CXR-risk | U.S. Lagging | Konica and Shimadzu's DDR Deal
By The Imaging Wire, July 22, 2019
"Solve what I whine about – & you'll be multi-millionaires."
A tweet from radiologist, Saurabh Jha, giving AI developers millions of reasons to automate radiologists' pain points, even if it's not related to interpretation.
CXR-risk
A team of Boston and Germany-based researchers developed a deep learning program that can predict a patient's long-term mortality from a single chest radiograph (no additional demographic or clinical information). Here's how the new CXR-risk convolutional neural network was able to produce risk scores that correlated with long-term mortality rates and what this may mean for healthcare:
Study – The CXR-risk study used 41,856 chest X-rays for CNN development and 10,464 for testing (sourced from the PLCO trial, 55-74 years, asymptomatic nonsmokers and smokers), while also using 5,493 images from the NLST for external testing (55-74 years, heavy smokers).
Results – The CNN scored each radiograph based on mortality risk (very low, low, moderate, high, and very high) and found that the "very high-risk" group had a 53% 12.2-year mortality rate with the PLCO set and a 33.9% 6.3-year mortality rate with the NLST set. These mortality rates are 18- and 12-times greater than the "very low-risk" group (3.8% and 2.7% mortality rates).
Significance – Noting that chest X-ray is the most common diagnostic imaging test, a CNN like CXR-risk could help patients and physicians understand mortality risks and "consider prevention, screening, and lifestyle interventions," while healthcare systems could use risk scores to properly allocate resources.
Future – The researchers suggested that additional demographic or clinical information could be combined with chest X-rays in future deep learning models to achieve even more precise scores.
U.S. Lags in Digital Health, Leads in DHR
The Philips Future Health Index 2019 reveals that the U.S. is among the top digital health records (DHR) users and is a big AI spender, but is below the 15-country average for most emerging digital health technologies. Here are some of the major takeaways:
84% of U.S. healthcare professionals use DHRs (e.g. EMRs and EHRs), but that's not necessarily a good thing. U.S. clinicians viewed DHRs negatively from a patient (53%), workload (61%), and professional satisfaction (44%) perspective.
Only 46% of U.S. healthcare professionals use telehealth (vs. 61% 15-country avg.).
Just 33% of U.S. healthcare professionals use AI-powered solutions (vs. 41% in Germany, 85% in China).
Despite lower AI usage, the U.S. spends $0.06 per capita on AI for preliminary diagnosis (vs. $0.03 in Germany, $0.02 in China).
As expected, China had a massive 60% share of global funding for AI companies, followed by the U.S. (29%) and India (5%).
https://www.usa.philips.com/a-w/about/news/archive/standard/news/press/2019/20190717-philips-future-health-index-2019-finds-us-among-leaders.html
Konica Minolta and Shimadzu's DDR Deal
Konica Minolta Healthcare Americas and Shimadzu Medical Systems USA announced a partnership to co-market Konica Minolta's Dynamic Digital Radiography (DDR) technology, which allows clinicians to view anatomical movement from rapidly-acquired X-ray images. The companies will support the DDR image processing technology with Shimadzu's RADspeed Pro radiographic imaging system, continuing their existing DR partnership in the U.S. and globally-expanding their DDR collaboration that began in Japan.
In addition to ensuring that DDR has a compatible X-ray system, this partnership should significantly expand DDR's U.S. channel and customer base, both of which would be necessary in order for DDR to become a mainstream healthcare option. Needless to say, this partnership is a major milestone for Konica Minolta, which has placed significant emphasis on DDR's potential over the last year, and would certainly benefit if DDR breathes new life into digital radiography.
Density Notifications Not Driving Breast Ultrasound, Either
Research from a team of Seattle area radiologists suggests that breast density reporting laws aren't driving the breast ultrasound use that lawmakers and density notification supporters may have expected.
The Study – Using National Ambulatory Medical Care Survey data from 2007 to 2015 (12,787 visits, asymptomatic women, 40-74 years), the team measured state-level breast ultrasound rates before and after adoption of notification laws.
The Results – The study found that screening ultrasound orders remained low throughout the 9-year period (just 3.3% of visits vs. 22.1% for mammography) and state-level orders did not change after adoption of density notification laws.
The researchers believe that notification laws still make it more likely that patients and physicians will discuss whether ultrasound screening is necessary, but this study suggests that the laws do little to drive orders, at least initially. Although this study slightly contradicts previous research from Emory that found a 1% increase in breast ultrasound after states adopted density notification laws, it also comes just a few weeks after a separate study found that DBT screening didn't change after North Carolina adopted its own density notification law in 2014.
The Korea Electrotechnology Research Institute (KERI) developed a superconducting insulation technology that can reduce the size and weight of MRI systems by more than half. The new superconducting insulation would significantly reduce the amount of copper wrapped around MRI superconducting wire to keep electricity from leaking and protect from overheating during operation, creating a "compact" superconducting electromagnet that allows much smaller and lighter MRIs.
After conducting an investigation into cases where patients were never informed of serious radiology findings, the UK Healthcare Safety Investigation Branch (HSIB) recommended a "digital safety net" that instructs patients via email or text to contact their physician. To support these automated digital notifications, the HSIB urged standardization of how results are graded across providers and the creation of a list of conditions that would require digital notification. The UK press quickly put a negative spin on the concept of informing patients about their cancer diagnosis via text, which isn't exactly accurate, but has made this proposed "digital safety net" a mainstream story in the country.
A team of UK-based researchers found that exposure to low-dose radiation, such as from CT scans, might promote the spread of cancer cells. The study exposed mice to 50 mGy of ionizing radiation (equal to 3-4 CT scans), finding that esophageal p53 mutant cells (associated with cancer) became larger and more numerous within 48 hours.
Those wondering how long Radiology Partners could maintain its current expansion pace don't have to worry about that for a while, as the mega practice just landed $700 million in long-duration capital from Starr Investment Holdings (SHI). To put that into context, RP's massive growth in recent years was fueled by $234 million and $200 million funding rounds in 2017 and 2018. RP will use its new funding to support "future practice and hospital system partnerships" and "clinically-focused technology and innovation." SHI's managing director, Geoff Clark, will become just the second institutional investor on RP's 11-member board (joining NEA).
Speaking of ongoing healthcare consolidation, a new report from Kaufman Hall found that although U.S. healthcare M&A activity fell in Q2 2019 (19 hospitals and health systems vs. 27 in Q1 2019), the revenue volume of the deals during Q2 reached $11.3 billion ($597m avg.), the highest since Q2 2017 ($12.6b) and four-times higher than Q2 2018.
Hologic announced a partnership with MagView to develop Unifi EQUIP, a forthcoming solution that helps mammography facilities comply with the FDA's EQUIP guidance and be prepared for inspections. Like Hologic's other acquisitions and partnerships, the MagView alliance is intended to allow Hologic to support its clients across the breast care continuum.
New Connecticut state legislation will limit co-pays for breast cancer screenings to $20, while adding breast ultrasound screening to its list of cost-protected screening options. Connecticut was among the first states to require breast ultrasound coverage for at-risk women in 2009, but since found that many women skipped this screening option because, unlike mammography, it wasn't covered until after they met their deductibles.
Paragon Biosciences acquired breast imaging AI company, Quantitative Insights, rebranding it as Qlarity Imaging LLC. Qlarity Imaging is highlighted by its FDA-cleared QuantX computer-aided breast cancer diagnosis system, which helps radiologists interpret cancerous and non-cancerous breast lesions, and was found to reduce missed breast cancers by 39% and improve diagnostic performance by 20%. In addition to commercializing QuantX, Paragon plans to expand Qlarity Imaging's AI technology to additional modalities and applications.
Major U.S. imaging dealer, Merry X-Ray, announced what it's calling a significant strategic shift, consolidating all of its existing companies under its new identity, MXR The Imaging Solution Company. This move seems appropriate from both a branding and strategic perspective, given MXR's aggressive expansion beyond its X-ray heritage in recent years, including acquisitions that expanded its MRI, CT, ultrasound, and veterinary capabilities.
NorthStar Medical Radioisotopes completed construction of its 20,000 square foot molybdenum-99 (Mo-99) facility in Wisconsin. Following FDA approval, NorthStar will use the Mo-99 that it produced at its Wisconsin and Missouri facilities to supply the company's RadioGenix System for the production of technetium 99m, the most widely used diagnostic imaging radioisotope.
MaxQ AI landed Philips and GE alum, Tom Neufelder, as its first CTO. Neufelder will lead MaxQ AI's engineering, product development, architecture, and technology strategy and represents a major hire for MaxQ AI.
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Focus Ultrasound-funded device maker, Carthera, received FDA approval to begin Phase 1/2a clinical trial on SonoCloud its low-intensity pulsed ultrasound device for recurrent glioblastoma (GBM) patients treated with carboplatin.
Catch up with the Nuance team and experience the company's latest solutions at AHRA booth 510.
This Qure.ai video details how its qXR TB chest X-ray tool is transforming tuberculosis screening.
POCUS Systems is approved as a Veteran Owned Business with the US Government Office of Veterans Business Development, paving the way for partnerships with the federal healthcare delivery systems.
Carestream's AHRA booth (number 503) spotlights its ImageView software and mobile imaging portfolio, including its CARESTREAM DRX-Revolution Nano Mobile X-ray System, CARESTREAM DRX-Transportable System/Lite, and new CARESTREAM DRX Plus 2530C Detector.
How much does a CT scan cost? According to Medmo, that depends. Scans made with the exact same device on the exact same body part could cost $225 at one facility and $2,500 at another. Medmo also provides some advice to make sure patients don't pay too much for their scans, including using the Medmo Marketplace, where the average CT costs between $225 and $700.
Tagged: AI, Artificial Intelligence, Breast Ultrasound, chest radiograph, CT, Dynamic Digital Radiography, Hologic, Konica Minolta Healthcare, MaxQ-AI, Medical Imaging, MRI, Paragon Biosciences, Qlarity Imaging, radiologist, radiology, Radiology Partners, Shimadzu Medical Systems, Ultrasound, x-ray
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