Brie Anna, in a Threads post on patient out-of-pocket costs.

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Breast Imaging

The Cost of Extra Cancer Detection

It’s well known that using additional screening modalities beyond traditional 2D mammography can detect more cancers in women with dense breast tissue. But at what cost? A new study in Clinical Breast Cancer documents both the clinical value and the economic cost of supplemental breast imaging technologies. 

2D mammography is the basis for any breast cancer screening program, but the modality’s shortcomings are well known, especially in women with dense breasts. 

• In fact, the FDA earlier this month began requiring breast imaging providers to notify women of their density status and explain how higher density is a breast cancer risk factor. 

Imaging vendors and clinicians have developed a range of technologies to supplement 2D mammography when needed, ranging from DBT to molecular breast imaging to breast MRI.

• Each has its own advantages and disadvantages, which can leave many breast imaging providers confused about the best technology to use.

To shed some light, Matthew Covington, MD, of the University of Utah compared detection rates for various supplemental imaging modalities; he then estimated costs for each if it was the only modality used for supplemental imaging with 2D mammography in a U.S. population with 469k detectable breast cancers. 

• The study assumed that 2D mammography would detect only 41% of cancers – leaving the majority undetected. 

Adding a supplemental modality boosted cancer detection rates, but also screening’s cost …

• DBT detected 47% of all cancers at a cost of $933M
• Ultrasound detected 51% at a cost of $1.84B
• MBI detected 71% at a cost of $4.16B
• Contrast-enhanced mammography detected 80% at a cost of $3.87B
• MRI detected 100% at a cost of $6.36B

As the data indicate, MRI is clearly the most effective supplemental modality, but at a cost that’s almost 7X that of DBT. 

The Takeaway

The new data are a fascinating – if sobering – look at the intersection of clinical value and economic cost. They also highlight healthcare’s inconvenient truth: The resources needed to provide the highest-quality care are finite, regardless of whether you’re in a single-payor or fee-for-service system.

Transforming Patient Care with Mach7’s eUnity Diagnostic Viewer

University of Michigan Health-West uses Mach7’s eUnity Diagnostic Viewer to drive patient care and provider satisfaction. Learn more about how one of the nation’s most-wired hospitals puts patients first through adoption of innovative imaging technology.

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.

Women’s Health and AI

With new breast density reporting requirements now the rule in the U.S., there’s a need for objective density assessment and reporting. Check out this article from Blackford Analysis on the AI solutions that can help.

The Wire

• How Cost-Sharing Hurts Screening: In a related article in JAMA Health Forum, researchers explain how requiring patients to pay for follow-up exams hurts the effectiveness of cancer screening. Previous research has shown that cost-sharing for tests like mammography discourages follow-up, and at least 12 states have passed laws eliminating cost-sharing for diagnostic breast cancer exams. At the federal level, the Find It Early Act was recently introduced in Congress and would require all health insurance plans to cover follow-up exams like MRI and ultrasound.  

• FDA Approves GE Cardiac PET Tracer: Cardiac imagers will soon have another tool in their arsenal. The FDA approved GE HealthCare’s Flyrcado (flurpiridaz F-18) radiopharmaceutical for PET myocardial perfusion imaging for patients with known or suspected coronary artery disease. GE is highlighting the tracer’s long half life of 109 minutes (10X existing cardiac PET tracers) and better diagnostic accuracy compared to SPECT MPI. GE licensed rights to flurpiridaz from Lantheus; shipments will begin in 2025.

• Breast Density Awareness: Women appear to be getting the message about the risks of dense breast tissue, but there’s room for improvement. In a survey supported by Bayer and published in Patient Preference and Adherence, researchers queried 3k women from six countries, with 39% aware of breast density, 31% knowing high density is a breast cancer risk factor, and 24% saying they had high breast density. Women with dense tissue were more aware of basic breast cancer facts, such as that high density is a cancer risk factor (58% vs. 22%). 

• Organized Breast Screening Is Best: A new study from Switzerland supports organized breast screening programs versus those relying on physician referrals. Researchers in ESMO Open analyzed tumor-node-metastasis status between Swiss regions with different types of programs, finding that women aged 50-69 in regions with organized programs were less likely to have larger tumors (classified as T1 to T3) and were more likely to have stage I disease. The study reaffirms the value of screening mammography, particularly in a country where it has been questioned in the past. 

• Sectra Signs $300M Quebec Contract: Sectra has signed a massive contract to provide its Sectra One Cloud enterprise imaging solution to 150 sites across Quebec, Canada. The company signed the contract with the MSSS Quebec provincial health authority, which is responsible for providing healthcare services to 9M residents and performs 12M imaging exams a year. The installation is valued at US$300M over 12 years, with options to extend for another three years for a total value of US$463M. 

• AI Attitudes Evolve after Deployment: AI will undoubtedly have a big impact on medical imaging, but what do radiology staff think about it? In a new study in Clinical Radiology, U.K. researchers studied staff attitudes before and after deployment of AI for detecting lung cancer on chest radiographs. Researchers found attitudes went from enthusiasm and apprehension to frustration due to technical setbacks, and finally matured into acceptance. Tellingly, the number of respondents who said they would agree to having AI analyze their own chest X-rays rose after deployment (48% vs. 31%). 

• ASTRO Study Supports Theranostics: The ASTRO annual meeting is underway in Washington, DC, this week, and a highlighted study supports theranostics for hard-to-treat meningioma brain tumors. Researchers used the lutetium-177 dotatate radiopharmaceutical in 20 patients whose tumors were resistant to traditional treatments; they received four infusions eight weeks apart. Six months after treatment, patients exceeded the benchmark rate for progression-free survival (78% vs. 26%), and overall survival at one year was 89%. 

• New Proton Therapy System Launched: In other news from ASTRO 2024, proton therapy developer ProTom International is launching Radiance 330-C, a compact, fixed-beam version of its flagship Radiance 330 system. The new system is being positioned as a modular, more economical offering that enables radiation oncology departments to develop a proton therapy service within or adjacent to linear accelerator-based vaults. Radiance 330-C includes the company’s Fidelity pencil-beam scanning technology and can be integrated with Leo Cancer Care’s upright patient positioning and imaging system. 

• Varian Debuts RapidArc Dynamic: Another ASTRO product launch comes from radiation therapy giant Varian, which is debuting RapidArc Dynamic, a new radiation dose modulation tool for the Eclipse and TrueBeam systems. An update on the company’s RapidArc technology, the technique uses a dynamic collimator and combines the benefits of intensity-modulated radiation therapy and volumetric modulated arc therapy in a single package. RapidArc Dynamic enables clinicians to reduce dose to at-risk organs, improve plan quality, and plan complex cases in less time.

• Interventional Knee Treatments: If you’re of a certain age, knee pain from osteoarthritis can be a nagging problem. In a new model-based study in AJR, researchers compared interventional treatments for knee osteoarthritis in people who aren’t quite ready for surgery. Of two options over a hypothetical four-year period, radiofrequency ablation had the largest treatment effect, but genicular artery embolization was the most cost-effective versus RFA based on cost-effectiveness probability (42-55% vs. 18-29%). 

• Prenuvo Hits the Slopes: Whole-body imaging provider Prenuvo has opened a new clinic in Denver with a new marketing program focused on snow sports enthusiasts. The company partnered with Ikon Pass to offer pass holders a $400 discount on whole-body scans. Ikon Pass gives skiers and snowboarders access to 50 mountain destinations, and the discount will be available at all Prenuvo clinics in the U.S. except its Boston location.  

• Siemens Installs First Self-Driving C-Arm: Siemens Healthineers made the first U.S. installation of the Ciartic Move self-driving mobile C-arm the company introduced at RSNA 2023. The system was installed at Tahoe Forest Health System of Truckee, California, where clinicians will use it to perform both 2D fluoroscopy and 3D cone-beam CT image-guided procedures. Siemens believes the system’s self-driving capabilities and automated workflows will improve efficiency, with time savings of almost 50% during spine surgery and 55% during pelvic surgery compared with traditional mobile C-arms.

• Photoacoustic Tomography Breakthrough? Photoacoustic tomography imaging has shown potential as a medical imaging technology, but it’s lacked the speed needed for clinical use. U.K. researchers have developed a 3D PAT scanner that could overcome this challenge by scanning 100-1,000X faster than previously, using laser-generated ultrasound waves to detect subtle changes in veins and arteries, hinting at possible applications in cardiovascular imaging. They describe their handheld 3D photoacoustic scanner – and show CT-like vascular images – in a paper in Nature Biomedical Engineering.    

• Naitive Inks BMD Research Agreement: Osteoporosis software developer Naitive Technologies signed an agreement with the University of Iowa to evaluate the company’s OsteoSight solution for identifying people at risk of low bone mineral density. Researchers will compare OsteoSight to dual-energy X-ray absorptiometry scans, using 2.5k hip and pelvic X-ray images acquired within 12 months of DEXA scans. OsteoSight received Breakthrough Device designation from the FDA last year. 

• Changes at Radiopaedia: After 19 years leading the radiology education website he founded, Radiopaedia.org’s Dr. Frank Gaillard is stepping down as editor in chief. A neuroradiologist in Australia by day, Gaillard founded Radiopaedia in 2005 and has grown it into one of the specialty’s preeminent educational sites, with over 60k cases and 16k reference articles; the site’s five-day virtual conference in July drew 13k attendees. Gaillaird will remain involved with the site, but is handing the editor-in-chief reins to Dr. Henry Knipe, also an Australian radiologist.

Breast Density Classification: From Conception to Routine Use

Knowing an individual’s mammographic breast density is key to understanding their risk for cancer. A new article from Visage Imaging explains how an AI-based solution can improve breast density assessment.

Address the Hidden Impacts of Legacy Image Exchange Solutions

87% of healthcare leaders identified patient satisfaction as a challenge in a recent survey. Get more insights and learn how healthcare providers are overcoming common challenges in this article from PocketHealth.

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.

The Resource Wire

• Focus on Mammography Workflow: Mammography workflow is key to providing high-quality breast imaging services. In this Imaging Wire Show, we talked with Christie Devine of Siemens Healthineers about how recent advances in mammography workflow are leading to more effective mammography technologists — and happier patients.

• Build Intelligent Connections at RSNA 2024: Visit AGFA HealthCare at booth #2565 at RSNA 2024 to learn how to elevate your radiology practice with enterprise imaging. Find out how their next-generation solutions empower you to read faster and work smarter by scheduling an appointment today. 

• Your In-Workflow Copilot Experience: Nuance’s PowerScribe Smart Impression harnesses generative AI to automatically generate draft impressions and recommendations, saving you time and reducing workload-related stress. Learn how it can become your in-workflow copilot today. 

• Unlock Medical Imaging’s Full Potential: Unlock the full potential of medical imaging with the power of cloud technology and discover how Optum’s solutions can streamline operations, enhance data security, and improve patient outcomes. Embrace the future of medical imaging today and see the difference the cloud can make!

• 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.

• Unprecedented Insights Made Possible with AI: With the largest normative dataset of whole-body imaging in the world, Prenuvo’s AI researchers partner with the best academic minds to understand – like never before – what “normal” aging means. Learn about their work today.

• A Cloud-Native Foundation for Your Imaging Needs: Merge by Merative’s Merge Imaging Suite is built on a cloud-native foundation to address your imaging needs today, providing an intuitive, feature-rich array of solutions thoughtfully designed to help you enjoy a seamless and frictionless workflow experience. Learn more about it today. 

• Heart Failure Screening at Home and in Primary Care: Heart failure is the number one cause of hospitalization in people over 65. The SYMPHONY study is investigating a screening strategy of point-of-care AI echo and NT-proBNP in primary practice and general community settings. Learn more on this page from Us2.ai. 

• Presenting Unboxing AI: Check out CARPL’s video series, Unboxing AI, featuring experts discussing AI and its future in radiology. The next episode on October 4 features Cameron Andrews of Sirona Medical – reserve your seat today. 

• 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. 

• 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. 

• Serving the Needs of Image-Driven Clinicians: TeraRecon serves the needs of image-driven clinicians and users across the entire healthcare enterprise. Schedule a demo today to explore the latest updates to industry-leading advanced visualization solutions and learn about new AI capabilities. 

• AI for Lung Cancer Diagnosis and Screening: Check out this comprehensive new eBook from Calantic by Bayer on the role of AI in lung cancer diagnosis and screening. It explores AI’s potential role in improving lung cancer screening strategies, identifying high-risk individuals, and enhancing diagnostic accuracy. Download it today.

• AI for Detecting Fractures on X-Rays: Missed fractures occur all too frequently and are a significant cause of patient morbidity. Learn how U.K. researchers in the FRACT-AI study are using Gleamer’s BoneView algorithm to discover how AI can help radiologists improve their diagnostic accuracy for fracture detection on X-rays.

• 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%.

• Learn the Basics of CT Colonography: Medicare will soon be paying for CT colonography exams for colon cancer screening. Get up to speed today with Medality’s comprehensive CT colonography course, led by experts Judy Yee, MD, Kevin Chang, MD. 

• Emerging Medical Imaging Trends and Industry Impact: Jordan Bazinsky, CEO of Intelerad, has led significant changes over the past year, focusing on cloud solutions, AI integration, and brand refinement. He shares insights on Intelerad’s future and the medical imaging industry.

The Industry Wire

1. Dems introduce legislation to permanently lower ACA plan costs. 
2. Cardinal Health acquires Integrated Oncology Network for $1B.
3. CDC: 40.3% of U.S adults are obese, 46.5% of adults aged 40-59.
4. VA’s new Oracle EHR saw 826 ‘major’ incidents since its launch.
5. U.S. House committee passes rare pediatric disease drug bill.
6. 29% of Americans have undiagnosed iron deficiency.
7. Senate holds Steward Health CEO in criminal contempt.
8. PA-based system fires workers for sharing inappropriate patient images.
9. Providers say reimbursement denials are getting worse.
10. How pediatricians created the peanut allergy epidemic