recommend routine breast screening for women in their 40s. But it did say that these women should be allowed to undergo screening if they choose it, while for women 50-74 it suggested screening every 2-3 years. The recommendations are more conservative than the recently updated USPSTF guidelines, and ultimately may not carry that much weight as most Canadian provinces are moving to 40 as mammography’s starting age. 

• CT Lung Screening at ASCO 2024: The ASCO 2024 meeting is underway this week in Chicago, and while most of the sessions have focused on clinical oncology, several addressed CT lung cancer screening. A VA medical center achieved 93% acceptance rate for those eligible to be screened by using a dedicated coordinator for follow up; meanwhile, a community practice in New York saw a 25% compliance rate after starting its screening program at outpatient centers located within communities with high smoking rates. 

• Mammography at ASCO: Mammography screening has also been covered in ASCO presentations. Among the talks was a meta-analysis by Brazilian researchers that confirmed the effectiveness of mammography screening in women 40-49; a study showing the value of Lunit’s Insight MMG AI algorithm for detecting contralateral breast cancer; research showing that eliminating an asset test for people applying for SNAP benefits led to higher mammography completion rates; and a study that linked social determinants of health like lower income and lack of a high school diploma with lower mammography rates. 

• DBT Doubles Reading Times: A study in European Journal of Radiology found interpretation times for DBT mammograms were double those of conventional FFDM mammography. In a study of 2.2k cases, average DBT reading times were longer than FFDM (2.09 vs. 0.98 minutes), and DBT with synthetic 2D images took longer than DBT+FFDM (2.24 vs. 2.04 minutes). But DBT times dropped with less than nine months’ experience. The findings are significant as European sites look to adopt DBT to replace conventional FFDM technology, as has been done in the US.

• VUZE Clearance for Spine Software: Israeli medical device company VUZE Medical said the FDA has cleared the second generation of its VUZE System for X-ray-guided spinal interventions. VUZE overlays graphical representations of surgical tools on intra-operative 2D X-ray images, and the initial version was cleared in 2022. The new version supports a broader range of surgical C-arms and more sources of 3D image data, including standard pre-operative CT and in-OR CT and CBCT scans. 

• Racism and CT Lung Screening: A new study in JAMA Network Open found that some minorities avoid CT lung cancer screening due to fears of racism in the healthcare system. In qualitative interviews from December 2021 to June 2022 with 34 screening-eligible people (47% of whom were Black), several participants said mistrust of medical care in the Black community – driven by knowledge of past healthcare atrocities – influenced decisions to avoid medical care. Cost was also an issue. Recent studies have shown lung screening can reduce healthcare disparities. 

• Kailo Lands Australian Install: Radiology reporting software company Kailo Medical has landed an installation with Eastern Health in Australia. Kailo will provide its SonoReview reporting software to the health system, which serves over 60 locations and delivers more than 1.3M episodes of care. SonoReview has been shown to cut reporting time by up to 50% in a recent clinical study through synoptic reporting, defined as AI-enabled reporting and LI-RADS categorization.  

• Study Supports Dynamic Radiography: A new research study in Chest Pulmonary supports Konica Minolta Healthcare’s dynamic digital radiography (DDR) technology for analyzing lung function. Mount Sinai researchers developed a machine learning algorithm to analyze and quantify lung function in DDR images, finding that in 55 patients the DDR measurements correlated well with pulmonary function tests for metrics like total lung capacity and forced expiratory volume in one second. DDR could be a good alternative where conventional tests aren’t available. 

• Dark-Field X-Ray’s Promise: Another intriguing X-ray technology under development is dark-field radiography, in which images are created from scattered X-ray photons rather than photons attenuated by the body, as with conventional radiography. In a proof-of-concept animal study in Radiology, German researchers found that dark-field radiography when added to conventional X-ray led to higher AUC for detecting nondisplaced fractures in four porcine loin ribs (1.0 vs. 0.87). More studies are needed to investigate the technique for human imaging, especially on commercially available radiography systems.

• deepc Partners with Radiobotics: AI platform company deepc has added musculoskeletal AI algorithms from Radiobotics to its offerings, integrating RBfracture for fracture detection on X-rays and RBknee for knee osteoarthritis grading into its deepcOS platform. The collaboration builds on deepc’s recent partnership with ImagineSoftware for medical billing and revenue cycle management applications.

• Active Prostate Cancer Surveillance: How to manage prostate cancer while avoiding overtreatment is a tricky task. In a paper in JAMA, researchers found that an active surveillance strategy that included clinical exams, PSA testing, and multiparametric MRI worked well in 2.2k men with favorable-risk prostate cancer who were followed for a median of 7.2 years. Based on 10-year incidence rates, 49% of men were free of cancer progression or treatment, only 1.4% experienced metastatic disease, and 0.1% died from prostate cancer. 

• Calantic Adds Scanslated: AI platform firm Calantic Digital Solutions by Bayer has added Scanslated to its library of available AI algorithms. Scanslated offers natural language processing software designed to produce radiology reports that are more patient-friendly than traditional reports; a 2023 JACR study found high levels of patient satisfaction with the reports. 

• Telix NDA for Prostate Radiotracer: Australian radiopharmaceutical developer Telix Pharmaceuticals has filed an NDA with the FDA for TLX007-CDx, a new PSMA-PET imaging agent for prostate cancer. Telix believes that TLX007-CDx has advantages over gallium-68-based PET radiotracers for prostate cancer, such as more flexible production, that will enable PSMA-PET to be used in more patients. Telix already markets a gallium-68-based radiotracer, Illuccix. 

• AdvaMed Touts Imaging Division’s Progress: Medical trade group AdvaMed is highlighting the progress its new medical imaging division has made since its formation in late 2023. The company said its staff and vendor members have been active educating and lobbying regulators about AI in healthcare, particularly on reimbursement issues, while also working in state capitols to eliminate patient cost-sharing for supplemental lung and breast imaging screening exams. The division was formed by companies that had been members of the Medical Imaging & Technology Alliance (MITA).

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 Robert Lauritzen of Cerebriu on June 7 – reserve your seat today.

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.

Meet DeepHealth This Month

DeepHealth is coming to a conference near you! From SIRM in Milan to SIIM in Maryland, schedule a meeting to learn more about their innovative AI-powered health informatics portfolio and explore how they can tailor their offerings to meet your healthcare needs.

The Resource Wire

• Clarity, Speed, and Confidence for MRI Efficiency: Radiologists have used a variety of methods to improve efficiency, but many of these methods come with drawbacks. Find out in this article how SpinTech MRI takes on the challenge of MRI efficiency with its STAGE software.

• Unlock the Power of Networked Radiology: Learn about the importance of networked radiology in modern healthcare systems in this webinar at 1 pm ET on June 11, hosted by SIIM and AGFA HealthCare. Reserve your spot today. 

• 4 Reasons Why Subscription Is Better: The KLAS-leading Intuition advanced visualization solution from TeraRecon includes all the clinical features you need, plus a growing list of exclusive subscription-only content. Learn more about what’s included. 

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

• Reimagine What’s Next with Intelerad: Every journey in healthcare is about seeking and providing answers. Intelerad is sharing a refined brand identity that encapsulates its commitment to simplifying the search for answers for both clinicians and patients. Learn more about what’s next today.

• Ignite Your Imaging AI Strategy: Take your imaging AI strategy to the next level at SIIM 2024 by attending June 28 sessions on AI adoption and deployment from Calantic by Bayer, including planning an AI orchestration platform and the benefits of integrating AI in radiology departments. Reserve your spot today.

• 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 study in European Journal of Heart Failure. 

• BoneView vs. ChatGPT for Wrist Fractures: See how Gleamer’s BoneView AI solution demonstrated expert-level performance for detecting distal radius fractures on wrist radiographs in a new clinical study, significantly outperforming ChatGPT 4 in sensitivity. 

• Experience the Platform for the Future: Register now for a priority demo at SIIM 2024 of Visage 7, Visage Imaging’s trailblazing platform for the future of enterprise imaging, based on industry standards and multi-cloud support. 

• Best in KLAS for Image Exchange: With over 15k connected facilities and a dedicated outreach team building new connections every day, it’s no wonder Nuance PowerShare Image Sharing was named #1 Best in KLAS 2024 for image exchange. Learn more about this award-winning solution. 

• Missed Appointments and No-Show Costs Can Add Up: Every missed appointment can cost providers an average of $200. PocketHealth’s new Appointment Reminders service can decrease no-show rates by up to 30%. Find out how in this article.

• Make Health Smarter with Merge: Address your imaging needs today and face the future with confidence with Merge by Merative. Learn more about enabling better outcomes for your physicians and patients with Merge Imaging Suite.

• 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. 

• AI and Matters of the Heart: As clinicians face increasing pressure from all sides, can AI provide some much-needed breathing space? In this article from Blackford, learn more about how AI is assisting with cardiac imaging with modalities ranging from CT to echocardiography. 

• The Latest Molecular Imaging Innovations: Visit Siemens Healthineers at SNMMI 2024 to learn about the latest innovations in molecular imaging, from new advances in precision PET/CT to integrating theranostics for personalized prostate cancer treatments.