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Two-for-One CT Screening | AI Health Registry
August 15, 2024
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Together with
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“Put simply, one cannot adequately manage what one does not know they have in use.”
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Pencina M et al, proposing the creation of a federated health AI registry.
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A new study takes CT screening on the road in rural Appalachia, showing how a mobile van outfitted with a CT scanner can screen at-risk individuals for both lung cancer and cardiovascular disease in one visit.
Recent studies have demonstrated the effectiveness of CT lung cancer screening not only among the overall population, but particularly among disadvantaged communities with lower healthcare access.
- Such limited access is common in rural areas of Appalachia, which also have some of the highest rates of smoking and cardiovascular disease in the U.S.
Researchers from West Virginia University wanted to tackle two challenges at once with LUCAS, a mobile van outfitted with a CT scanner for lung cancer screening.
- They noted that CT lung scans can also be used to acquire data on coronary artery calcium (CAC), a known risk factor for cardiovascular disease.
LUCAS was launched in September 2021, so WVU researchers analyzed data acquired for 526 low-dose CT screenings of high-risk people conducted through December 2022.
- They used the CT lung scans to calculate CAC scores based on Agatson criteria, in which a score of 101-400 indicates moderate risk of cardiovascular disease and >400 is classified as high risk; individuals with scores ≥100 should be referred to aspirin or statin therapy.
They found that LUCAS scans revealed …
- Over 54% of patients had coronary calcification on LDCT scans
- 31% of patients had CAC scores ≥100
- 14% had CAC scores ≥400
- Elevated CAC scores correlated with lung cancer risk based on Lung-RADS scores as well as smoking history based on pack-years
- Of the patients with CAC scores ≥1 and who weren’t already on statin or aspirin therapy, 6.2% started statins and 3.3% started aspirin
Despite the firm link between CAC scores and lung cancer risk, the researchers expressed disappointment that so few patients started prevention therapy like statins or aspirin after their exams.
- Indeed, researchers noted that few patients from the study got additional cardiac testing or follow-up referrals for cardiovascular prevention after their screenings.
The Takeaway
The new study not only confirms recent research showing that opportunistic screening can enhance the value of CT lung cancer scans, but also the role that lung exams can play in reducing healthcare disparities. On the down side, it shows that all the screening in the world won’t make a difference if patients don’t get appropriate follow-up.
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Are You Getting the Most Out of Your Image Exchange Solution?
Ask yourself these 5 questions on this page from PocketHealth to find out whether your enterprise image exchange solution is maximizing patient satisfaction and efficiency and driving revenue.
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Unlocking Value in Healthcare
How can the Value Realization Pyramid help you unlock value from your technological investments? The pyramid outlines how high-quality data from advanced technologies like AI can drive enterprise-wide workflows and better decisions. Learn more on this page from Enlitic.
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- Do We Need a Health AI Registry? A new editorial in JAMA makes an interesting proposition: an interconnected registry of all AI applications “in development, deployed, or retired from use” at healthcare facilities. Using the ClinicalTrials.gov registry as a model, the authors suggest each health system would have its own AI registry with categories that track national standards; health AI developers would have to provide key characteristics for their products, including the results of independent testing. Local registries would be connected at a national level.
- CT Finds Lung Nodules in Non-Smokers: Dutch researchers using CT discovered a disturbingly high rate of clinically relevant lung nodules in low-risk people in a study in Radiology. They scanned 10.4k never or former smokers, finding clinically relevant nodules in 14% of men and 8.9% of women, and actionable nodules in 2.4% of men and 2.1% of women. Due to their smoking histories (or lack of same), 94% would not have been eligible for CT lung screening, raising questions about the suitability of screening criteria.
- Living with Lower Contrast Dose: There may have been a silver lining to 2022’s shortage of iohexol (GE HealthCare’s Omnipaque) CT contrast media. In a study in JACR, researchers described how hospitals during the shortage implemented dose-reduction protocols that lowered mean contrast dose per CT exam by 13% (89 vs. 78 mL); the interesting thing is that dose remained 10% lower post-shortage at 80 mL per exam. Researchers credited standardized weight-based contrast protocols for the reduction, but some hospitals reverted to previous use patterns after the shortage resolved.
- Photon-Counting CT Reduces Contrast: Another way to reduce CT contrast dose was suggested by a paper in European Journal of Radiology, where researchers found photon-counting CT can lower dose in abdominal scans. In 193 patients, total iodine load was 20% lower for photon-counting CT with Siemens Healthineers’ Naeotom Alpha scanner compared to conventional CT. Photon-counting CT also had 8.7% higher signal-to-noise ratio (9.9 vs. 9.1) and 19% higher contrast-to-noise ratio (5.1 vs. 4.3). Image quality was rated as moderate or good in all cases.
- Qure Nabs Siemens Startup Award: Qure.ai received the coveted Startup Award from Siemens Healthineers. The award recognizes startups that have developed “unique and effective solutions to healthcare challenges,” and have the potential to make a significant impact on healthcare. Qure received the award for its AI-based solutions for stroke, tuberculosis, and musculoskeletal conditions. Qure’s algorithms are being used in diverse environments ranging from analyzing head CT scans in the UK to detecting tuberculosis in the Philippines.
- Cardiac Ultrasound Scanner Cleared: In other Siemens Healthineers news, the company received FDA clearance for Acuson Origin, a cardiovascular ultrasound scanner with AI-powered features. The system is targeted at a range of cardiac applications, including pediatric, structural heart, vascular, and EP exams, and includes the company’s 2D and 4D HeartAI tools. Other echo AI features assist with tasks like automated measurements in both TTE and TEE scans. Also available on Origin is the new AcuNav Lumos 4D ICE intracardiac echo catheter for complex heart procedures.
- Leveraging Mammography for Screening: Mammography screening is a public health success – what if it were leveraged to boost other screening tests? In a study from Denmark in PLOS Medicine of 27.1k women attending mammography screening, researchers offered self-testing kits like stool and vaginal HPV sampling tests. They found that overall screening rates went up for both colorectal (88% vs. 84%) and cervical cancer (80% vs. 76%). Rates went up even more for women overdue for screening tests for colorectal (24% vs. 9%) and cervical cancer (32% vs. 6%).
- CEM for High-Risk Women: MRI is used to screen high-risk women for breast cancer, but it’s expensive and time-consuming. Contrast-enhanced mammography could be an alternative that’s more widely available. In a study in Journal of Clinical Oncology, researchers tested CEM in 460 high-risk women, finding a cancer detection rate of 24 cancers per 1k women, close to breast MRI, with sensitivity of 0.92 and specificity of 0.88. In the first year of follow-up, only one interval cancer was detected on breast MRI after a negative CEM.
- Lunit Lands Singapore Hospital: AI company Lunit will be installing its Lunit Insight CXR AI solution for chest X-ray at National Healthcare Group in Singapore. Insight CXR will be used to detect and prioritize chest X-rays that have clinically significant abnormalities, with the goal of streamlining triage and improving patient care. The partnership will begin with a pilot project at NHG’s Geylang Polyclinic in October.
- Cardiac MRI Predicts Heart Failure: U.K. researchers used a specialized cardiac MRI technique to predict who in a study of 39k people would develop heart failure. In a study in European Society of Cardiology Heart Failure, researchers used CMR to estimate pulmonary capillary wedge pressure, finding that PCWP was associated with a nearly 3X higher risk of heart failure and almost 50% higher risk of MACE (HR=2.91 and 1.48). The findings echo another recent study on the value of CWP for predicting heart failure.
- Synthesis Gets FDA Nod for Viewer: Enterprise imaging startup Synthesis Health received FDA clearance for its Synthesis Vision diagnostic viewer. The application is a cloud-based zero-footprint viewer that can pre-cache entire exam worklists for faster image loading speed. The viewer joins other Synthesis offerings including a unified worklist, reporting, speech recognition, and cloud-based archiving. Synthesis emerged from stealth mode earlier this year and was founded by PACS pioneer Murray Reicher, MD.
- SandboxAQ & Mayo’s MCG Alliance: SandboxAQ and Mayo Clinic launched a research collaboration evaluating SandboxAQ’s AI-powered CardiAQ magnetocardiography (MCG) cardiac diagnostic system. The study will initially explore the relationship between MCG and angiography findings, potentially expanding from there. CardiAQ is a mobile and radiation-free cardiac imaging device, leveraging advanced sensors and AI to support the visualization and assessment of the heart’s magnetic signals. SandboxAQ hopes to establish CardiAQ as a right-sized option between ECG or biomarkers and CTs or angiography.
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The Clinical Value of Soft-Tissue Chest X-Ray
Soft-tissue techniques can improve the visibility and accuracy of chest X-ray. Learn about two important soft-tissue methods – bone suppression and dual-energy subtraction – in this white paper from Riverain Technologies.
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In Their Own Words
What are radiology professionals saying about the Visage 7 enterprise imaging platform? Visage Imaging has curated a select group of video interviews with Visage 7 users so you can hear what they think in their own words.
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- 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.
- How Duly Health and Care Streamlined Cardiology Reporting: Duly Health and Care wanted to streamline their cardiology reporting and make it easier for clinicians to access studies. Learn how they turned to Merge Cardio from Merge by Merative to create a more structured and consistent approach to reporting.
- Transforming Cardiovascular Ultrasound Analysis: Learn how cardiovascular ultrasound is on the verge of transformation with the latest version of Us2.ai’s new echo AI analysis software, featuring 45 automated echo parameters for streaming clinical workflow.
- An End-to-End AV and AI Solution: Never buy separate AV and AI solutions again. Get in touch with TeraRecon to find out how your health system can benefit from all the Intuition clinical features you need, plus a growing list of exclusive subscription-only content that leverages the power of AI.
- Smart Bytes on Cardiology Workflows: Check out Smart Bytes, a new series of webcasts giving you bite-sized insights for smarter imaging from AGFA HealthCare. At 12:30 ET on August 15 learn about improved cardiology workflows using cutting-edge AI technology.
- 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.
- 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.
- Making Advanced Cardiac CT Accessible Everywhere: How do you bring cardiac CT to high-risk patients in rural areas? Watch this video from Siemens Healthineers to learn insights into setting up a cardiovascular CT program in a rural area – and how to overcome associated challenges.
- 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.
- Preparing for the Future of Enterprise Imaging: Check out this white paper from Optum to learn what you need to know when moving your enterprise imaging to the cloud. Learn how to assess the various approaches and develop a strategy that works for you.
- Break Down Boundaries in Healthcare: Break down boundaries in healthcare with Intelerad’s InteleShare image sharing solution. InteleShare brings you enhanced access that bridges the gap between care teams and patients to ensure that distance is no barrier to quality care.
- Improving Cancer Screening by Empowering Radiologists: Learn how the use of AI-based tools for cancer screening holds immense promise for addressing the lack of trained radiologists in this downloadable eBook from Bayer.
- Building a Brand in Radiology: Check out the next episode of Medality’s Radiology Report Podcast featuring Toronto Radiology’s Anish Kirpalani, MD, who talks to host Daniel Arnold about challenges and strategies in radiology, such as proactive recruitment and the importance of building a strong brand.
- 2 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.
- AI and Cancer Screening: Cancer screening saves lives, but right now screening is limited to a few cancer types. That could change with AI, which opens new possibilities for earlier disease detection. Learn more in this article by DeepHealth clinical AI leader Greg Sorensen, MD.
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