Nanox Goes Big | X-Ray Mutations | Radiology-as-a-Service

“Hold on to your exclamation points. Machine-enabled health care may bring us many benefits in the years to come, but those will be contingent on the ways in which it’s used.”

Wired.com with a reminder that the benefits of AI will rely on targeting the right problems.



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The Imaging Wire

Nanox Lands Foxconn, Dreams Big

Nanox Imaging landed $26 million in funding from manufacturing giant, Foxconn, that it will use to finalize and commercialize its novel digital X-ray system. Startup funding stories like this are rarely featured at the top of The Imaging Wire, but Foxconn’s big name and Nanox’s big ambitions are worth the attention.

Big Name Backers – Foxconn joins Fujifilm and SK Telecom on Nanox’s list of big-name backers, who’ve contributed a combined $55 million to the Israeli X-ray startup. Although this number falls short of the $1 billion in R&D that Nanox previously highlighted (likely aggregated across the industry), the financial and industry clout of its backers is notable.

The Nanox System – Combining its Nanox.ARC digital X-ray device and Nanox.CLOUD AI-based software, The Nanox System hits on many of the major industry focus areas for scanning hardware (small size, low cost, low voltage, fast scans) and imaging workflow (image repository, radiologist matching, online / offline diagnostics review & annotation, connectivity to diagnostic AI, billing, and reporting). Not to mention the fact that the Nanox.ARC X-ray is “inspired by Star Trek’s famous biobed” and they are so similar “that differentiating between the two medical systems is no easy feat.” That’s right…

Medical Screening As A Service – Nanox also introduced plans to commercialize the Nanox System through a Medical Screening As A Service (MSaaS) model, charging its provider customers on a pay-per-scan business model (vs. hardware and service). Nanox sees the MSaaS model as a crucial part of its plan to make early detection accessible worldwide.



X-Ray Mutations

Dutch researchers found that low doses of radiation, comparable to X-ray dosage, causes mutations in lab-grown human cells. Here are some details:

Low Dose Mutation – The scientists exposed human cells to radiation dosage comparable to the “upper range of common diagnostic procedures,” finding that the radiation created breaks in human cells that allowed additional DNA to enter the chromosome.

What that Means – Although these low dose cellular mutations may not mean that X-ray scans are harming humans, it does reveal that science still doesn’t totally understand how radiation affects the human body. It also suggests that more studies are warranted.



Radiology-as-a-Service

A new post from Frost & Sullivan forecasts a shift towards a “Radiology-as-a-Service” imaging system procurement model, driven by major changes taking place across the healthcare industry. Here are the main takeaways:

The Value-Based Shift – The adoption of value-based care (VBC) has introduced major changes in care delivery, increasing expectations that the cost of medical products and services are in line with care improvements. The $250 billion global medical imaging industry (12% of which is hardware) is definitely exposed to the VBC trend, prompting Frost & Sullivan to predict that imaging hardware will shift from its current capital-intensive structure, to a hybrid model, and finally to an ‘as-a-service’ operational expense model within the next 10-12 years.

Equipment Selling to Service – Hospitals and clinics operating within VBC systems are struggling to acquire imaging equipment through a traditional procurement model due to a range of challenges (VBC requirements, financial constraints, complicated procurement process, lack of expertise in managing imaging tech), forcing administrators to consider imaging ‘as-a-service’ models. Rather than purchasing imaging systems outright, these providers would partner with imaging vendors who would provide them an equipment and service package paid for on a per-use or a periodic basis.

What’s in it for Imaging Vendors? – Growth. Frost & Sullivan suggests that “traditional product selling is no longer an avenue for long-term growth” for imaging vendors as hospitals scale back spending on capital intensive equipment, while long-term as-a-service agreements will give imaging vendors more cross-selling opportunities. However, imaging vendors will miss out on the traditional revenue boost that they are accustomed to after a big system deal.


The Wire

  • New research from Yale found that when imaging order change requests are built into the EMR, radiologists request changes on 2.9% of CT orders and 5.2% of MRI orders (n = 79,310 outpatient studies, 2,865 change orders) and the requests are “well accepted by ordering providers” (82% accepted change orders). Change orders were most commonly due to improper contrast media (76% CT, 65% MRI), followed by changes from “with and without contrast” to “contrast-only” for CTs (39%) and from “with and without” MRI contrast to “without contrast” for MRIs (26%), generally leading to lower CT radiation exposure (51%) and less costly exams (CT 67%, MRI 48%).
  • Wired weighed in on Google’s recent breast cancer screening model, warning that by applying AI to mammography screening it risks making “bad medicine worse.” At first glance the article comes off as a criticism of AI (and it did have plenty of critiques), but the article really was about using AI to automate/expand healthcare practices that might not actually be beneficial for patients like breast cancer screening (early detection vs. radiation, incidental findings, excess treatment). Although plenty of folks would disagree with Wired’s premise that breast cancer screening is a “deeply flawed medical intervention,” it’s a fair argument that AI’s value will rely on having algorithms target the right problems.
  • Two teams of scientists at Columbia University and University of Turku in Finland are simultaneously developing two-person MRI scanners (w/ specialized head coils, unique poses) intended to measure the role of social interactions on neural activity. Although fMRI research is far from new, the fact that current studies rely on photos and recordings (not real social interactions) makes it “reduced and artificial” and these new systems may reveal new insights on how the brain works.
  • A letter from the ACR to the Centers for Medicare and Medicaid Services expressed concerns that the “loosening” of supervision requirements for PAs and other non-physician practitioners (NPPs) could lead to safety and quality issues if these mid-levels are allowed to perform image interpretation. The letter comes in response to a presidential order focusing on improving senior care and argues that all NPPs should work under direct supervision of on-site physicians, no NPPs should be allowed to interpret images, and CMS should not give states the autonomy to set their own laws regarding NPP image interpretation.
  • A report from IMV Medical Information Division detailed on AuntMinnie.com revealed that MRI procedure volume in the U.S. reached a record 42 million procedures in 2019, following 8% procedure growth in both 2018 and 2019 and a notable slowdown between 2004 and 2017. IMV finds that MR administrators expect more MRI procedures in 2020, warning that it may strain workflow, while also driving demand for workflow-improving products and services.
  • Chuck Norris and his wife Gena voluntarily dismissed their $10 million lawsuit against Bracco Diagnostics that alleged Bracco’s MultiHance MR agent gave Gena Norris gadolinium deposition disease after she underwent several MRI scans to confirm whether she had rheumatoid arthritis (she didn’t). This is actually the second Imaging Wire issue to cover Chuck Norris, coming just a year after the Hollywood tough guy and health advocate spoke out against the role of EHRs on physician burnout.
  • A new report from KLAS found that of 113 healthcare organizations with enterprise imaging, 69% have achieved progress in their enterprise imaging strategy since 2018 due to the addition of new components (service lines, VNAs, universal viewers) and/or the addition of new sites (new hospitals or imaging centers). KLAS found that 89% of the organizations have both a VNA and a universal viewer (vs. 55% in 2018), while image access through VNA and a universal viewer increased by 20%.
  • Swiss researchers found out that a radiology e-learning system with “gamification” elements can help improve diagnostic confidence, reduce error rates, and can be fun too. The study provided 59 participants (med students, radiology residents, technicians) with an e-learning system featuring gaming levels designed to detect pneumothorax. A pair of surveys performed before and after using the e-learning system (59 completed first survey, 29 second survey) revealed improvements in diagnostic confidence in pneumothorax detection (mean 4.3 ± 2.1 to 7.3 ± 2.1, on 1-10 scale) and error rates (39% to 22%), while 93% indicated that they would use the system for educational purposes again and 87% indicated that they had fun using it.
  • Hyland Healthcare announced the launch of PACSgear Video Touch 4K, a new addition to Hyland Healthcare’s PACSgear MDR-Video Touch family that allows clinicians to capture videos and images from visible light modalities (endoscopy, microscopy, photography) and associate them with the correct patient record on archive systems.
  • ENDRA Life Sciences renewed its collaboration agreement with GE Healthcare through 2021 (it started in 2016) as ENDRA works towards commercializing its Thermo Acoustic Enhanced UltraSound (TAEUS) technology this year. GE Healthcare will introduce a TAEUS technology fatty liver application to its clinical ultrasound customers in return for rights to manufacture and license the technology.
  • UChicago Medicine will use Life Image’s Mammosphere solution to improve patient access to their prior breast health records and to recruit participants for its WISDOM study intended to develop optimal screening guidelines. Mammosphere is a digital tool that creates a longitudinal view of the individual patient’s breast history to track changes over time and allows women to request, store, and share their breast health records. It will also provide the historical medical records that are needed to support the WISDOM study.

The Resource Wire

– This is sponsored content.

  • Did you know that India is home to 1/4th of the world’s TB cases? In this video, Qure.ai’s Prashant Warrier takes to the TEDx stage to discuss how the company is changing the country’s TB screening process to solve this problem.
  • The GE Healthcare Venue Go features a uniquely adaptable design, a simple interface, and streamlined probe layout so you can go through your day quickly, efficiently, confidently.
  • The Scottish government is considering adopting focused ultrasound to treat essential tremor. Read how patient advocates are helping make this happen.
  • By partnering with Medmo, imaging centers can keep their schedules full, their equipment busy, and increase revenue. Here’s where to get started.

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