“When the era of Imaging 4.0 arrives, it will be characterized by a human-centric approach to augmentation, wherein smart humans, who are caring and emotional, leverage smart machines to provide high-value, superhuman patient care.”
A Baylor Radiology team on the next frontier of imaging, or as they call it, Augmented Radiology.
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
Medical Schools Are Getting It All Wrong
Thomas Jefferson University and Jefferson Health CEO, Stephen Klasko, came out with some strong words against the way medical schools are doing just about everything. Klasko suggests med schools are “still choosing students who can reel off organic chemistry compounds, rather than screening for qualities like critical thinking, entrepreneurship and empathy,” then forcing them to competitively memorize information for years (vs. collaborate and understand), before eventually “sucking the creativity” out of tomorrow’s doctors. The executive believes med schools need to change their recruitment process to better match tech giants like Google and he’s trying to do just that at Thomas Jefferson, such as focusing on problem solving skills and emotional intelligence rather than traditional interview criteria and seeking talent from atypical undergrad programs (e.g. humanities departments, design universities, and drama schools). Although there may be room for a middle ground between these two extremes, we’re seeing a similar recruiting approach at Mount Sinai, Yale, and Stanford, and there is a strong argument that the advancement of AI will make interpersonal skills far more important than memorization skills in the future.
Q4 Imaging Financials Off to a Positive Start
The first round of medical imaging company financials from the October-December 2018 period hit the press, revealing solid results from Canon, GE, Hologic, Philips, and Siemens, but mixed-to-poor results from Hitachi, Konica Minolta, and Samsung. Here’s how Q4 worked out for these companies:
- Canon – Canon’s Q4 brought a 5.5% revenue decline to ¥1.058 trillion ($9.6b), but the Japanese imaging giant can feel good about its hefty 31% net income improvement to ¥71.7 billion ($652.6m) in Q4, helped by strong office printing profitability. Canon Medical scored a solid Q4 performance, with 14% revenue growth to ¥118.2 billion ($1.07b) and 83% operating profit growth to ¥8.8 billion ($80m), marking its third straight quarter of strong medical OP growth.
- GE – An above-expected Q4 performance (overall Q4 revenue +5% to $33.3b, net earnings up $5.5B to $0.9B) sent GE’s stock surging up 11%, driven in part by strong Aviation revenue and profit growth, while GE Healthcare remained strong and stable (revenue +2% to $5.4B, profit +2% to $1.2B).
- Hitachi – Hitachi’s Q4 revenue fell slightly to ¥2.291 trillion ($20.8b) and its net income fell to a ¥91.3 billion loss ($831m loss, vs. $1.2b profit). As usual, the company did not disclose financials for its healthcare business, although it did say that healthcare achieved increased revenue and operating profit.
- Hologic – Hologic’s fiscal Q1 brought a 5% revenue increase to $830.7 million, driven in part by a 12.6% increase in breast health sales to $252.6 million (the highest in three years), while profit plummeted from a tax-aided $406.7 million last year to $98.6 million.
- Konica Minolta – Konica Minolta’s fiscal Q3 saw a 1% drop in revenue to ¥260.5 billion yen ($2.37b) and an 84% jump in operating profit to ¥15.9 billion yen ($144.7m). However, its healthcare segment struggled with a 13% revenue decline to ¥20.9 billion yen ($190m) and a 65% drop in operating profit to ¥300 million yen ($2.7m), due in part to strong 1-time sales last year.
- Philips – Driven by 5% comparable revenue growth in its Diagnosis & Treatment business (and particularly its image-guided products) to €2.201 billion ($2.5b), Philips achieved 5% overall comparable sales growth to €5.586 billion ($6.36b) in Q4, while operating income increase by 6.3% to €769 million ($879m).
- Samsung – Samsung Electronics’ Q4 2018 brought a 29% drop in operating income to KRW 10.8 trillion ($9.6 billion) and a 10% revenue decline to KRW 59.27 trillion ($52.7 billion), as revenue fell across every business segment including its important semiconductor business. Samsung’s financial announcements provide little insight into the performance of its medical business, although its Consumer Electronics division (which somehow includes healthcare) fell by 7% to KRW 11.79 trillion ($10.5 billion)
- Siemens Healthineers – Siemens Healthineers’ fiscal Q1 brought decent revenue (+2.5% to €3.3b/$3.7b) and net income growth (+11% to €345m/$394m), helped by a 3% increase in imaging sales to €2.02 billion ($2.31b). The imaging business also achieved a 40bps adjusted profit improvement to €404m (20% margin, $461m) and achieved strong CT and molecular imaging sales.
Self-Compression: Less Pain and Equal Quality
A team of French researchers found that when patients perform self-compression during their mammography scans it does not increase pain or result in inferior image quality, providing even more evidence that self-compression is a helpful way to encourage patients to attend their screening appointments. The study looked at 548 French women who attended screenings (50-70yrs, 275 self-compression, 273 standard), finding that the self-compression group applied more force than the standard group, but reported less pain and no difference in image quality. News of this study made it beyond radiology and breast health circles, and for good reason, as the psychological advantages of self-compression were already largely proven and are further bolstered with this image quality evidence. This can also be seen as good news for GE Healthcare, which has invested in positioning itself as the self-compression technology and branding leader, and as a result has a solid patient-centric breast health story to tell.
- Siemens Healthineers’ re-entry into the Canadian ultrasound market took another step forward last week when the company licensed its Acuson Sequoia system to Health Canada, coming just a month after the Acuson Juniper brought Siemens back into the Canadian US market. The Acuson Sequoia is highlighted for its performance with overweight patients (can penetrate up to 40cm) and combines with the Acuson Juniper to give Siemens Canada a pretty competitive high-end ultrasound portfolio, although previous statements suggest that the company is just getting started at building-out its Canadian ultrasound lineup.
- A team of Columbia University and UCI scientists developed a CNN algorithm that is able to accurately predict breast cancer molecular subtypes based on breast MRI images, potentially allowing for more personalized treatment plans. The algorithm used pre-treatment MRI images and immunohistochemical staining pathology data from 216 patients with known breast cancer (40 patients used for testing), predicting subtype with 70% accuracy (AUC = 0.871, sensitivity = 0.603, specificity = 0.958). They also suggested that more images would further improve the algorithm’s accuracy.
- The Australian government announced plans to spend an additional $150 million AUD on 20 MRI licenses for the country’s Medicare-eligible facilities, increasing its total MRI investment since September 2018 to $375 million AUD and 50 MRI licenses. The announcement concludes what was called a “political arms race” that won’t reduce actual scan costs, following MRI funding pledges from both the standing Liberal National Government (who made this investment) and the opposition Labor Party.
- A team of South Korean researchers trained a recurrent neural network (RNN) algorithm to classify important findings in unstructured radiology report text in EMRs, potentially making large scale retrospective studies more efficient. The researchers used 3,032 sentences pulled from a full year’s worth of musculoskeletal radiography exams, building an RNN-based system to automatically identify fracture and non-fracture cases with just a 1.03% error rate.
- Philips announced a collaboration with MIM Software that will integrate the companies’ radiation oncology solutions, specifically combining Philips’ radiation oncology imaging systems and treatment planning software with MIM Software’s oncology imaging, automation, and data analysis solutions. Philips has made partnerships like this a big part of its radiation oncology strategy, as this new collaboration with MIM Software follows 2018 alliances with Sun Nuclear and Lifeline Software.
- Canon Medical Systems USA launched new FDA-cleared software for its Celesteion PET/CT systems (including new and installed systems) intended to improve workflow and image quality. The software includes a series of new acquisition techniques that largely improve efficiency (Variable Bed Time (vBT), PET Respiratory Gating, PET ECG Gated Scanning) and new reconstruction techniques that improve image quality (Clear Adaptive Low-noise Method (CaLM) +PSF, Single Energy Metal Artifact Reduction (SEMAR)).
- Emergency medicine mobile communication company, Pulsara, announced a partnership to integrate iSchemaView’s RAPID neuroimaging platform with Pulsara’s stroke module, enabling real-time sharing of iSchemaView’s RAPID images with an entire stroke team.
- GE Healthcare announced its collaboration with POCUS website, podcast, and conference host, UltrasoundPodcast.com. Through the partnership, GE will serve as the exclusive POCUS equipment provider for UltrasoundPodcast.com’s conferences and will sponsor one student per month to attend the conferences over the next two years. One of the cool parts of POCUS is that its broad user and application base allows for marketing approaches like this.
- Trivitron Healthcare’s radiology arm, Kiran Medical Systems, unveiled its Elite flat panel digital C-arm (highlights: 1K x 1K flat panel, 16 bit processing, 5 kW, 40 KHz) and its Felicia digital mammography system (highlights: comfort, advanced Cesium Iodide scintillator detector, 77 micron pixel pitch, 5MP resolution monitors) at last week’s Arab Health convention. Like other Kiran systems, 50% to 65% of the systems’ materials and components are made in India, and the new products are expected to mainly target the Indian market, although Kiran also claims a presence in over 165 countries.
- Intelligent Imaging announced an updated version of its Heartbeat DICOM diagnostic and monitoring tool (monitors DICOM devices and integrations for problems), expanding Heartbeat’s monitoring capabilities to include more modalities, adding new mobile support capabilities, and adding the ability to differentiate between a slow system and a down system.
The Resource Wire
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- A new Gallup poll revealed that 13.7% of American adults are uninsured, representing the highest rate since 2013 when it was 18% (before most of ACA went into effect). These are the exact patients who can be helped by the Medmo platform, which connects high-deductible or uninsured patients with radiology centers, ensuring the best value for patients and a profitable revenue stream for imaging centers.
- Carestream cleaned up in KLAS’ 2019 awards, earning Best in KLAS VNA/Image Archive, Best in KLAS PACS Middle East/Africa, and Category Leader in Universal Viewer for the second consecutive year.
- 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 system.
- Focused Ultrasound Foundation-funded researchers at the Ohio State University College of Medicine have begun a clinical trial investigating the use of focused ultrasound to control medication-refractory lobe focal onset epilepsy in adult patients.