“This is gibberish, totally meaningless, a foreign language to me,”
Frustrated potential patient, Sara Stovall, in a recent New York Times story on how federally-required online price lists have fallen well short of their goal to improve healthcare price transparency.
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.
- 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
Visage’s Big Partners Win
Visage Imaging added another big logo to its client list, winning a system-wide enterprise imaging deal with Partners HealthCare. Partners will make the Visage 7 Enterprise Imaging Platform the core component of the Partners Radiology Enterprise Platform (PREP), representing a key step towards eliminating decades-old legacy PACS (Agfa at MGH, GE at BWH, plus others across its network) and allowing system-wide imaging access across the healthcare provider. The Visage implementation is already underway, with planned go live at both MGH and BWH in mid-2019 (that’s really fast compared to similar-size legacy PACS upgrades), followed by a second implementation phase at other Partners network hospitals. Partners joins an increasingly noteworthy list of Visage clients (including Mayo Clinic, Mercy Health, and Yale-New Haven — all of which completed rollouts last year), suggesting that the company’s value proposition is resonating with nation’s largest hospital systems.
Radiology Reading Levels
A pair of studies revealed that most radiology reports are written for advanced reading levels, which is understandable given their writers and traditional audience, but the studies suggest that report language should be simplified as more patients and their families access them. A U Penn study (n=97,052 reports) found that radiology reports are written at a 13th grade mean level, while just 4.2% of reports were written at or below an 8th grade reading level (the US average) and just 0.7% were at or below a 6th grade reading level (the NIH/AMA recommended level). Separate research from Johns Hopkins and the University of Wisconsin looked at 110 lumbar spine MRI reports, finding that the reports were written at a 12th grade mean reading level and only one report was written at or below an 8th grade reading level (0.9%). Given The Imaging Wire’s focus on simplifying complex radiology information, this study isn’t a big shock to us.
Philips Azurion with FlexArm
Philips made a big flexibility upgrade to its Azurion image-guided platform with last week’s launch of the Azurion with FlexArm. Due to the FlexArm’s ceiling mounting, eight-axes design, and image beam rotation technology, the new configuration can image in 2D and 3D from a full array of directions, reducing the need to reposition patients/tables or otherwise shift clinicians’ attention from the patient. This all adds up to a potential to expand procedures, perform procedures with less support, and perform procedures in less time.
No Gambler’s Fallacy
The gambler’s fallacy, also known as the Monte Carlo fallacy, is the mistaken belief that, if something happens more frequently than normal during a given period, it will happen less frequently in the future (or vice versa). This certainly can happen, but the good news is it may not be evident in radiology decision making, at least when reading mammograms. A team of UCSF radiologists reviewed BI-RADS assessments of 8,500 consecutive examinations and found no evidence of gambler’s fallacy, such as an increase in false positives after a streak of negative assessments.
Radiologists reported about “average” levels of burnout compared to other specialties in a recent Medscape report (n=15,069 physicians, 29 specialties), with 45% of radiologists claiming burnout (vs. 44% of all physicians). The report cited high levels of bureaucratic tasks (59% of burnt-out respondents), long hours (34%), and increasing computerization (32%) as the most common burnout contributors, all of which play a role in radiology, although only 45% of radiologists worked more than 51 hours per week (vs. 77% of surgeons, 76% of urologists). This report confirms what many readers already know, that burnout is common in radiology, while providing some useful context that burnout is far more than just a radiology problem.
- “It’s turning into a fiasco.” That’s the New York Times summing-up the new law requiring healthcare providers to post their prices online, reporting that the information is unusable to most patients who are interested in comparing prices or deciphering their out-of-pocket costs. There are a number of contributors to this “fiasco,” but it’s mostly due to the use of confusing formats, high reliance on technical terms, inconsistency between providers, and the use of list prices (not post-coverage prices).
- Massachusetts General Hospital researchers found that a fluoroscopy radiation reduction program (including: monitoring, encouraging lower-dose and shorter-exposure fluoroscopy, suggesting ultrasound alternatives, and reviewing high-Ka,r procedures) helped significantly decrease high-dose procedures over eight years. Analyzing data from the provider’s dose monitoring system (n=41,585 procedures), the researchers revealed that the number of procedures with Ka,r greater than or equal to 5 Gy fell from 1.0% in 2010 to 0.13% in 2017, while procedures with a Ka,r of 2–5 Gy fell from 5.9% in 2010 to 2.0% in 2017.
- Spanish medical imaging company, QUIBIM, announced that its Precision image analysis platform received CE Mark certification as a class IIa Medical Device. The platform is highlighted by its ability to provide both quantitative image analysis and structured reporting, by combing 15 imaging biomarker analysis algorithms, the company’s DataMiner visual analytics software, and a zero footprint DICOM viewer.
- The FDA cleared iSchemaView’s RAPID neuroimaging platform for use in identifying stroke patients who are likely to benefit from endovascular thrombectomy (clot removal), making iSchemaView’s RAPID CT-Perfusion and RAPID MR-Perfusion the only imaging products approved for this use.
- A team of Stanford researchers performed the first human test on a new PET tracer (18F-P3BZA) that could safely detect malignant melanoma and predict radiotherapy outcomes, while overcoming some limitations found with 18F-FDG (false positives, lower tumor-to-muscle contrast). The researchers injected six healthy individuals with 18F-P3BZA, followed by performing whole-body PET/CT scans and blood tests, finding that the new tracer is indeed safe and clearly delineates melanoma tumors.
- Ultrasound AI analysis company, Koios Medical, raised $5 million in a new round of equity financing that will likely be used to fund the development and commercialization of its ultrasound cancer decision support software platform. Koios Medical is still seeking $6 million that would raise the round to $11 million.
- Researchers from RTI Health Solutions and the National Pharmaceutical Council found that rising costs from treating chronic conditions from 1996 to 2015 have been a worthwhile investment in terms of improving morbidity rates and disability-adjusted life-years (DALYs). The researchers revealed notable total cost increases for the study’s seven targeted conditions, but per-person costs for four conditions actually declined (lung cancer, ischemic heart disease, cerebrovascular disease, HIV/AIDS) and the other three only had “moderate increases” (breast cancer, COPD, diabetes), while every condition except COPD saw DALYs improvements.
- A team of UNC and Duke researchers found that stationary digital breast tomosynthesis (sDBT) outperformed mammography for soft tissue interpretation and diagnostic accuracy. In the study, four radiologists reviewed scans from 43 patients who underwent sDBT scans after suspicious digital mammography findings (12 later receiving malignant biopsy results). Each radiologist found sDBT to have significantly greater mean areas under ROC for all breast density categories and breast thickness, while also preferring sDBT for evaluating mass margins and shape, architectural distortion, and asymmetry, although they preferred mammography when characterizing microcalcifications.
- MIM Software announced the FDA 510(k) clearance of its SurePlan MRT molecular radiotherapy dosimetry software, which “provides both quantitative SPECT reconstruction and voxel-based absorbed dose calculation,” to help clinicians measure a patient’s therapeutic radiopharmaceutical absorption.
- UCSD researchers created 3D printed and MRI-based spinal cord “scaffolding,” stuffed with neural stem cells, that was able to promote nerve cell growth in rats with spinal injuries, suggesting that the approach could also help humans. In the rat models, the 2mm spinal implants with dozens of tiny channels successfully supported tissue regrowth, stem cell survival, and expansion of neural stem cell axons out of the scaffolding and into the host spinal cord. None of the researchers were radiologists, and MRI was just one tool used in this process, but this is still amazing and worth sharing.
The Resource Wire
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- Carestream Health was awarded 42 new patents from the U.S. Patent and Trademark Office and 37 new patents in European and Asian countries last year, including patents for extremity CT systems and image quality enhancing-patents across its portfolio.
- The University of Queensland received $10 million in funding from the Australian Minister for Health to support clinical research on a potential Alzheimer’s disease treatment that uses focused ultrasound and microbubbles to open the blood-brain barrier (BBB).
- The POCUS Systems founding team has over 80 years of combined experience in the ultrasound industry.
- The New York Times just revealed widespread confusion over healthcare prices, representing a major barrier for patients trying to shop around for the best value. These are the exact patients who can be helped by the Medmo platform, which connects high-deductible patients with radiology centers, ensuring the best price for patients and a profitable revenue stream for imaging centers