Breast MRI Breakthrough | PE’s Surprise Billing Spotlight | Microwave Imaging

“Nobody wants to defend the insurers.”

An unnamed democratic aide on providers’ inherent advantage in the ongoing surprise billing legislation battle.


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The Imaging Wire

Breast MRI Breakthrough

A potential breast imaging breakthrough made national news this week after a JAMA study revealed that “abbreviated” breast MRI scans outperform DBT among women with dense breasts, while taking far less time than traditional breast MRI.

  • The Study – 1,444 women with dense breasts underwent both abbreviated breast MRI and DBT at 48 U.S. and Germany centers over 13 months. Abbreviated breast MRI detected significantly more invasive cancers (17 women; 11.8 per 1k women) than DBT (7 women; 4.8 per 1k women), while DBT didn’t catch any invasive cancers that weren’t also identified by abbreviated MRI.
  • Abbreviated MRI Benefits – With scan times as short as 8-10 minutes and better performance than DBT, abbreviated breast MRI could be a valid screening option for higher-risk women who haven’t been able to use breast MRI due to traditional cost and time barriers (breast MRI usually 45-60 minutes). The theory is, if imaging centers can increase their breast MRI productivity by 3x or more, they should be able to address both historical challenges.
  • Big Exposure – In addition to widespread coverage in the healthcare press, this study made its way to NPR’s Inside Edition on Tuesday, introducing abbreviated breast MRI and its benefits to about 12 million listeners.



PE in Surprise Billing Spotlight

The role of specialist physicians and private equity-owned physician groups in Congress’ inability to pass surprise billing legislation was in the media spotlight this week. Even if many view these efforts to protect physicians earning potential as justifiable, the coverage wasn’t very flattering.

  • NEJM Targets PE A widely-covered NEJM perspective highlighted the role of private equity in Congress’ “stalled efforts” to end surprise medical billing. After detailing how 2019’s various legislative efforts fell through, the article pointed to opposition “from a shadowy lobbying effort by private-equity–backed physician-staffing companies that profit from out-of-network billing strategies” and suggested that those in Congress who stopped previous legislation “appeared to be influenced by” these PE firms. Although most are optimistic that we’ll solve surprise billing in 2020, the article warns that these “deep-pocketed” groups will continue to interfere if the resolution isn’t in their favor.
  • Dr. LobbyistKHN’s latest exposé on surprise medical billing explored the connection between physician-led political lobbying and politicians’ decisions to side with providers (or at least stall anti-provider legislation). KHN started off by detailing how this is happening at the grassroots level (e.g. physician-led fundraisers for local politicians), but revealed that these grassroots efforts are often actually supported by the physicians’ PE-backed practices.



Microwave Imaging

University of Waterloo researchers developed a new microwave-based breast imaging system that they claim is faster, lower-cost, and safer (zero radiation) than mammography.

  • The System – A prototype of the new system features a flat sensor in a 15 square centimeter box that’s positioned below an opening in a padded examination table, allowing for an under-$5k build cost.
  • Operation – Patients lie face-down on the table, positioning one breast at a time in the exam box. The sensor emits microwaves that bounce back and are then processed by laptop-based AI software that can detect under-1cm anomalies “within minutes.” Patients with positive results would be referred for mammography or MRI follow up exams.
  • Role – The researchers suggest that the system’s low cost and radiation-free operation would allow for more regular screenings and greater accessibility, “reserving much more expensive options for when they’re really needed.”
  • Next Up – This team doesn’t plan to keep their microwave system in academia, as they’ve already filed a patent application, started a company (Wave Intelligence Inc. of Waterloo), and are planning clinical trials. There’s also a similar microwave-based system in the works in Japan.



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The Wire

  • MXR Acquires: MXR Imaging purchased Oxford Instruments’ healthcare division for $15 million, returning MXR (previously known as Merry X-Ray) to acquisition mode after buying at least six companies in 2017 and 2018. The deal expands MXR Imaging’s MRI & CT operations in Florida, California, and Michigan, and is highlighted by the addition of Oxford’s mobile fleet rentals, coil repair, and refrigeration services.
  • DBT AI Funded: A UW School of Medicine radiology professor landed $4.5 million from the NIH to fund his research into using AI to improve breast cancer screening accuracy. With the new funding, the UW team plans to leverage an algorithm that they developed for 2D mammography to create a similar algorithm for 3D mammography screening.
  • Finland’s Adverse Events: Although rare, adverse radiology events do happen and a new study from Finland detailed their most common causes. The study reviewed Finland’s adverse radiology events between 2010 and 2017 (n = 293 included in study), finding that the majority were related to CT and X-ray exams (68.3%, 27.6%) and the events generally occurred because the wrong patient was scanned (32%), an incorrect procedure was performed (30%, including wrong site or side), human errors occurred (20%, e.g. incorrect use of contrast agent injector), or equipment malfunctioned (12%).
  • Emagine’s New US: Emagine Solutions Technology announced the FDA clearance of its smartphone/tablet-connected VistaScan mobile ultrasound platform, which combines a set of probes with VistaScan’s Dynamic Precise Point Measuring System to support on-device measurements and diagnostics. Like other handheld ultrasound systems, VistaScan launches with an accessibility-based strategy that focuses on its low costs and the need for imaging across much of the developing world.
  • Digital PET Advantage: New research from the Netherlands reveals that digital PET can detect smaller lesions than conventional PET systems and produces images that nuclear medicine specialists prefer. In the study, FDG-enhanced PET and digital PET images from 66 patients were reviewed by two nuclear medicine specialists. The specialists spotted 37 lesions in 27 patients with digital PET that wouldn’t have been identifiable with conventional PET and they preferred the digital PET-based images in 65% of cases.
  • Subtle & Incepto: Subtle Medical signed a distribution deal with French AI provider, Incepto Medical, which will offer the SubtlePET PET reconstruction solution through its AI platform. Subtle joins a growing list of AI brands available through Incepto including Qure.ai, ScreenPoint, and Aidence.
  • Pneumonia Ultrasound: A team of Turkish researchers found that bedside lung ultrasound (LUS) is a reliable method for pneumonia diagnosis and could be a viable first line option in emergency settings. In a study of 127 patients with suspected pneumonia (101 later diagnosed), LUS achieved respective sensitivity and specificity of 98.0% and 95.8% (comparable to CT, better than X-ray) and correctly indicated pneumonia in 97 of the 101 positive cases.
  • 5G Imaging: Verizon and Emory Healthcare announced a partnership that will support the Emory Healthcare Innovation Hub (EHIH) with Verizon 5G service, creating the “nation’s first 5G health care innovation lab.” EHIH’s addition of 5G will allow it to explore a range of new healthcare solutions, including “next-generation medical imaging” solutions and emergency imaging that spans from the ambulance to the ER.
  • AI Peer Reviewer: An AI peer review tool can help radiologists diagnose ICH and reduce false negative errors. That’s the conclusion from a new Yale study that used an FDA-approved AI solution to assess non-contrast CT scans that were initially found to be negative for ICH (n = 5,585). The AI solution identified 28 previously-negative cases that might have ICH, 16 of which were later confirmed to be positive by three neuroradiologists.
  • More Coronavirus Support: United Imaging and Samsung both announced new efforts to support China’s coronavirus fight. United Imaging announced the installation of new Emergency Radiology Departments (modular, transportable, workflow-connected CT rooms) for use in China’s pop-up mobile cabin hospitals, while donating another $14 million worth of devices and services to help fight the disease. Meanwhile, Samsung NeuroLogica accelerated its mobile CT production to meet growing demand from China, noting that it already received an order for 10 BodyTom CT scanners.
  • CurveBeam AI: CurveBeam launched its new CubeVue Autometrics AI platform, which uses images from its weight-bearing CT system to automatically segment and identify complex foot and ankle bone structures. The partner-developed tool was trained using 300 datasets of healthy feet and ankles and taught to account for typical variations in anatomy (e.g. accessory ossicles).

The Resource Wire

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  • UPenn radiologist and Radiology Twitter star, Suarabh Jha, MD’s second installment on thehealthcareblog.com walked through all the discoveries that happened along Qure.ai’s path towards developing their qXR solution for TB screening.

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