“This is category-redefining technology in the field of nuclear medicine and will set the standard for years to come.”
Spectrum Dynamics president and CEO, Michael Joos, is expecting big things for the company’s now-FDA-cleared VERITON-CT 64 Digital SPECT/CT scanner.
Imaging Wire Sponsors
- Carestream – Focused on delivering innovation that is life changing – for patients, customers, employees, communities and other stakeholders
- Focused Ultrasound Foundation – Accelerating the development and adoption of focused ultrasound
- Medmo – Helping underinsured Americans save on medical scans by connecting them to imaging providers with unfilled schedule time
- OpenMarkets – A marketplace for healthcare equipment, used by hundreds of hospitals and suppliers to buy and sell imaging equipment in the most efficient way possible.
- Pocus Systems – A new Point of Care Ultrasound startup, combining a team of POCUS veterans with next-generation technology to disrupt the industry
The Imaging Wire
Happy Thanksgiving, Imaging Wire Readers!
Heads-up that this is going to be a one-issue week (our first ever), so we made this issue a bit more robust to tide you over until next Monday. The Imaging Wire is thankful for all of you who spend each Monday and Thursday morning catching up on the news with us and we’re super thankful for our newsletter sponsors. Please make sure to visit their sites, and if you see them at RSNA (or anywhere), thank them for sponsoring The Imaging Wire. They make this publication possible.
Keep an eye out for me at RSNA, too. I’d love to meet you.
Canada’s CT Alternative
Canadian medical imaging startup, KA Imaging, developed a new portable X-ray system that provides a clearer view of patient’s lungs and may serve as a lower-dose/cost and more-accessible alternative to CT scans for lung cancer screening. As may be interpreted from its very specific name, the “high-resolution multi-energy digital X-ray imager” allows clinicians to view images of the body in layers, separating bone structure and soft tissue, thus improving their ability to spot cancers that may be hidden behind the ribs. Next up is a study where 30 already-diagnosed patients will have their KA Imaging scans compared with their regular CT scan to assess image quality (not a diagnostic study), in preparation for a possible mid-2019 launch.
Photoacoustic Imaging Targets Ovarian Cancer
Researchers at St. Louis’ Washington University developed a new technique that combines coregistered photoacoustic tomography with transvaginal ultrasound and may allow earlier ovarian cancer detection. The researchers created a sheath with laser-connected optical fibers that wrap around a standard transvaginal ultrasound probe, shining the laser at the tumor to generate sound waves. These sound waves provide information about tumor angiogenesis (hemoglobin concentration – rHbT) and oxygen saturation (sO2), thus revealing signs of ovarian cancer (extensive blood vessels and lower sO2). In a 16-patient pilot study, the team found that rHbT was 1.9-times higher with invasive epithelial cancerous ovaries (90% of all ovarian cancers) and mean oxygen saturation of invasive epithelial cancers was 9.1% lower than normal and benign ovaries. Ovarian cancer patients have a much higher survival rate if identified in stages 1 or 2 (70%-90% in 5yrs) versus stages 3 or 4 (just 20% in 5yrs). However, only 20% of ovarian cancers are identified early, making this a very important breakthrough that may save lives and help women avoid unnecessary preventative surgery. Washington University’s ovarian cancer detection technique represents the latest in a number of recent photoacoustic imaging discoveries to come from US academia, following advancements at Purdue University (cardiovascular disease, cancer, and diabetes), SUNY Buffalo (swallowing disorders), and Caltech (breast cancer).
The Case for Screening
A Swedish study (n= 52,438) found that early breast cancer detection, achieved from regular breast cancer screenings, can reduce breast cancer deaths by 60% within 10 years of diagnosis and by 47% within 20 years, allowing these women to live an average of 16.5 years longer (and better) lives. The researchers state that early detection allows women with breast cancer to benefit from modern treatment advancements, taking specific aim at other studies (like this one) that suggest that improved treatment is primarily responsible for falling breast cancer mortality rates (and not proactive screenings). This study makes sense to us.
Fujifilm Rolls Out RSNA Announcements
Fujifilm hit the presses with a quartet of announcements highlighting its upcoming product debuts at RSNA 2018, with a focus on its DR, mammography, and artificial intelligence lines.
- Fujifilm will unveil a pair of new DR detectors at RSNA, the 17×17” CALNEO Dual (currently Japan-only; produces traditional, soft tissue, and bone-only x-rays) and the FDR ES (for X-ray room retrofit conversions), and will preview its future DR detector technologies.
- The company will introduce articulating stand-added configurations of its 17×49” FDR D-EVO GL single exposure long length detector (allows for positioning below an OR table) and 14×17″ FDR D-EVO II DR detector (allows 2 sequential images for 34” images), intended to support long-length imaging applications in the operating room.
- Fujifilm will premiere new image processing and software upgrades to its currently-ITC-contested ASPIRE Cristalle mammography system including: S-View (creates a synthesized 2D image from DBT, lowers dosage by ~50%), Iterative Super Resolution (a reconstruction process that lowers dosage and improves image quality), Tomosynthesis Biopsy (improves workflow by identifying targeted area on a tomosynthesis slice), Tomosynthesis Spot (focuses compression at a specific area), Breast Density Measurement (provides density measurement at the point of image acquisition), and Comfort Comp (a new design to apply compression more gradually).
- Following a busy year of AI investments, Fujifilm will present its REiLI global medical imaging AI initiative and brand at RSNA, providing details on its AI advancements and in-development solutions.
The Shift to Single Source PACS
New research from Reaction Data suggests that imaging providers are moving away from “Best of Breed” enterprise imaging (a “deconstructed PACS” approach with different vendors for PACS, VNA, viewers, etc.) in favor of a “Single Source” approach (all components from a single company/platform). The survey of 297 providers revealed that between 2016 and 2018 the share of providers with single source infrastructure increased from 54% to 67%, while providers using a “Best of Breed” infrastructure fell from 46% to 33% (no calculator needed for that). This trend is likely to continue as 42% of the providers that are still using a “Best of Breed” approach would prefer to shift to a “Single Source” infrastructure, while only 29% of the providers who have adopted a “Single Source” approach would prefer to shift to a “Best of Breed” system.
- Speaking of the shift to Single Source PACS, Carestream won a pretty major enterprise imaging deal to replace existing RIS and PACS systems with a unified Carestream solution across all four hospital trusts in Southern Denmark (all previously using a “Best of Breed” approach). The multi-year agreement includes a number Carestream Clinical Collaboration Platform modules including: ordering, scheduling, worklist, radiology workstation, enterprise viewer, capture, and business analytics.
- Researchers at Washington University School of Medicine may have found a way to perform PET imaging with far lower radioactive tracer doses and costs using artificial intelligence. The researchers created a convolutional neural network (CNN) that can analyze PET images with one-tenth the typical dose (this would normally result in poor image quality) and then create estimated images with full-dose quality for clinical use.
- Canon Medical Systems announced an investment in and partnership with Tokyo University AI spinoff, LPixel Corporation, revealing plans to integrate LPixel’s AI diagnostic technology with its medical imaging products. The deal comes about six months after LPixel and Fujifilm partnered with similar plans to integrate the company’s AI technology into Fujifilm’s PACS system.
- Hide this story from any significant others who say you two don’t do enough together. A husband and wife-led team from the University of Virginia Cancer Center were awarded $1.8 million by the NIH to evaluate a new technique, called Precision Breast Intraoperative radiation therapy (IORT). Leveraging UVA’s CT-on-rails brachytherapy suite, the technique is intended to improve conventional breast IORT by making it more targeted, more powerful, and more personalized.
- Hitachi Healthcare will unveil its new Scenaria View 64/128-slice CT for the first time in western markets at RSNA 18. The premium CT is not yet available in the US, but launched in Japan last spring, and is highlighted by its 80cm wide opening (vs. 75cm) and added Hitachi IPV image reconstruction solution (improves chest resolution at an unchanged dose).
- Spectrum Dynamics announced the FDA clearance of its VERITON-CT 64 Digital SPECT/CT scanner, a hybrid version of the company’s highly-touted 12-detector CZT system that launched earlier this year. The VERITON platform is highlighted by its 3x greater volumetric sensitivity and 2x higher throughput versus conventional systems, while the new CT-attached version further expands on the system’s potential applications and (as Spectrum Dynamics emphasizes) could allow health systems to consolidate multiple modalities into one system.
- Northwestern professor, Ellen B. Mendelson, published a new article detailing advancements taking place in artificial intelligence for breast imaging, revealing an overall positive view for using AI to support breast imaging workflow improvement, outcome analysis, and diagnosis (w/ high quality/quantity imaging data). However, Mendelson warned that as long as there is a potential for algorithmic error, AI should not be relied on for life-or-death decisions. Even without the chance for error, Mendelson urged physicians to become more educated on AI.
- Canon Medical Systems Japan announced the expansion of its AiCE (Advanced Intelligent Clear – IQ Engine) CT reconstruction technology to its Aquilion ONE / GENESIS Edition CT scanner. AiCE first launched in Japan in April as an add-on to Canon’s Aquilion Precision CT and reduces noise to achieve high-quality images at a lower dose.
- Machine data analytics company, Glassbeam, announced a deal with Renovo Solutions that will allow the medical imaging service company to resell a version of Glassbeam’s predictive analytic software for ultrasound equipment, later expanding the partnership to CT and MRI systems. The deal continues Glassbeam’s ISO channel expansion, following similar partnerships with NIR, Brown’s Medical Imaging, Radiographic Equipment Services, and Calmed since May.
- Agfa signed a three-year group purchasing agreement with Premier, giving Premier’s members (3,900 hospitals, 150,000 provider organizations) access to special pricing and pre-negotiated terms for Agfa’s Direct Radiography and fluoroscopy imaging systems. Agfa’s systems have been available through Premier for years and it’s likely that this deal is an extension from a previous agreement.
- GE Healthcare issued a Class I recall on 996 Millennium Nuclear Medicine Systems in the US following an incident where a top detector detached and fell onto a bottom detector. Although no patient injuries were reported, patients could suffer life threatening harm if a detector detached during an exam, justifying the Class I recall. Between September 14th and November 6th GE stopped all use of the Millennium systems in the US while it inspected each system, eventually confirming that no other systems were at risk.
- HealthLytix announced the RSNA launch of its CT CoPilot software, used to improve head CT exam workflow (particularly interpretation time and measurement accuracy), revealing CT CoPilot distribution deals with Blackford (integrated with the Blackford Platform) and CorTechs Labs.
- Halifax Biomedical gained FDA clearance for its GE XR656+ Halifax Radiostereometry Upgrade, which upgrades the GE X-ray systems to support in vivo 3D measurements, and is the first product launched under the companies’ year-old joint development agreement. Primarily intended for orthopedic applications, the upgrade includes an L-arm imaging device with an X-ray tube that synchronizes with the XR656’s X-ray tube and GE imaging plates to take two simultaneous digital X-rays.
- Carestream will showcase Carestream Vue Reporting’s multimedia advancements at RSNA, including the integration of graphs, tables, images, and hyperlinks, suggesting that these elements add value to traditional reports, and boost productivity and collaboration. Carestream highlighted early results at the NIH Clinical Center, which within several months is using multimedia reporting in 70% of all CT reports and 50% of all MR reports.
- General Electric sold a $1.5 billion healthcare equipment finance portfolio to TIAA Bank for an undisclosed sum (1,100 hospitals and 3,600 practices and imaging centers), in a deal that also includes plans for GE Healthcare to manage US leases under a co-branded arrangement with TIAA Bank. The deal is part of GE’s ongoing effort to trim $25b from GE Capital’s assets, but should also help alleviate its cash flow issues and may represent at least a symbolic step in the separation of its healthcare business.
- Volpara Solutions announced the upcoming RSNA launch of its VolparaLive mammography decision-support software. The software gives mammography technologists information on patient positioning and breast compression to support mammogram consistency and reduce patient recalls for technical reasons.
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- A new study in JACR revealed that the rise of high-deductible health plans has led to greater patient concerns over imaging costs than ever before, while patient price shopping often leads to “confusion, misinformation, and opaqueness.” These are the exact patients who can be helped by the Medmo platform, which connects high-deductible patients with radiology centers, ensuring the lowest costs for patients and a profitable revenue stream for imaging centers.
- OpenMarkets recently welcomed several new ultrasound refurbishing companies, including Trisonics and Redstone Healthcare, giving radiology directors who work with OpenMarkets the flexibility to order new ultrasounds from brands like Philips and Mindray or evaluate lower-cost refurbished options using the same platform. To get connected to OpenMarkets’ ultrasound suppliers, Imaging Wire readers just need to describe their current and future needs here.
- Carestream highlighted the ongoing adoption of its OnSight 3D Extremity Systems, which provide orthopaedic specialists with high-resolution 3D images for more accurate diagnostic and treatment decisions, providing testimonials from a number of OnSight 3D customers.
- The Focused Ultrasound Foundation announced that Taiwan-based focused ultrasound manufacturer, NaviFUS, began its first clinical trial for glioblastoma, already treating its first three patients by using focused ultrasound to open the blood-brain barrier and treat the deadly cancer.
- 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.