Edwards D et al, on a new study on CT lung cancer screening.

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CT Scanners

More Backing for CT Lung Screening

Yet another study is showing support for CT lung cancer screening. In a real-world study in Cancer, researchers tracked screening’s impact on military veterans, finding that it contributed to more early-stage diagnoses as well as lower all-cause mortality. 

It’s no secret that uptake of CT lung screening has been disappointing since the USPSTF in 2013 endorsed the test for high-risk people – mostly those with smoking histories. 

• Uptake rates have been estimated to be under 10% by some studies, although recent research has shown that targeted interventions can improve that figure.

In the new study, researchers described results from the Veterans Health Administration’s effort to provide low-dose CT lung cancer screening to veterans from 2011 to 2018.

• The researchers noted that smoking rates are higher among veterans, resulting in lung cancer incidence rates that are 76% higher than the general population. 

Researchers tracked outcomes retrospectively for 2.2k veterans who got screening before a lung cancer diagnosis and compared them to those with lung cancer who weren’t screened, finding that screening led to…

• Higher rates of stage I diagnosis (52% vs. 27%)
• Lower rates of stage IV diagnosis (11% vs. 32%)
• Lower rates of cancer mortality (41% vs. 70%)
• Lower rates of all-cause mortality (50% vs. 72%)

The sharp reduction in all-cause mortality is particularly striking. 

• As we’ve discussed in the past, most population-based cancer screening tests have been shown to reduce cancer-specific deaths, but it’s been harder to show a decline in deaths from all causes. 

The study also illustrates the advantage of providing lung screening within a large, integrated healthcare system, where it’s easier to track at-risk individuals and direct them to screening if necessary.

The Takeaway

Of all the positive studies published so far this year on CT lung cancer screening, this one is the most exciting. The findings show that even in an environment of low lung screening uptake, dramatic benefits can be realized with the right approach.

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The Wire

• News from SNMMI: SNMMI 2024 is underway this week in Toronto, and researchers are presenting papers on the state of the art in nuclear medicine and molecular imaging. In weekend oncology presentations, researchers found that PET/CT with gallium-68 DOTATATE was better than MRI for head and neck paragangliomas; PET/CT with a FAPI radiotracer was better than FDG for predicting progressive pulmonary fibrosis in interstitial lung disease; and radioligand therapy that targeted fibroblast activation protein (FAP) was effective for treating advanced sarcomas. 

• PET Shows Impact of Hearing Aids: In a fascinating neurology study from SNMMI 2024, researchers used FDG-PET to show how hearing aids can slow metabolic decline in adults with mild cognitive impairment (MCI). They tracked people with amnestic MCI and compared those with hearing loss who got hearing aids to those who didn’t. FDG-PET showed the hearing loss group had metabolic decline in six frontal cortical brain regions, while the control group didn’t see any decline in frontal regions. The results show hearing aids can mitigate decline in those with MCI. 

• Milestones in Ac-225 Production: The alpha-emitting radioisotope actinium-225 (Ac-225) is gaining attention as a therapy for difficult-to-treat cancers, and companies reported production milestones on the eve of SNMMI 2024. Ionetix said that it produced the first batch of Ac-225 in its cyclotron in Lansing, Michigan, where it also plans to produce astatine-211 and lead-212. Meanwhile, BWXT Medical is submitting a drug master file to the FDA for no carrier added Ac-225, which results in a more pure form of the radioisotope. 

• FDA Clears New Siemens PET/CT:  With the SNMMI exhibition hall opening this weekend, Siemens Healthineers announced the FDA clearance of Biograph Trinion, a new high-performance PET/CT scanner. The platform includes a new scalable air-cooled LSO digital detector with high spatial resolution and time-of-flight performance of 239 picoseconds, giving it effective sensitivity up to 128 cps/kBq. Siemens migrated CT technology from its Somatom.go platform to give Trinion 128-slice CT scanning, and in a nod to environmental concerns the company designed the system to cut energy use 46%.

• GE’s SNMMI Product Launches: GE HealthCare also got into the pre-SNMMI act, announcing two new products on the eve of the show. MINItrace Magni is a new cyclotron that’s optimized for in-house production of radiotracers like gallium-68 and that can be paired with the company’s TRACERcenter radiopharmacy. The second product, Omni Legend 21 cm, is a performance-level PET/CT scanner with 21cm digital detectors with higher sensitivity; when combined with deep learning reconstruction it can reduce dose by 40% while maintaining image quality.  

• United Closes in on Milestone Shipment: United Imaging is closing in on a milestone scanner shipment, preparing to install its 30,000th scanner worldwide. The milestone system is a uMI Panorama GS PET/CT scanner that will be installed at a US facility this summer. The scanner is the flagship of United Imaging’s uMI Panorama family and sports a 148cm axial field of view; it is suitable for both clinical and research applications. At SNMMI, the company is also featuring uNeuroEXPLORER, a dedicated brain PET/CT scanner.

• Telix Files for $200M IPO: Hot off recent regulatory filings for its radiopharmaceuticals, Telix Pharmaceuticals plans to raise $200M in an IPO. Telix last week filed SEC paperwork to list 17M shares on the Nasdaq exchange; the company’s stock is already publicly traded in Australia. Proceeds from the offering will be used to advance Telix’s therapeutic radiopharmaceuticals, as well as expand the labeling for its Illuccix prostate radiotracer and support the launches of its Zircaix PET agent for renal cell carcinoma and Pixlclara PET tracer for glioma.  

• Lung Screening and EHRs: In more CT lung cancer screening news from last week, researchers writing in JAMA Network Open were able to boost screening rates through EHR reminders sent to providers and patients. In 1.9k people eligible for screening, researchers said they were able to close gaps in screening compliance – defined as completion of either screening, a shared decision-making session, or opportunistic screening from chest CT scans – from a rate of 16% at baseline to 47% after two interventions. 

• Philips Launches Echo AI Platform: Philips revealed a major investment in AI for echocardiography last week with the launch of its new echo AI platform. The new platform features new FDA-cleared as well as existing echo AI solutions that have deeper integration into the company’s Epiq CVx and Affiniti CVx echo scanners, for clinical applications such as segmented wall motion, 3D mitral regurgitation volume quantification, and automated LVEF measurements. Get a complete rundown on the launch from our Cardiac Wire sister site. 

• Lung Ultrasound of Preemies: Another research study points to the value of lung ultrasound in predicting respiratory problems in premature infants. In a research letter in JAMA Network Open, an Italian group presented results in 51 preemies who got ultrasound scans at various time points for two weeks after birth; those who ultimately needed medication or hospitalization had higher median lung ultrasound scores at days 3, 7, and 14. The results are similar to a recent finding that POCUS can predict the need for surfactant therapy in preemies. 

• fMRI Scans Predict Dementia: In a new paper in Nature Mental Health, UK researchers describe how they used functional MRI to predict dementia up to nine years before a diagnosis. They used fMRI to analyze changes in the brain’s default mode network (when the brain is at rest) in 1.1k volunteers in the UK Biobank study, finding that problems in network connectivity predicted future dementia incidence (AUC=0.82) and time to diagnosis (R=0.53). The findings could help guide future treatments for Alzheimer’s disease. 

• RADPAIR Signs Deal with Radiopaedia: Radiology reporting software start-up RADPAIR has signed a technology integration collaboration with Radiopaedia. The firms collaborated to develop PAIR Insights, which enables radiologists using RADPAIR to automatically insert guidelines and classifications from Radiopaedia directly into their reports. RADPAIR users can also search within Radiopaedia without leaving the reporting interface, giving them seamless access to Radiopaedia’s knowledge base within their existing workflow. RADPAIR emerged from stealth mode at RSNA 2023 and has been signing OEM relationships with PACS firms and teleradiology providers.

• Corscadden Tapped as Oxipit CEO: AI software developer Oxipit has tapped Peter Corscadden as CEO, replacing Gediminas Pekšys, who will transition to a new role as head of AI. The moves come as Oxipit expands globally and is commercializing its AI solutions, which include autonomous AI technology like its ChestLink software, which received the CE Mark in 2022 for identifying normal chest X-rays and producing reports without the need for a radiologist’s intervention.  

• Hospital Performance Gap: Kaufman Hall’s latest Flash Report revealed that hospital operating margins ticked up to 4.3% in April, breaking a three-month streak of declines. Outpatient revenue increased 10% on-year, while average length of stay dropped 4% and ED visits increased to hit pre-pandemic levels. The story beneath the surface-level margin improvements is that the performance gap continues to widen, with the best-performing hospitals now seeing 28.9% margins, versus -16.1% for the worst performers (95th vs. 5th percentile).

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The Resource Wire

• A Holistic Strategy For Enterprise AI: Finding, vetting, and deploying the right radiology AI solutions can be challenging. In this SIIM 2024 session on June 27 presented by Microsoft + Nuance, learn how industry leaders are laying the foundation for AI while solving today’s real-world workflow challenges.

• 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 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. 

• A Step-by-Step Approach to Radiology AI Adoption: Widespread adoption of radiology AI has the potential to revolutionize patient care, but the path to success requires a systematic approach. Blackford offers a step-by-step guide for healthcare providers looking to get started. 

• 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. 

• 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 radiologist Dr. Gilberto Szarf of HIAE in Brazil on June 14 – reserve your seat today. 

• Introducing Merge Consulting Services: How can your radiology practice manage change and expectations in healthcare with workforce flexibility? Merge by Merative is launching Merge Consulting Services to help you face the challenges of sourcing expertise and staff. Learn more about it today. 

• Learn How to Achieve Quadruple Aim Goals: Watch a highlight from RSNA where PocketHealth Co-Founder and CEO Rishi Nayyar shares insights on overcoming barriers to improving population health, patient experience, revenue, and staff wellness.

• BoneView vs. ChatGPT for Wrist Fractures: Learn 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. 

• The Radiology Report with Francis Deng, MD: In this episode of The Radiology Report podcast, Medality Co-Founder and CEO Daniel Arnold talks to Francis Deng, MD, about his decision to enter neuroradiology. Listen to this episode as well as other interviews with leaders in radiology. 

• Redefining Excellence in Molecular Imaging: United Imaging is set to disrupt molecular imaging once again at SNMMI 2024. Reserve your spot today for their June 10 satellite symposium on unlocking new clinical horizons with PET.

• Echo AI and Mobile Health: Powered by AI-automated software, mobile ultrasound devices are taking echo exams out of the conventional clinical setting and on the road. In this article, learn how Singapore is using Us2.ai’s echo AI software to complete the full mobile exam pathway while maintaining high clinical standards.  

• Data Standardization Gets Even Better: With the release of Enlitic’s Ensight 2.0, the radiology industry’s premier solution for data standardization has gotten even better. Find out how the new enhancements in 2.0 can help your organization transform your imaging data into actionable insights.

• Improving Patient Outcomes in Lung Cancer: Early detection is key to improving treatment pathways and patient outcomes in lung cancer. Learn more facts about lung cancer screening on this resource page from Riverain Technologies.