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RSNA Goes All-In on AI | RSNA Attendance Up 18%
December 5, 2024
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Together with
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“The only way to predict the future is to create it.”
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Nina Kottler, MD, in the keynote address at RSNA 2024.
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How are breast imaging practices implementing mammography AI? In this edition of the Imaging Wire Show, we talked to two breast imaging key opinion leaders on their experiences — Shadi Aminololama-Shakeri, MD, and David Forsberg, MD.
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CHICAGO – It’s been AI all the time this week at RSNA 2024. From clinical sessions packed with the latest findings on AI’s utility to technical exhibits crowded with AI vendors, artificial intelligence and its impact on radiology was easily the hottest trend at McCormick Place.
Radiology greeted AI with initial skepticism when the first applications like IBM Watson were introduced at RSNA around a decade ago.
- But the field’s attitude has been evolving to the point where AI is now being viewed as perhaps the only technology that can save the discipline from the vicious cycle of rising exam volume, falling reimbursement, and pervasive levels of burnout.
RSNA telegraphed the shift last year by announcing that Stanford University’s Curtis Langlotz, MD, PhD, would be RSNA 2024 president.
- Langlotz is one of the most respected AI researchers and educators in radiology, and even coined the phrase that while AI would not replace radiologists, radiologists with AI would replace those without it.
In his president’s address, Langlotz echoed this theme, painting a picture of a future radiology in which humans and machines collaborate to deliver better patient care than either could alone.
- Langlotz’s talk was followed by a presentation by another prominent AI luminary – Nina Kottler, MD, of Radiology Partners.
Kottler took on the concerns that many in radiology (and in the world at large) have about AI as a disruptive force in a field that cherishes its traditions.
- She advised radiology to take a leading role in AI adoption, repeating a famous quote that the best way to predict the future is to create it yourself.
What were the other trends besides AI at RSNA 2024? They included…
- Photon-counting CT, which is likely to see new market entrants in 2025.
- Total-body PET, with PET scanners that have extra-long detector arrays.
- Theranostics, a discipline that integrates diagnosis and therapy and promises to breathe new life into SPECT.
- CT colonography and CCTA, which will see positive reimbursement changes in 2025.
- Continued growth of CT lung screening, especially as a tool for opportunistic screening of other conditions.
- Continued expansion of AI for breast screening.
The Takeaway
The RSNA meeting has been called radiology’s Super Bowl and World Cup all rolled into one, and this year didn’t disappoint. RSNA 2024 showed that radiology is prepared to fully embrace AI – and a future in which humans and machines collaborate to deliver better patient care.
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- RSNA 2024 Attendance up 18%: RSNA 2024 attendance is up about 18% at mid-week compared to the same point in RSNA 2023. RSNA is reporting that about 40k total attendees were registered through Tuesday, compared to 34.2k at the same point last year. The number of exhibitors is flat at 715 companies. The double-digit increase is welcome news and shows the meeting is back on a growth trajectory after attendance declines following the COVID-19 pandemic.
- Mammography AI Pays Off: You get what you pay for. In an RSNA 2024 presentation, researchers found higher cancer detection rates for women who paid for AI analysis of their mammograms in RadNet’s Enhanced Breast Cancer Detection service. In a study of 748k women, the cancer detection rate was 43% higher for EBCD-enrolled women, with AI accounting for 21% of the increase and the remaining 22% due to higher-risk women being in the program. The findings are a boost for EBCD, a closely watched barometer of real-world AI.
- Patient Prep Bays Boost MRI Throughput: In a Wednesday RSNA presentation, researchers improved MRI efficiency by prepping patients on dockable tables in dedicated prep bays and wheeling them into scanning rooms. In a study of 5.8k patients at a facility with three scanners and four dockable tables, researchers saw shorter table prep times (2.4 vs. 2.9 minutes) and table turnover times (6 vs. 10 minutes). Turnaround times fell 5.4 minutes for brain MRI scans and 2.8 minutes for C-spine and 2.3 minutes for lumbar spine scans.
- CT Opportunistic Screening: ClariPi’s ClariMetabo algorithm was used to perform opportunistic screening of 1.3k people in their 30s who got abdomen-pelvis CT scans during emergency room visits in 2016. Patients were tracked for eight years, with researchers finding higher hazard ratios for MACE and dyslipidemia in patients with higher visceral fat (HR=1.7) and waist circumference (HR=2) at multiple vertebral levels. The study shows how single-click AI can perform opportunistic screening in younger people.
- Guideline Conflict of Interest? A new study at RSNA 2024 suggests that clinicians who develop ACR Appropriateness Criteria guidelines aren’t adequately disclosing industry payments. Researchers analyzed authorships and disclosures in ACR guideline articles from 2019-2023 (633 authorships, 333 unique authors). Median industry payment rates per authorship ranged from $3,876-$6,040, and failure-to-disclose rates per unique authors were from 76%-96%. Researchers suggested more transparency and stronger journal guidelines for disclosures.
- Imaging Costs Scare Patients, Redux: Patients who know how much their imaging exams will cost them are still more likely to cancel their appointments. In a follow-up at RSNA 2024 to a study published earlier this year, UC Irvine researchers expanded their patient population (now 608 patients), but the results were mostly the same: patients who knew their out-of-pocket estimated costs were more likely to cancel (48% vs. 28%). The findings show the unintended consequences of price transparency.
- MSK Research from RSNA: Musculoskeletal imaging has figured prominently at RSNA 2024 over the last two days. In a Wednesday presentation, researchers found that people who ate high levels of ultra-processed food had higher amounts of fat stored in their thigh muscles on MRI scans – a sign of poorer muscle quality that could lead to knee osteoarthritis. And in a Thursday paper, another group found that skeletal muscle loss on MRI could be a precursor to Alzheimer’s disease in their study of 621 patients over almost six years.
- GE Unveils Head-Only MRI at RSNA 2024: A new head-only 3T MRI scanner called Signa Magnus led GE HealthCare’s list of innovations at RSNA 2024. The scanner enables neuroscience scans previously not possible through whole-body MR. In nuclear medicine, GE unveiled its Aurora dual-head SPECT/CT enhanced with ASiR-V, SnapShot Freeze 2, SwiftScan SPECT, and SmartMar solutions. In ultrasound, GE launched the Logiq Totus mid-range scanner, showcased its Versana Premier multi-purpose system, and touted improvements to its tablet-based Venue Sprint system and Vscan Air SL handheld ultrasound with integrated Caption AI guidance. Meanwhile, in mammography, GE announced the Pristina Via for improved workflows and image acquisition. Other GE RSNA highlights included the MR Max 3 syringeless power injector, MINItrace Magni theranostics cyclotron, and Flyrcado (F-18 flurpiridaz) PET MPI radiotracer.
- Siemens Expands CT Portfolio at RSNA: Siemens Healthineers ushered in two new photon-counting CT scanners at RSNA 2024 as part of its Naeotom Alpha series; the dual-source Alpha.Pro and the single-source Alpha.Prime, while rebranding the Naeotom Alpha to Alpha.Peak. Siemens also expanded its 1.5T Magnetom Flow MRI with a 70cm bore and flexible XL coil for larger body regions. In ultrasound, Siemens announced AI Abdomen for AI-based labeling on the Acuson Sequoia 3.5 ultrasound scanner as part of the 3.51 release, while in molecular imaging the company said the Biograph Trinion PET/CT scanner is now shipping. Siemens also debuted its remote-controllable tableside fluoroscopy and radiography platform, the Luminos Q.namix, while Ciartic Move is a new self-driving mobile C-arm for intraoperative imaging.
- Microsoft Adds Viz.ai to PIN: Microsoft has added AI algorithms from Viz.ai to its Precision Imaging Network AI orchestration platform. Thirteen Viz.ai solutions will be added to PIN, which is part of the Microsoft Cloud for Healthcare offering. The Viz.ai algorithms include solutions for acute and non-acute care and cover diseases ranging from stroke to aortic dissection.
- United Imaging’s Ultra MRI: Kicking off its RSNA 2024 product lineup, United Imaging introduced the 510(k)-pending uMR Ultra 3T MRI, with gradient performance of 100mT/m at 200T/m/s, 192 receive channels, and up to 96-channel coil capabilities. For molecular imaging, United showcased its new uMI Panvivo PET/CT platform with 219ps time-of-flight resolution, 2.9mm NEMA spatial resolution, and 181 cps/kBq effective sensitivity alongside its uMI Panorama GS PET/CT system. United also dove into AI at RSNA, exhibiting its uAIFI.LIVE platform for motion visualization and remote scanning technology, as well as Vera, an AI avatar that responds to over 10k commands. The company also showed its first interventional X-ray system as a work-in-progress, as well as CT, MRI, and PET/CT scanners in mobile coaches.
- Hyland Shows Cloud Updates: Hyland showed updates to its Cloud Imaging SaaS-based image management software at RSNA 2024. The company has combined clinical imaging content with multiple specialties for AI insights into clinical workflows and research. The company also touted NilShare, its image sharing solution for transferring data without a VPN.
- Philips RSNA Introductions: The launch of the newest generation of its BlueSeal sealed-magnet MRI technology paced Philips’ RSNA exhibit. The 1.5T scanner ships with just 0.7 liters of helium and doesn’t require a quench pipe, making for easier installation and operation. In CT, CT 5300 is a 64-slice mid-range high-performance scanner that uses AI to optimize the imaging chain. Philips is partnering with Annalise.ai on a pilot to test using AI to triage critical cases. In ultrasound, the company is rolling out a new Elevate software release for the Epiq and Elite scanners with new functions and better clarity and quality. Finally, Philips expanded its partnership with Amazon Web Services for cloud-based diagnostics.
- 3T MRI Spearheads Canon: A new edition of its 3T MRI platform spearheaded the RSNA 2024 activities for Canon Medical Systems USA. Vantage Galan Supreme Edition includes a Japanese-made magnet and Canon’s Altivity AI suite for helping clinicians improve image quality and reduce scan times, as well as the company’s advanced image reconstruction techniques. In CT, the company reported that it has a photon-counting CT scanner pending FDA 510(k) clearance – four of the systems are installed globally. Canon is also highlighting how its Instinx deep learning platform can simplify CT workflow, while in angiography the company is expanding its range of high-definition detectors and adding a new real-time AI solution.
- Alzheimer’s PET Access Varies: A new study found that access to beta amyloid PET scans has varied greatly in the U.S. since CMS’ October 2023 decision to let coverage decisions be made by Medicare Administrative Contractors. In a research letter in JAMA Neurology, researchers found that scan prevalence per 100k beneficiaries varied by MAC jurisdiction from October to December 23 (7 to 176) and then got even worse from January to March 2024 (31 to 613). Uneven access to dementia PET scans worsens health disparities.
- Lung Screening Finds Heart Disease: Canadian researchers writing in CMAJ reported that CT lung cancer screening can detect signs of coronary artery calcium, another sign of the exam’s two-for-one potential. In a population of 1.5k patients screened in Ontario, CAC was detected in 83%, and high CAC levels in 30%. Other research has also demonstrated the potential for leveraging CT lung scans to perform opportunistic screening, from heart disease to abdominal aortic aneurysm.
- contextflow Gets AI Reimbursement: AI company contextflow has signed an agreement with German healthcare system IKK Südwest in which the system will pay a per-exam fee for each chest CT scan using the company’s AI algorithms. The fee will be shared between contextflow and the imaging provider, and the company is claiming the arrangement is the first AI radiology reimbursement contract in Europe. contextflow specializes in AI for heart and lung diseases.
- NVIDIA Adds Siemens to MONAI: GPU manufacturer NVIDIA has added Siemens Healthineers to its MONAI open-source R&D platform for AI. MONAI connects doctors with data scientists for faster development of AI models, and Siemens has adopted MONAI Deploy, a module that builds AI applications with a few lines of code that can run anywhere. Integrating MONAI Deploy with the Siemens platform reduces the time needed to transfer AI models into real-world clinical settings.
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- 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%.
- LDCT Screening: To Scan or Not to Scan? Lung cancer accounts for more cancer deaths than prostate, ovarian, and breast cancer combined, but low-dose CT lung screening is catching on. Learn how tools like Intelerad’s InteleScreen can help you provide lung cancer screening with better nodule tracking and navigation.
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