“I think that we are seeing POCUS evolving more rapidly than any other EMS technology in the past,”
– Thomas Hudson, a flight paramedic with Guardian Flight from Fairbanks, Alaska, on the significant expansion of prehospital point-of-care-ultrasound that he’s witnessed.
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
A recent article on the EMS and paramedic news site, ems1.com, detailed the emergence of prehospital point of care ultrasound (P-POCUS) as one of top EMS trends of 2018. The article attributes P-POCUS’ emergence to the increasingly sophisticated role of paramedics, an influx of P-POCUS education programs, and the growing number of available POCUS devices (in increasingly small form factors). As we head into 2019, ems1.com suggests we’ll see P-POCUS usage expand from early adopters towards mainstream members of the EMS community, although a lot more adoption has to happen before P-POCUS becomes truly mainstream.
McKinsey Follows the Money
The ACR published some pretty interesting research from McKinsey & Company, using the focus of radiology-related imaging startups (n=146) and the value of their VC funding as evidence of how the medical imaging landscape is changing, now and into the future. The usual suspects lead the technology side of this landscape change, specifically AI and ML “Paradigm Shift” companies (32 startups, $555m funding) and blockchain and cloud-based “Distributed and Secure” technology companies (27 startups, $265m funding). On the medical side, there is a major startup focus on “Real Time & Improving Imaging” (e.g. 3D & MR, intraoperative, nuclear & hybrid; 46 startups, $704m funding) and “Incremental Improvements & End Point Solutions” (e.g. portability, telemedicine, 3d printing, etc.; 41 startups, $341m funding). The study is pretty detailed and has some helpful visuals, making it worth a look for those interested.
Is That What Xi Said?
It’s been hard to tell what really happened during President Trump and Chinese President Xi Jinping’s tariff-negotiation dinner at the G20 summit. The President left the dinner claiming they reached an “incredible” trade deal, before Chinese officials and White House staff revealed there is much more work to be done. The good news for those against the tariffs is we’re a few days into a 90-day truce that will at least delay the US’ plan to raise tariffs on $200 billion in Chinese products to 25% from 10% (originally scheduled to go live on January 1). The bad news is that medical imaging imports from China are still subject to significant tariffs and the consensus on Wall Street is we’re pretty far from a resolution.
AI’s Big Impact on Pathology
A recent article on Spectrum IEEE began by detailing the ways that a pathologist could accidentally kill “you,” suggesting that “an artificially intelligent pathologist probably wouldn’t make that mistake.” This attention-grabbing hook set up Spectrum IEEE’s lengthy argument that artificial intelligence will have a greater impact on pathology than any other part of medicine, including radiology. The article suggests that while medical imaging AI mainly “automates” human tasks, pathology AI will achieve a beyond-human level of diagnosis due to its ability to tie together biochemistry, immunology, and genetic data. The promise of AI in pathology is well-known at this point, and there is plenty of money flowing into pathology AI as a result. This article is a good reminder to radiology folks that AI may be poised to make a big impact across much of the key diagnostic areas of healthcare.
A pair of radiology professors from Indiana University School of Medicine took a stand against the growing pressure that radiologists are facing to standardize the language they can use in reports. The professors took a fittingly literary approach in their editorial, suggesting that although the intentions behind this push may be good, “efforts to control their speech and thought” may have “Orwellian” consequences. The professors argued that by constraining the words radiologists can use, it will also limit their ability to recognize and share new ideas and exacerbate the frustration radiologists have felt since the adoption of EHRs and their “rigid and ill-fitting templates.”
- Women as young as 30 years old with dense breasts or a personal/family history of breast cancer may benefit from mammography screening. That’s from a recent study of over 5.7 million mammograms that found that women in their 30s with at least one of these three main breast cancer risk factors showed similar cancer detection and recall rates as 40-to-44-year-old women with “average” risk factors.
- Fujifilm and Korean medical imaging AI developer, Lunit, announced a joint collaboration with major Mexican diagnostic service provider, Salud Digna (94 clinics, 24 states). The pilot project will integrate Lunit’s INSIGHT chest radiography and mammography solution with Fujifilm’s REiLI AI platform (part of its Synapse 5 PACS) at multiple Salud Digna facilities, with the goal of getting feedback to apply to future AI development efforts. Fujifilm will also use the project to evaluate new AI-based worklist prioritization features within Synapse 5 PACS.
- Italian researchers found that persistent lower-back pain can be treated with CT-guided pulsed radiofrequency (pRF), which involves applying 10 minutes of pulsed energy directly to nerve roots at the site of an injury. The researchers treated 128 patients with lumbar disk herniation using CT-guided pRF and another group of 120 patients with CT-guided steroid injections, with 95% of the pRF group remaining pain-free a year later compared to 61% of patients from the steroid injection group.
- NVIDIA’s medical imaging AI business took several big and highly-anticipated steps last week. The company officially launched its Clara medical imaging AI platform (previously available to early access partners), while adding a pair of new SDKs to streamline medical imaging AI development, and announcing partnerships with The Ohio State University (building an AI marketplace) and the NIH (investigating if AI can streamline trials).
- Changes to the FDA’s De Novo classification pathway may lead to faster and lower-cost clearances for certain low-risk Class I and Class II medical devices, while helping make the process more transparent and predictable for manufacturers. Ongoing efforts to streamline the De Novo process have led to increased clearances in recent years, but it’s still viewed as difficult and costly, especially for novel devices.
- Subtle Medical announced the FDA 501(k) and CE clearance of its SubtlePET solution, making it the first AI product intended for medical imaging enhancement to be cleared by the regulators. SubtlePET accelerates PET scan times four-fold and can reduce PET radiation dose by up to 75%, providing a solid value from a productivity and patient care perspective by focusing on AI-based image acquisition and workflow (vs. most AI systems’ focus on post-processing and CAD). Subtle Medical has more on the way, including SubtleMR to accelerate MR scans (in clinical trials) and SubtleGAD to reduce gadolinium dosage (in development).
- RSNA brought evidence that gadolinium accumulation may be more prevalent than many previously believed. Using PACS/RIS data from 3,021 patients (who received 11,922 MRI scans), the researchers found significantly higher signal intensities in different parts of the brain depending on whether the patient previously received linear (intensities in brain dentate nucleus and globus pallidus) and macrocyclic (intensities in brain nuclei) GBCAs, although linear GBCAs had an estimated increase of 0.23 (p = 0.006) versus macrocyclic GBCAs’ 0.06 (p < 0.001) increase.
- Just three months after opening for business, Illinois-based medical imaging sales and service company, HealthMed360, acquired its second imaging equipment parts company. HealthMed360 will integrate Ohio-based Prime Medical Imaging Solutions (CT, MRI and PET/CT parts), which combined with its previous acquisition of Vector Medical Imaging, should give the new company a solid parts operation to complement its service offering.
- Guerbet officially launched the second generation of its Contrast & Care contrast media management solution, which works with all of Guerbet’s injectors, and allows imaging centers to collect and share injection data to help with patient care. The new version adds cloud service support for installation, updates, and maintenance.
- HeartVista announced the launch of its One Click Autonomous MRI Solution, which integrates with existing MRIs, and uses AI-guided image acquisition to complete cardiac ischemia exams in less than 15 minutes (vs. 90 minutes), with one click. The company claims that One Click lowers adoption barriers, reducing patients’ required breath holds and discomfort, while simplifying exams for technologists.
The Resource Wire
– This is sponsored content.
- If you couldn’t make it to Chicago, here’s a video tour of Carestream’s RSNA18 booth, introducing the latest in the company’s healthcare IT, DR, digital output, and 3D imaging lineups.
- It all starts with research. This video details why the OpenMarkets platform is the smarter way to shop for medical equipment, providing insights, specifications, photos, and case studies on over 30,000 products.
- Focused Ultrasound Foundation-funded researchers had a big October, with breakthroughs in brain navigation, cancer treatment (breast, liver, and lung), and veterinary applications.
- 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.
- 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.