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Studies Support Breast Ultrasound | Subspecialists Fall Short
November 7, 2024
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Together with
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“Physicians are easy targets. They don’t organize and they tolerate the death by a thousand cuts model. They aren’t stupid. If they cut reimbursement 30% overnight they’d have an uprising. 1-2% a year plus inflation, the world goes on.”
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radstra, in a post on RadHQ.net on Medicare reimbursement cuts.
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Radiologists are looking to maximize their efficiency through new reporting tools that integrate easily with their PACS and RIS. In this episode of the Imaging Wire Show, we talked to Jason Mercieca and Dieter Smith of Kailo Medical about new developments in radiology reporting.
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A pair of new research studies offers guidance on when and where to use ultrasound for breast screening. The publications highlight the important advances being made in one of radiology’s most versatile modalities.
Ultrasound is used in developed countries for supplementary breast cancer screening in women who may not be suitable for X-ray-based mammography due to issues like dense breast tissue.
- Ultrasound is also being examined as a primary screening tool in developing regions like China and Africa, where access to mammography may be limited.
But despite growing use, there are still many questions about exactly when and where ultrasound is best employed in a breast screening role – and this week’s studies shed some light.
First up is a study in Academic Radiology in which researchers compared second-look ultrasound to mammography in women with suspicious lesions found on breast MRI.
- Their goal was to find the best clinical path for working up MRI-detected lesions without performing too many unnecessary biopsies.
In a group of 221 women, second-look ultrasound was largely superior to mammography with…
- Higher detection rates for mass lesions (56% vs. 17%).
- A much higher detection rate for malignant mass lesions > 10 mm (89%).
- But worse performance with malignant non-mass lesions (22% vs. 38%).
They concluded second-look ultrasound is a great tool for assessment and biopsy of MRI-detected lesions > 10 mm without calcifications.
- It’s not so great for suspicious non-mass lesions, which might be better sent to mammography for further workup.
Breast ultrasound of non-mass lesions was also the focus of a second study, this one published in Radiology.
- Non-mass lesions are becoming more frequent as more women with dense breast tissue get supplemental screening, but incidence and malignancy rates are low.
So how should they be managed? In a study of 993 women with non-mass lesions found on whole-breast handheld screening ultrasound, researchers classified by odds ratios the factors indicating malignancy…
- Associated calcifications (OR=21.6).
- Posterior shadowing (OR=6.9).
- Segmental distribution (OR=6.2).
- Mixed echogenicity (OR=5.0).
- Larger size (2.6 vs. 1.9 mm).
- Negative mammography (2.8% vs. 29%).
The Takeaway
Ultrasound’s value comes from its high prevalence, low cost, and ease of use, but in many ways clinicians are still exploring its optimal role in breast cancer screening. This week’s research studies should help.
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A Sneak Peak at Intelerad for RSNA 2024
Join Intelerad for a webinar at 1 pm ET on November 19 to get a sneak peek at what they’ll be highlighting at RSNA 2024. Company executives will explore the transformative impact of AI and cloud technology on radiology.
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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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- Subspecialists Fall Short for COVID: Is subspecialization in radiology really all that? A new study in Journal of Radiation Research and Applied Sciences found that general radiologists performed better in diagnosing COVID-19 on chest CT scans than those with respiratory imaging subspecialization. Researchers analyzed the performance of 74 radiologists from 29 countries with 30 anonymized chest CTs, finding general radiologists had higher sensitivity (74% vs. 48%) and ROC AUC (0.83 vs. 0.70).
- CMS Finalizes Radiotracer Unbundling: In its final version of the Hospital Outpatient Prospective Payment System, CMS followed through on its intention to unbundle payment for radiotracers that cost more than $630 per day. Nuclear medicine proponents are hailing the move as a major victory that enables providers to separate radiotracer billing from the scans themselves. Providers have found that payment bundling depresses nuclear medicine reimbursement, especially with the new generation of more expensive radiotracers.
- CCTA’s Reimbursement Boost: Another important change that was finalized in HOPPS 2025 is a significant increase in coronary CTA reimbursement, more than doubling outpatient payments to $386 (previously $175). The reimbursement hike was made possible by a new cardiac CT code; previously, CCTA scans were previously billed the same as lower-cost chest CTs, making the heart exams unprofitable for many providers.
- Low CT Lung Screening Awareness: Medicare rules on CT lung cancer screening reimbursement require patients to get a healthcare provider’s referral. But a new research letter in JAMA Network Open discovered that among 929 current and former smokers surveyed, the vast majority were not getting information about screening: less than 16% had either heard of CT lung screening or had discussed it with their provider. Researchers noted that 13.1M Americans meet screening eligibility criteria, and the survey results highlight the need for better communication.
- Volpara Gets Big DoD Contract: Volpara Health secured a five-year $7.3M contract with the U.S. Defense Health Agency to deploy its solutions across the military health system. Volpara will provide its Patient Hub mammography reporting, risk assessment, and patient tracking system across DHA sites. Patient Hub eliminates paper-based functions like scheduling and risk assessment and centralizes them to reduce administrative burdens, streamline workflow, and improve guideline adherence.
- $5M Grant for Portable Brain PET: Researchers at Weill Cornell Medicine in New York City received a $5M NIH grant to develop a portable high-resolution PET scanner. The grant follows a proof-of-concept study on a scanner called Prism-PET with spatial resolution less than 1 mm. Under the grant, researchers will use Prism-PET to detect tau tangles in the brain that can be early indicators of Alzheimer’s disease. Interest in lower-cost, higher-resolution PET has risen with the approval of Alzheimer’s therapies like Leqembi.
- Annalise Lands More NHS Trusts: Annalise.ai continues to see success deploying its AI solutions in the U.K.’s NHS system. The company’s chest X-ray AI technology went live at several NHS trusts in the Manchester area, and ultimately will be deployed at seven regional trusts in the next few months through Sectra image management networks at the hospitals. The rollout focuses on detection of lung cancer, a major problem in the Manchester region. Annalise announced a similar deal for northern England last month.
- Imaging Directs Pancreatic Cancer Follow-Up: Using medical imaging to follow up patients after pancreatic cancer surgery produced better outcomes than waiting for them to present with symptoms of recurrence. In a study of 333 patients in JAMA Surgery, researchers found that pancreatic cancer patients who got routine imaging follow-up (mostly CT) had longer overall survival over a median of 40 months than those who presented with symptoms (28 vs. 23 months). Patients who got imaging also were more likely to receive treatment focused on the recurrence (OR=2.57).
- Mindray Inks Deal with TeleRay: Ultrasound company Mindray signed a new partnership with remote image software developer TeleRay that illustrates the growing importance of remote ultrasound. Mindray’s Resona 7 and Resona I9 ultrasound scanners have been integrated with TeleRay’s platform to enable secure real-time ultrasound image streaming and remote interpretation. The alliance also supports the ability to guide sonographers in real time, and the TeleRay Live feature provides a web-based viewer with no app downloads required.
- Bracco to Triple Ultrasound Contrast Production: Use of contrast-enhanced ultrasound is growing, a trend that prompted Italian contrast company Bracco to build a new factory dedicated to CEUS production. The company has invested €80M in the Hexagon factory in Geneva, Switzerland, which will triple its production of microbubble-based ultrasound contrast agents like its Lumason product.
- CureMetrix Supplies BAC to SimonMed: CureMetrix will be supplying its cmAngio software for calculating breast arterial calcifications from mammograms to imaging services provider SimonMed. cmAngio is an AI-based solution that analyzes both 2D mammograms and DBT images to find BAC, which can indicate future heart disease risk. The partnership underscores the growing potential to turn mammography into a two-for-one screening exam for both breast cancer and heart disease.
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Meet with Medality at RSNA 2024
Book a visit with Medality at RSNA 2024 to see how they are at the forefront of practice growth and training in radiology. Also be sure to sign up for their RSNA after party at Flight Club at 6 pm CT on December 3.
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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.
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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.
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- Harnessing the Power of a Connected Network: Check out the next Road to RSNA virtual session from Microsoft at 2 pm ET on November 20 to discover how their network, powered by Microsoft Azure, can help increase efficiencies and improve patient care while building a scalable foundation for the future.
- Harnessing the Power of AI to Improve Patient Care: Endeavor Health is one of the first healthcare providers in the Midwest to use AI in the echocardiography lab. Learn how they are harnessing echo AI’s tremendous potential to improve diagnostic capabilities and help patients on this page from Us2.ai.
- Leading Radiology Forward at RSNA 2024: DeepHealth is leading radiology forward through AI-powered informatics and smart technology. Book a meeting today at RSNA 2024 booth #1340 to learn how they can help you achieve increased staff productivity and a better experience for patients and staff.
- Book an RSNA Meeting with CARPL: Explore radiology AI like never before by booking a meeting with CARPL at RSNA 2024, or drop by booth #5733 to tune in to any of seven research presentations across the show.
- Connecting Patients to Exceptional Care: Mach7 Technologies’ enterprise imaging solutions connect patients and clinicians across the globe to enable exceptional care. As modern healthcare evolves, so should your strategies. Schedule a demo at RSNA 2024 or stop by booth #3953 to learn more.
- 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.
- Register Today for a Visage 7 Priority Demo: Visage continues to lead imaging’s managed services SaaS move to the cloud with their Visage 7 CloudPACS solution. Register today for a priority demo at RSNA 2024 at booth #4329.
- The Growth of AI in Pulmonology: Learn more about the capabilities of AI for chest imaging in this on-demand webinar from Blackford. You’ll hear pulmonology professionals discuss several promising areas, from acute imaging through chest X-ray analysis to lung cancer screening.
- Get the 2024 Radiology Practice Development Report: Medality surveyed more than 3,300 radiologists and discovered the most critical training gaps and growth opportunities in radiology for its 2024 Radiology Practice Development Report. Download your complimentary report today.
- Come See Enlitic at RSNA 2024: Visit Enlitic at RSNA 2024 at booth #4365 to learn how the company is revolutionizing radiology with its data standardization solutions, including data migration technology through its acquisition of Laitek. Book a demo today.
- Learn how Industry Leaders are Improving Patient Experience: Join industry leaders at RSNA for a Lunch & Learn hosted by PocketHealth where they’ll share real-world strategies for enhancing patient engagement, tackling interoperability challenges, and reducing costs despite budget and staffing constraints. RSVP required!
- Connect with United Imaging at RSNA 2024: United Imaging will be celebrating the theme of Building Intelligent Connections at RSNA 2024. Come visit the company at booth #1929 to learn about their imaging solutions and how they connect to United’s mission of Equal Healthcare for All.
- Networked Radiology Empowers Radiologists: Join AGFA HealthCare at 11 am ET on November 12 for a webinar on how networked radiology can bridge health systems and empower radiologists. Learn about the role of networked radiology and get acquainted with new strategies for enterprise imaging implementation.
- 4 Reasons Why Subscription Is Better: The KLAS-leading Intuition advanced visualization solution from TeraRecon includes all the clinical features you need, plus a growing list of exclusive subscription-only content. Learn more about what’s included.
- Meet Merge at RSNA 2024: Merge is looking forward to sharing a wide range of news, innovations, and updates at RSNA 2024. Join them at booth #6100 to explore how their imaging solutions put your workspaces, clinicians, and transformation into focus.
- How to Standardize CT Images: The quality and appearance of CT scans can vary considerably. In this white paper from Riverain Technologies, find out how image normalization can standardize CT images, making them easier to analyze and interpret.
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