Herman Oosterwijk, in an overview of the top 10 trends from SIIM 2024.

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Artificial Intelligence

Top 6 Radiology Trends of 2024’s First Half

You can put the first half of 2024 in the books … and it was full of major developments for radiology. What follows are the top six trends in medical imaging – one for each month of the first half.

• The Rise of AI for Breast Screening – The first half of 2024 saw the publication of studies conducted in Norway and Denmark that underlined the potential role of AI for breast screening, particularly for ruling out exams most likely to be normal. But research conducted within Europe’s paradigm of double-reading workflow for 2D mammograms may not be so relevant in the US, and more studies are needed.

• Mammography Guideline Controversy – Changes to breast screening guidelines in both the US and Canada were first-half headlines. In the US, the USPSTF made official its proposal to lower to 40 the recommended age to start screening, but many were disappointed it failed to provide stronger guidance on dense breast screening. Things were even worse in Canada, where a federal task force declined to lower the screening age from 50 to 40. Canadian advocates have vowed to fight on at the provincial level. 

• AI Funding Pullback Continues – The ongoing pullback in venture capital funding for AI developers continues. A study by Signify Research found that not only did VC funding fall 19% in 2023, but it got off to a slow start in 2024 as well. The new environment could be putting more pressure on AI firms to demonstrate ROI to both healthcare providers and investors, while also having broader implications – a major AI conference rescheduled a show that had been on the calendar for May, citing “market conditions.” On the positive side, Tempus AI’s IPO boomed, raising $412M. 

• Is Lung Screening Ready for Prime Time? CT lung cancer screening has been the cancer screening test that just can’t seem to get going … until this year. A series of studies were published illustrating lung screening’s ability to shift diagnoses to an earlier stage while reducing mortality, and even counter healthcare disparities. Researchers also presented solutions for boosting the exam’s stubbornly low compliance rates, but downstream testing costs need to be managed. Meanwhile, Germany (see below) and Australia are moving ahead with national programs.

• Opportunistic Screening Gains Steam – The concept of opportunistic screening – detecting pathology on medical images acquired for other indications – has been around for a while. But it’s only really started to catch on with the development of AI algorithms that can process thousands of images without a radiologist’s involvement. The first half of 2024 saw publication of several exciting studies for indications including detecting osteoporosis, scoring coronary artery calcifications, and predicting major adverse cardiac events. 

• ChatGPT Frenzy Subsides – The frenzied interest in ChatGPT and other generative AI large language models seen throughout 2023 seemed to subside in the first half of 2024. A quick search of The Imaging Wire archives, for example, finds just four references to ChatGPT in the first six months of 2024 compared to 21 citations at the same point in 2023. LLM developers need to address major issues – from GenAI’s “hallucination effect” to potential misuse of the technology – before LLMs can be used in clinical settings.

The Takeaway

The midpoint of the year is a great time to take stock of radiology’s progress and the issues that have bubbled to the surface over the past six months. In 2024’s back half, look for renewed attention on breast screening as the FDA’s density reporting rules go into effect in September, and keep on the lookout for signs that real-world AI adoption is growing, even as AI developers look for consolidation opportunities.

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The Wire

• Herman O’s Top 10 SIIM List: Last week we gave you our list of the top four trends at SIIM 2024 … for another (more expansive) viewpoint, check out imaging IT and AI consultant Herman Oosterwijk’s list of top 10 topics on LinkedIn. Herman O notes a shift from online to in-person participation at SIIM, and also sees maturity in pixel-based AI for image interpretation. Other notable trends include AI workflow and non-imaging use cases like scheduling, ordering, and image acquisition, as well as non-AI topics like data anonymization and enterprise imaging.  

• CEM’s Breast Screening Edge: Contrast-enhanced mammography has advantages over conventional digital mammography when working up women with suspicious lesions on breast screening. In the RACER trial in The Lancet Regional Health – Europe, researchers compared CEM to digital mammography for 526 recalled women; while both approaches had similar sensitivity and specificity (98% and ~75%), CEM helped reach a final diagnosis in more patients (28% vs. 1.1%), and detected more malignant occult cancers (13 vs. 3). CEM is a more efficient workup pathway that reduces the need for other modalities.

• I-MED to Enter US Market: Australian imaging services giant I-MED Radiology Network is entering the US market through its acquisition of teleradiology provider StatRad. I-MED is the dominant player for radiology services in Australia and New Zealand, and the StatRad deal will give it a foothold in the lucrative US market. StatRad employs 90 US-based radiologists who read 1.8M scans annually; I-MED will certainly be looking to grow that business, possibly through additional acquisitions. I-MED also has relationships Down Under with AI firms like Annalise.ai. 

• Vapers Not Getting Screened: E-cigarettes were initially marketed as smoking cessation aids that could be safer than combustible cigarettes. So maybe that’s why vapers had lower odds of undergoing CT lung cancer screening in a new study in JAMA Network Open. Researchers checked the screening status of 22.7k people eligible for screening, finding that those currently using e-cigarettes had 33% lower odds of being up to date with screening than people who never vaped; this rose to 46% among those who switched from combustible cigarettes to e-cigarettes.

• Germany Launches CT Lung Screening: Meanwhile, add Germany to the list of countries launching national CT lung cancer screening programs. The country on July 1 began offering low-dose CT scans to current and former people who smoke; German authorities estimate that 57k new lung cancer cases are diagnosed every year, and 45k people die. Officials are still researching how much to reimburse for the scans. Germany joins Australia among countries launching national screening programs. 

• Photon-Counting CT Cuts Lung Dose: In more CT news from Europe, researchers in European Radiology described how they cut radiation dose 52% in lung perfusion studies using Siemens Healthineers’ Naeotom Alpha photon-counting CT scanner. Compared to third-generation dual-slice CT with energy-integrating detectors, photon-counting CT acquired images more quickly (0.93 vs. 3.98 seconds) with lower dose-length product (173 vs. 339 mGy·cm), although some mild motion artifacts occurred. The combo of faster scans at lower dose could enable wider use of photon-counting CT for lung perfusion.

• Bayer’s Calantic Signs Barcelona Site: Bayer has signed a deal to install its Calantic Digital Solutions AI platform at Instituts Guirado, a hospital in Barcelona. The hospital will deploy the Calantic platform to improve its tracking of lung nodules, among other clinical use cases. Bayer has added a number of AI algorithms to the platform in recent months, including solutions from Rad AI and Scanslated. 

• ASRT Launches BeRAD Awards: The ASRT has started a new awards program – the BeRAD Professionalism Award – to recognize healthcare providers where radiologic technologists and radiation therapists show a culture of professionalism. Two awards will be given in the program’s first cycle, with nominations accepted through September 30, 2024 and award winners announced in April 2025 at the ASRT Annual Governance and House of Delegates Meeting in Reno, Nevada. The program is open to health systems, imaging centers, hospitals, and other facilities. 

• PSMA-PET vs. MRI for Prostate Staging: MRI has shown its value for prostate cancer screening, but PSMA-PET/CT may be even better for working up confirmed cases. In a paper in JAMA Oncology, researchers compared PET/CT with a fluorine-18 PSMA-1007 radiotracer to MRI in 134 men for locoregional staging of prostate cancer. They found that PSMA-PET/CT was more accurate in identifying final pathological tumor stage (45% vs. 28%) and for correctly identifying the dominant nodule (94% vs. 83%). PET/CT should be used for preoperative workup.  

• Echo AI HFpEF Code: Ultromics announced that the AMA has issued a CPT III reimbursement code for echo AI-based HFpEF detection (0932T), including the startup’s EchoGo Heart Failure solution. The new code will go live in January 2025, replacing a previous HCPCS outpatient code (C9786), while joining a New Technology Add-on Payment code for hospital inpatient settings (XXE2X19). Although CPT III codes don’t have assigned RVUs, they can be reimbursed on a case-by-case basis and help collect data for more permanent reimbursement code decisions.

• Segmed Rebrands Data Platform: Imaging data aggregation firm Segmed has rebranded its Segmed Insight platform as Openda. Openda gives researchers and software developers access to medical imaging data, and includes tools to help users unlock insights from healthcare datasets. In addition to the rebrand, Segmed released new tools for Openda including new search capabilities, easier navigation through longitudinal studies and patient data, and the integration of PET/CT and PET/MRI into the platform. Segmed launched the platform in late 2022 with a $5.2M funding round.

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The Resource Wire

• Automating Abdominal CT: This Bayer Radiology case study details how its Certegra P3T Software automates contrast-enhanced abdominal CT injection protocols based on patient characteristics and contrast concentration.

• Imaging in the Cloud: The healthcare imaging market in the US is moving to the cloud. In this new report from KLAS Research, find out why companies like Merge by Merative are instilling confidence in customers thanks to their cloud approach.

• Automated MSK Measurements: BoneMetrics from Gleamer is an automated AI solution that can help diagnose scoliosis by automating Cobb angle calculations on images acquired with X-ray and EOS systems. Learn more about how it works 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.

• 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.

• Celebrating Happy Customers: There’s nothing better than happy customers. Find out what radiology personnel at Western New York MRI in Buffalo had to say about their new uMR 680 scanner from United Imaging.

• 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%.

• Which Imaging Vendors Are Ready for the Cloud? Which medical imaging vendors are perceived as ready for the cloud? In a new survey from KLAS Research, AGFA HealthCare’s approach to the cloud won high marks from customers.  Learn more about the report today

• Looking to Get Started with AI? Learn how Milton Keynes University Hospital adopted a successful AI strategy in this on-demand webinar from Blackford. You’ll discover how to evaluate and select the best AI solutions for your facility, tips for getting started with AI, and more. 

• 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. 

• Top Takeaways from SIIM: Don’t miss the top themes and insights from SIIM 2024. PocketHealth Co-Founder & CEO Rishi Nayyar shares challenges, opportunities and trends that were discussed by industry experts at SIIM. Read the article here.

• 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. 

• 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. 

• Clearly Superior Chest X-Ray Imaging: Chest X-rays can help identify many abnormalities, but interpretation is often difficult due to obstructing bone, patient positioning, and image quality. Book a demo to see how Riverain’s ClearRead Xray with Clear Visual Intelligence provides a clearly superior view of the chest.

• Artificial Intelligence for Coordinated Care: TeraRecon’s Eureka AI platform is a vendor-agnostic hosting platform that can help execute clinical and non-clinical AI algorithms to improve outcomes, reduce burnout, and streamline radiology workflow. Learn how it works on this page.