“The best AI isn’t even noticed by the user.”
– GE Healthcare’s X-ray CMO, Chiranjiv Singh, with a very timely reminder that the role of AI is to deliver outcomes and the best AI-based products lead with their utility, not their technology (think: Google Search or Spotify’s fantastic Discover Weekly app).
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
FDA’s 510(k) Overhaul
The US FDA is planning a ‘generational’ overhaul of the 510(k) medical device approval process that will bring a big de-emphasis on older predicate devices for approvals and new efforts to streamline the approval process for new, innovative technologies. Given the changes in medical technology since this process was introduced 40 years ago, this shift makes sense and should help drive innovation, even though it’s certain to create new hassles for established product lines and industry players.
“Sometimes when you win, you really lose…” These words of wisdom from Gloria to Billy in White Men Can’t Jump can apply to a lot of things, including the controversy swirling around DeepRadiology right now. Earlier this month, the AI educational services company put out a press release entitled “DeepRadiology Wins International RSNA Medical Artificial Intelligence Challenge,” which can be VERY easily be interpreted as a victory announcement, despite their 7th place finish (still a strong showing out of 346 entries). The actual winners were a radiologist and med student duo from Canada, who beat out a field of AI experts, but didn’t score any press coverage until after DeepRadiology’s creative PR maneuver was exposed. As expected, the internet is not happy with DeepRadiology, and given the specter of fake news in our society combined with the importance of trust in AI-related claims, DeepRadiology will have to work to rebuild its reputation. Or they might be on their way to the White House. Who knows these days.
GE “Elevates Radiology” at RSNA 2018
GE was once again extremely active at RSNA, launching a range of new products and solutions, as well as showcasing a number of recently-launched or still-forthcoming technologies. You may want to get comfortable before you jump into this one:
- Artificial Intelligence – GE’s RSNA presence was headlined by the launch of its Edison AI development platform. Edison with be at the center of GE’s future AI development, as GE will work with its technology partners to bring new data processing capabilities to Edison-based applications and devices, while clinical partners can use the platform to develop algorithms. RSNA brought a trio of new Edison solutions, including AIRx (MRI brain scanning workflow), Critical Care Suite (X-ray pneumothorax prioritization solution), and Automated Lesion Segmentation ultrasound solution, although plenty more are coming.
- CT Systems – GE Healthcare arguably made the greatest updates to its CT lineup, unveiling its FDA-pending Revolution Apex CT and showcasing its next-generation Revolution Frontier Gen 2 (oncology) and Revolution EVO Gen 2 (radiology) systems. The majority of GE’s focus went to the Revolution Apex CT, which adds the company’s new Quantix 160 X-ray tube and Deep Learning Imaging Reconstruction platform to produce “TrueFidelity” images at lower radiation dosage.
- CT Solutions – GE expanded its Smart Subscription CT software service, adding five new solutions (reconstruction, image quality, cardiac, neuro and oncology work) that can be acquired at an annual, per-device rate.
- X-Ray – GE’s X-ray showcase was highlighted by its new Edison AI-based Critical Care Suite, embedded on the company’s Optima XR240amx mobile X-ray. The simple yet potentially valuable AI solution is used to identify pneumothorax cases in chest X-rays (>0.95 AUC) and immediately alert the clinical team to prioritize image review.
- Interventional – GE expanded its Discovery IGS 7 hybrid OR system to support neuro, spine and orthopaedic surgery (previously only CV) due to the system’s enhanced conebeam CT capabilities and the addition of a new neurosurgical head holder during spinal surgery. The company also unveiled its Liver Assist V.I. (Virtual Injection) simulation tool, used to help clinicians identify injection points for liver embolization procedures.
- Surgical Imaging – GE’s recently-updated OEC Elite CFD mobile C-arm lineup welcomed a new range of compatible applications, highlighted by the company’s new Live Zoom feature (allows real-time zoom up to 4x) and new General HD imaging profile (enhances visualization during catheter insertion procedures). The company also released a Motorized Drive configuration for the OEC Elite CFD portfolio, targeted at vascular and cardiac procedures.
- MR – Although GE already made its MR hardware updates for this year, the manufacturer did showcase its FDA-pending AIRx AI-based automated workflow tool for brain scanning, its new AIR Technology RF coils for more flexible coil positioning during scans (1.5T & 3T compatible; 30 channel AA coil; 21 channel multi-purpose (MP) large coil; and 20 channel MP medium coil), and its new MyLiver MRI liver imaging toolset.
- Enterprise Imaging – GE showcased enhancements to its Centricity Universal Viewer (adds native breast imaging, immediate access to patient priors, connectivity with most EMRs, and exam prioritization using iCAD-based AI tech to score DBT images) and Centricity Clinical Archive (adds embedded IT and process analytics, multi-media image capture and documentation improvements to its Media Manager application)
- Protocol Management – GE introduced its Imaging Protocol Manager solution, providing “access, insight, and governance for imaging device protocols” to reduce variation and improve consistency.
Canon Medical Systems’ Really Big RSNA Refresh
Canon Medical Systems announced a wide range of new systems and technologies at RSNA, bringing a number of feature improvements and net new lineup additions, while avoiding the level of AI focus seen from many of its rivals at the show.
- Angiography – Canon launched its flagship Alphenix interventional imaging platform, which includes the Alphenix Biplane and Alphenix Core + angiography systems and their Alphenix Hi-Def Detector (76-micron resolution 12×12 panel). The platform is highlighted by its enhanced image quality and improved support for complex interventional procedures.
- Angiography & CT – Canon’s new Alphenix 4D CT interventional configuration combines its Alphenix Sky + C-arm and Hybrid Catheterization Tilt/Cradle Table with its Aquilion ONE / GENESIS Edition CT system, allowing clinicians to plan, perform, and verify procedures in a single setting.
- CT – Canon introduced its FDA-pending Advanced Intelligent Clear-IQ Engine (AiCE) CT reconstruction technology, intended for use with its Aquilion CT scanners, and leveraging AI/CNNs to reduce noise and allow high-quality images at a lower dose.
- MRI – Canon debuted its recently-FDA-cleared Vantage Orian 1.5T premium MRI system, representing Canon/Toshiba’s first premium wide-bore 1.5-tesla MRI and joining its current 1.5-tesla lineup.
- MRI – Canon’s new 1.5T Vantage Orian and existing 3T Vantage Galan MR systems added a pair of time-saving software: the SUREVOI Knee and KneeLine+ (automates localized knee scans, aligning with anatomy with over 95% accuracy) and Quick Star – Breathe Freely (allows free breathing image acquisition due to artifact reduction).
- R/F – Canon updated its well-seasoned Ultimax-i R/F system with a new single console (versus one each for fluoroscopy and radiography), streamlining exams and giving it bragging rights as “the only multipurpose system in the market equipped with a single console solution.” The Ultimax-i also adds optional support for Canon’s RAD Mode software, an optimized user interface to support rad and flouro workflows.
- Ultrasound – Canon announced the FDA clearance of its Aplio i800 ultrasound system’s Contrast Vector Imaging (CVI) feature, joining the system’s Liver Analysis Suite, improving performance related to Liver hemodynamics and contrast enhanced ultrasound.
- Ultrasound – Canon’s Aplio i-series ultrasound line welcomed “the industry’s first” 33 MHz linear transducer probe (features iDMS and single crystal wide band, 50-micron resolution) for imaging just below the skin.
- IT – Canon unveiled its Collaborative Imaging program, integrating multiple modalities with clinical applications and providers’ IT systems across the “scan, diagnose, share, and analyze” steps of the patient journey.
Philips Shows off its Latest at RSNA
After a busy year of launches, Philips was a bit more targeted with its RSNA-specific announcements, showcasing a number of new systems and technologies that were announced in recent months (Ingenia Ambition 1.5T MR, IntelliSpace Discovery 3.0, Pinnacle Evolution, Ultimate Ultrasound for Breast Solution) and introducing several products for the first time.
- Informatics – Philips expanded the business management capabilities of its IntelliSpace Enterprise Edition informatics platform with the addition of PerformanceBridge, which features a suite of solutions to help optimize operational and workflow efficiency, and “bridges the gap between data and decision.”
- Radiography – Philips unveiled its next-generation premium ceiling-mounted DR system, the Philips DigitalDiagnost C90 (available in EU, FDA-pending), inheriting many of the features of the DigitalDiagnost 4.0x while adding a new live camera to support patient positioning and reduce re-takes.
Siemens Healthineers Expands Portfolio, Embraces AI at RSNA 2018
Siemens Healthineers had another incredibly active RSNA, making big updates to its MRI and DR line and introducing a number of new AI-based solutions.
- MRI – Siemens officially launched the MAGNETOM Altea 1.5T and the FDA-pending MAGNETOM Lumina 3T 70-cm MR systems, bringing BioMatrix technology (patient personalization/positioning tech) downstream to its “broad market” MRIs for the first time. The new system also adds Siemens’ Turbo Suite (up to 50% faster exams), Innovision (in-bore infotainment option), and Tim 4G and Dot (automates reproducible scan procedures) technologies, plus an optional dockable table.
- MRI – Siemens Healthineers launched upgrades to its 60-cm MAGNETOM Amira 1.5T MR scanner intended to improve scan result consistency and productivity including new Compressed Sensing applications (dynamic imaging for patients who struggle holding their breath) and Turbo Suite applications (up to 50% faster exams).
- Mobile X-Ray – Roughly a month after launching in Europe, Siemens Healthineers’ Mobilett Elara Max mobile X-ray made its US debut, updating the high-end of its mobile radiography lineup. The new system launches with an emphasis on its non-imaging feature set including its easy-to-clean surface, strong security capabilities, maneuverability and positioning advantages, and its technological consistency with other Siemens X-ray systems.
- Floor-Mounted X-Ray – Although far from a new segment, Siemens Healthineers FDA-pending Multix Impact floor-mounted DR system could play a strategic role for the vendor. The “affordably priced” system (floating flat table, in-room touch UI, positioning camera) fills a hole in Siemens’ X-ray lineup that could help it sell to smaller hospitals and clinics, but perhaps more importantly better-support smaller locations within larger healthcare system.
- CT AI – Siemens Healthineers unveiled its new AI-Rad Companion Platform, a very purposefully-named new AI platform intended to streamline radiologists’ workflows (and definitely not steal their jobs). The new AI-based platform’s first solutions will be the AI-Rad Companion Chest CT AI assistant (FDA-pending, automates CT image visualization and creates structured exams) and the AI-Pathway Companion (in-development, clinical decision support system along clinical pathway), although more Companion solutions are surely coming.
- Mammography AI – Siemens Healthineers previewed a forthcoming version of its syngo.Breast Care mammography reading and reporting software, featuring its new SmartSort AI-based decision support software, designed to sort and score cases automatically. The software was developed in collaboration with Dutch image analysis developer ScreenPoint Medical, following a Series B investment from Siemens in June.
- Remote Viewing – Siemens Healthineers unveiled its new syngo Virtual Cockpit solution, which allows experienced technologists to remotely view and support onsite personnel during imaging procedures (Siemens’ CT, PET/CT, MRI, PET/MRI), allowing healthcare providers to address personnel shortages and logistic bottlenecks, improve standardization, and support training. syngo Virtual Cockpit solution does not require FDA clearance, streamlining its US rollout, but its international availability is not confirmed.
- A team of New York area researchers set out to prove that CT Colonography (CTC) screening is less expensive than optical colonoscopy (OC), and did just that. Pulling data from 28 million US medical claims (all in 2016), the researchers found that CTC’s cost per screening year was at least 22% below OC screening ($265 vs. $340) and could be as much as 50% lower, due largely to CTC’s elimination of anesthesia and low pathology needs. There are surely arguments on both sides of this, but if CTC could reduce costs and improve screening rates, it may deserve a larger role in the colon cancer screening process (at least larger than its <1% share as of 2015).
- Amazon’s push into healthcare took another step into clinical environments this week. Amazon Comprehend Medical is a new healthcare extension of AWS’ Comprehend natural language processing service that mines EMRs for unstructured medical text to more accurately diagnose diseases (including pulling from radiology reports, as well as just about every other department). This one may be lost amid the RSNA noise, especially because it 1,750 miles away in Las Vegas, but it could solve a lot of problems across the healthcare ecosystem and help bolster Amazon’s role as healthcare’s go-to cloud provider.
- United Imaging Healthcare (UIH) made its US debut this week, putting the $500 million that it raised in the last year to use, with a big, bright, and centrally-located RSNA booth (right across from a German startup named Siemens Healthineers). More notably, the company announced the establishment of its U.S. headquarters and manufacturing facility in Houston, proclaiming that they “are officially open for business in the United States!” It’s not every day we see a new player come into the hardware side of the industry, but we’re already seeing some interesting innovations from UIH and their push into the US (and globally) is worth keeping an eye on.
- Mega practice, MEDNAX, launched an AI incubator that combines two of its major assets (radiologists and radiology data) with a group of 15 technology partners to support AI innovation and product development. MEDNAX’s DIY approach to AI is interesting, and given its industry role and the capabilities of its vRAD subsidiary, this incubator model is worth monitoring.
- About seven months after launching with the goal of becoming “the premier physician-owned radiology partnership in the country,” US Radiology Specialists announced its partnership with Denver-based Diversified Radiology (65 physicians). The highlight of the deal is Diversified Radiology’s teleradiology capabilities, allowing US Radiology Specialists to provide 24-hour support, while also expanding the growing firm to Colorado.
- Nuance’s RSNA showcase was highlighted by the launch of its next-generation PowerScribe One radiology reporting platform, adding new AI and decision support tools to the dominant platform. PowerScribe One’s enhancements place a specific focus on addressing efficiencies related to inconsistent recommendations and failed follow-up, leveraging a range of technological and process improvements to do so.
- A team of Stanford researchers presented evidence that artificial intelligence may allow clinicians to reduce Gadolinium dosage with MRI scans, without sacrificing imaging quality. The researchers collected three sets of images from 200 patients (zero-dose scans; “low-dose” 10% Gadolinium scans, and “full-dose” 100% Gadolinium scans), and were able to achieve similar image quality with trained algorithm-enhanced “low-dose” images as they achieved with the “full-dose” non-AI scans.
- Hyland Healthcare announced upgrades to its NilRead Universal Viewer and Acuo VNA, while debuting its new ImageNext enterprise workflow orchestration platform that’s due to launch in early 2019. NilRead Universal Viewer and Acuo VNA boast a pretty long list of upgrades that you can dive into on the press release, while the new ImageNext platform is highlighted by its universal worklist, support for multiple PACS and centralized VNA deployments, intelligent case routing and workload balancing, and diverse list of system configurability options and analytics tools.
- Intelerad acquired Clario Medical, adding the company’s zero-footprint worklist to its enterprise imaging portfolio and revealing plans to leverage Clario’s Seattle headquarters to strengthen its US presence and its relationships with cloud providers.
- Strategic Radiology expanded to the Wisconsin and Connecticut markets, adding Radiology Associates of Appleton (Appleton WI, 24 radiologists) and Naugatuck Valley Radiological Associates, PC (Waterbury CT, 13 radiologists) to its consortium that now includes 26 private radiology practices and over 1,100 radiologists.
The Resource Wire
– This is sponsored content.
- 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.