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When Follow-Up Falls Short | Pediatric CT Use
August 26, 2024
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Together with
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“I think it’s great the new generation doesn’t want to take care of the ever increasing old and sick people given how physicians have been turned to poop over the [l]ast few decades. They can triple the reimbursement to doctors if they want to get appropriate care. Otherwise have fun with your messed up mid-level taking over.”
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aRadUser, in a thread on RadHQ.net on work habits of younger radiologists.
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Making sure suspicious imaging findings are followed up appropriately is a key element in providing quality patient care. But a new study found that some suspicious findings aren’t being adequately tracked, especially when it comes to lung nodules.
Lung nodules are commonly detected on chest CT exams, and are often found incidentally, when patients are being examined for other reasons.
- While most smaller nodules don’t represent a threat to patients, it’s important to work up the ones that could be clinically significant.
In the new paper, Japanese researchers studied 10.5k initial chest CT reports at their institution from 2020 to 2023.
- They developed a natural language processing algorithm that analyzed free-text reports to see which ones recommended follow-up.
They determined that 1.5k reports (14%) recommended additional imaging with exams like chest CT or PET/CT; they then calculated whether these follow-up exams were conducted within 400 days of the initial exam. Further analysis indicated …
- For 36% of exams (543) researchers could not confirm that follow-up imaging had taken place.
- In a random sample of 42 of these patients, 40.5% (17) were not followed up appropriately.
- For these cases, either no imaging was documented or no reason was given for the lack of follow-up.
The researchers clarified that they found no evidence of false negatives (missed cancers), as that wasn’t a goal of their study.
The Takeaway
The new findings indicate both the challenge and opportunity of follow-up management. While radiology must do better in tracking patients with suspicious findings, the study shows that software-based solutions could help, especially those that are automated to scan radiology reports and alert radiologists to cases that need their attention.
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Cloud-Based Disaster Recovery
When disaster strikes, have peace of mind knowing your imaging data is safe. Securely store backups with Intelerad’s InteleArchive solution, ensuring your imaging data is there when you need it. Get started by booking a demo today.
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What Does Improved MRI Efficiency Mean?
There’s a growing need for practical, cost-effective solutions to improve efficiency in MRI and other modalities. Read this article from Karen Holzberger of SpinTech MRI and James Backstrom, MD, to learn how the company’s STAGE software can help.
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- Pediatric CT for Appendicitis: U.S. hospitals aren’t reducing CT use for assessing appendicitis in children, even though other imaging tools that don’t use radiation are available. In a paper in Journal of Pediatric Surgery, researchers analyzed 115k pediatric exams from 2015 to 2021, finding that CT use remained unchanged at 43% despite recommendations to use ultrasound or MRI instead. Fortunately, ultrasound use grew (from 69% to 72%) but MRI less so (1.7% to 2.9%). Ultrasound should be better promoted as a diagnostic strategy for appendicitis.
- Rad to Settle Kickback Charges for $8.8M: An interventional radiologist in Texas has agreed to pay the U.S. government $8.8M to settle charges he paid physicians kickbacks for patient referrals. Andrew Gomes, MD, and his firm National Interventional Radiology Partners (NIRP) were charged with paying kickbacks for referrals to treat peripheral arterial disease (PAD). Gomes started NIRP in 2015 and raised money from physician investors who could provide a referral base; NIRP allegedly funneled profits back to doctors as dividends.
- Gen AI Simplifies Patient Materials: Radiology is looking for ways to help patients better understand their radiology exams – how about trying generative AI? In a paper in Clinical Radiology, researchers used ChatGPT-4 and Google Gemini to simplify patient education materials, finding that the algorithms lowered the average reading level required to understand the materials from the 11.7th grade to 6.6 for Gemini and 7.3 for ChatGPT-4. Gemini also was more effective in reducing word count while retaining information (-33% vs -15%).
- Maui Emerges from Stealth: Maui Imaging emerged from stealth mode with a new type of ultrasound technology the San Jose, California company believes will produce images that look like a cross between ultrasound and CT. The company received FDA clearance in October 2023 for its K3900 scanner, which uses receive-side ultrasound beamforming and proprietary algorithms to create images. Maui received a $4M grant from the U.S. Department of Defense to develop the technology for trauma medicine, but it also has applications for fetal, abdominal, pediatric, small organ, and other uses.
- Sticky Contrast Agents: It may sound wacky, but which contrast agents are the stickiest? Residue from iodinated contrast media can stick to gloves, guide wires, and catheters, complicating interventional radiology procedures. In a paper in European Journal of Radiology, researchers applied seven different contrast agents to surgical gloves and used computer control to pull them apart. The stickiest agents were Omnipaque 300 (GE HealthCare), Ultravist 300 (Bayer), and Xenetix 300 (Guerbet), while the least sticky were Hexabrix 320 (Guerbet) and Visipaque 270 and Visipaque 320 (GE).
- POCUS Software Cleared: Israeli AI startup AISAP received FDA clearance for its Cardio software for analyzing point-of-care ultrasound scans. Cardio is designed to help clinicians who only have basic scanning skills diagnose up to 90% of the most common cardiac structural and functional parameters at bedside. The cloud-based platform combines four modules for valvular pathologies and eight cardiac measurements and can generate analyses, interpretations, and reports. AISAP earlier this year raised $13M in seed funding.
- Honing Cardiac CT Protocols: Radiologists are lucky to have a variety of CT-based cardiac imaging tools at their disposal, but what works best for ruling out coronary artery disease? In a study in Radiology, researchers preferred a sequential approach in which CCTA and CT-FFR were used for initial evaluation and CT perfusion reserved for hemodynamically relevant stenosis. In 105 patients, the approach had higher specificity than CCTA and CT-FFR alone (88% vs. 77%), while sensitivity was comparable (88% vs. 90%, p > 0.99).
- RamSoft’s Mobile Mammo Expansion: RIS/PACS company RamSoft is extending its reach in mobile mammography through a relationship with Mammolink, which provides mobile mammography services in Florida. Mammolink has begun operation of its fifth mobile mammography van powered by RamSoft’s cloud-based PACS software, with the company’s PACS and Gateway routers enabling transfer of large imaging datasets from vans to centralized reading locations. RamSoft also provides radiologist viewing and analysis tools and a communication portal for patients.
- CT Matches Images to Dental X-Rays: Now this is wild – a paper in European Radiology used computer vision software to match single head CT slices to dental X-rays. The open-source AKAZE algorithm was used to analyze head CT scans of 722 people and match them to a database of orthopantomograms using landmarks like the maxillary sinuses. The technique could be used to identify unknown patients in mass casualty events like natural disasters and terrorist attacks.
- Qure Clearance for Chest CT AI: Qure.ai received FDA clearance for qCT LN Quant, a new AI solution that provides advanced analysis of suspicious lung nodules on CT scans. The application performs quantitative characterization of solid lung nodules by measuring features like average, short-axis, long-axis, and effective diameters, helping radiologists track nodule changes over time that can be signs of malignancy. qCT LN Quant can be used with other Qure applications like qXR LN for chest X-ray analysis and qTrack for lung nodule management.
- CARPL Adds Thoracic AI to Platform: CARPL.ai has added cardiac and thoracic AI algorithms from United Imaging Intelligence to its platform. UII’s solutions in its uAI Discover family include applications for coronary CT angiography, CT of pulmonary nodules, and CT of bony thoracic fractures.
- Tech Exec’s Firm Raises $54M: A startup company called Openwater founded by tech executive Mary Lou Jepsen has raised $54M (total funding: $100M) to advance its technology for using infrared imaging and ultrasound to diagnose and treat disease. Jepsen served stints at Google and Facebook before founding Openwater in 2016; the company’s low-intensity focused ultrasound (LIFU) technology could be used in low-cost devices worn by patients to deliver LIFU waves to targets such as cancer cells. Openwater’s technology is still pre-FDA, but has been used in animal studies.
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MRI of the Pelvis and Lower Extremities
Join Donald Resnick, MD, and guest faculty in this Virtual Conference series on MRI of the pelvis and lower extremities, hosted by Medality from September 30-October 4. Register your team and save on your group enrollment.
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Discover AI Apps Curated by Body Regions
Discover how Calantic Digital Solutions by Bayer supports you in tackling radiology challenges through multiple stages of the patient’s journey by offering AI solutions curated for specific body regions. Learn more about Calantic today.
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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.
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- 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.
- Fully Automated AI for Mitral Regurgitation Grading: Echo AI can help address challenges with mitral regurgitation assessment quality and efficiency. Find out how researchers used Us2.ai’s fully automated echo workflow for grading MR severity and predicting one-year mortality.
- The UK’s Lung Cancer Screening Rollout: The UK has launched a targeted lung cancer screening program to improve lung cancer outcomes through earlier detection. Learn how DeepHealth’s Saige Lung is the preferred AI solution in this case study.
- 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.
- Seamless, Connected Healthcare: Clearpath is committed to facilitating seamless, continued healthcare by optimizing automation and workflows between patients and providers. Learn how the company’s solutions contribute to a healthcare environment where every step of the patient journey is connected and efficient.
- Presenting Unboxing AI: Check out CARPL’s video series, Unboxing AI, featuring experts discussing AI and its future in radiology. The next episode on August 30 features Avi Sharma, MD, of Einstein Healthcare Network – reserve your seat 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.
- Visage’s Top 5 Topics from SIIM 2024: What were the hot topics from SIIM 2024? Check out this article from Visage Imaging that breaks down the biggest trends in National Harbor, MD, from the growth of cloudPACS to spatial computing.
- Top 5 Benefits of Standardizing Medical Imaging Archives: 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.
- Top-Tier Care at Rural Hospitals: Holzer Health System in Jackson, OH, treats local patients like family. In this video, learn how United Imaging equipped Holzer Health with its uMR 570 MRI scanner, helping them to offer top-tier care.
- Turning Medical Imaging into Great Medicine: TeraRecon is continually innovating to bring the latest in advanced visualization capabilities to radiology. Intuition 4.7 includes a variety of new features, from structural heart workflow to the ability to trigger AI on demand. Learn more about them on this page.
- Monitoring AI Solutions in Healthcare: Clinical applications for healthcare AI are rapidly expanding, but many barriers are still preventing widespread adoption. This Nuance post explores a critical set of questions: what happens after an AI model goes into production, and how to know if it continues to perform as expected?
- Simplifying Patient Access to Imaging: A major U.S. healthcare provider faced challenges in simplifying imaging workflows while ensuring cost-effectiveness. Discover how PocketHealth improved patient access and drove annual cost savings of $130,000.
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