CV19 Imaging Update | The First US Biosensor

“Boom, argument done. CT sucks.”

Dr. Luke Oakden Rayner on using CT to diagnose COVID-19.


Imaging Wire Sponsors

  • Focused Ultrasound Foundation – Accelerating the development and adoption of focused ultrasound.
  • GE Healthcare – Providing point of care ultrasound systems, from pocket-sized to portable consoles, designed to support your clinical needs and grow along with your practice.
  • Healthcare Administrative Partners – Empowering radiology groups through expert revenue cycle management, clinical analytics, practice support, and specialized coding.
  • Nuance – AI and cloud-powered technology solutions to help radiologists stay focused, move quickly, and work smarter.
  • Qure.ai – Making healthcare more accessible by applying deep learning to radiology imaging .
  • Riverain Technologies – Offering artificial intelligence tools dedicated to the early, efficient detection of lung disease.

The Imaging Wire



The Latest on COVID19 Imaging

It was another big few days for COVID-19 imaging as more dedicated CV19 imaging products began to emerge, CV19 imaging opinions got a bit stronger, pandemic prep started to have a major impact on overall imaging volumes, and CV19-related federal policy changes made their way to practices. Thanks to all the fighters.

  • Qure.ai’s COVID-19 Solutions – Qure.ai joined the coronavirus fight, expanding its qXR chest X-ray interpretation solution and launching its new qSCOUT smartphone app. In addition to qXR’s standard range of automated chest X-ray interpretations (e.g. TB, COPD, lung diseases & emergencies), the solution can now detect signs of COVID-19 in X-rays and quantify how patients’ lungs are affected. Meanwhile, the new qSCOUT app allows frontline CV19 workers to register COVID-19 patients and their contacts to support public health management efforts.
  • Imaging Cancelled – As the ACR, CDC, and Susan Komen all called for providers to cancel/postpone non-urgent imaging, we quickly started to see these policies make their way to major hospitals including Mercy, Brigham and Women’s, NY Presbyterian, and UCSF. This feels like the right thing to do, but the radiology volumes created by COVID-19 patients definitely aren’t making up for these cancellations/postponements. For example…
  • Pent Up ImagingAidoc reported that COVID-19 is quickly driving down imaging volumes, as its data shows that last week’s CT volume was 20% lower than the same week in February, including a 39% drop in Europe and a 20% drop in the U.S. However, Aidoc suggests that this backlog of CV19-postponed scans is going to create future bandwidth challenges as providers address their imaging backlog in the coming months.
  • CT is Awful for COVID-19 – Dr. Luke Oakden Rayner just gave us another blistering post, this time on how “CT scanning (with or without AI) is just awful for diagnosing COVID-19.” Here are the key points before you check it out for yourself: 1. CT’s high sensitivity in initial CV19 studies is “unfounded and unbelievable;” 2. The major radiology associations already say CT shouldn’t be used for CV19 screening for good reasons; 3. So far, most CT CV19 studies have been “fatally flawed” due to selection bias (focusing on already-hospitalized patients) and because they follow practices that inflate sensitivity (reader tests, calling any abnormality a CV19 sign); 4. Because of this, CT’s sensitivity for CV19 detection is likely under 50%, not 97% or 98% as often cited.
  • Akumin DesignatesAkumin will dedicate 10 of its freestanding imaging centers for patients who have active/suspected COVID-19 cases, allowing them to undergo imaging as part of their CV19 treatment or for their other needs. These dedicated locations will maintain heightened decontamination protocols, while Akumin’s other centers will focus on non-CV19 cases (screening for symptoms before allowing entry) and will support local hospitals that are focused on the coronavirus outbreak.
  • CMS Relaxes MIPS Healthcare Administrative Partners detailed how CMS’ CV19-related adjustments to certain aspects of the Quality Payment Program (QPP) will impact radiology. CMS extended the deadline for reporting 2019 MIPS data to April 30 (vs. March 31) and effectively eliminated the 2021 penalty for practices who fail to submit 2019 MIPS data (“neutral adjustment” vs. a 7% fee schedule reduction) due to a new “extreme and uncontrollable circumstances” exception.
  • behold.ai Identifies CV19behold.ai announced that its red dot AI algorithm can identify COVID-19 patients’ chest X-rays as abnormal, suggesting that this ‘Instant triage’ capability could speed up CV19 diagnosis. The company reviewed chest X-rays from 28 CV19-positive patients with the red dot algorithm, correctly identifying 85% of the scans as abnormal. behold.ai will continue to validate the algorithm’s use in CV19 identification.



First US Biosensor

An Australian team developed the “world’s first ultrasound biosensor” that they suggest could change how clinicians diagnose patients and monitor therapy effectiveness.

  • The Tech – The new nanoparticle-based technology can be inserted deep into tissues where it alters its stiffness in response to changes in the body. Ultrasound then detects these changes.
  • Applications – The ultrasound biosensor was initially tested for measuring pH change (to signal chemotherapy effectiveness), but could expand to more complex markers such as oxygen (to indicate stroke) or disease-related proteins. Future tests will also evaluate whether the technology can be used to measure more rapid changes, such as monitoring the body’s reaction to treatments in real time.
  • A Lab Alternative – The team believes that these ultrasound biosensors will eventually be able to be read by handheld ultrasound systems, proving particularly valuable for remote and developing regions without access to lab-based testing.

The Wire

  • Connecticut Proxy War: Two of Connecticut’s largest health systems, Hartford HealthCare (HHC) and Trinity Health Of New England, are reportedly waging a “proxy war” to maintain control of the region’s radiology business. Jefferson Radiology (49% owned by HHC) is trying to block Radiology Associates of Hartford (RAH, contracted with Trinity hospitals) from opening a new imaging center and lobbying keep RAH from changing its legal structure in a way that would allow future expansion (via potential hospital or PE-funding).
  • Qure.ai & Medica Partner: Qure.ai and UK teleradiology provider Medica Group announced a partnership to develop AI tools targeting case prioritization and workload efficiency. Medica will launch a Qure.ai-based head CT decision support tool to flag urgent cases for prioritization and highlight critical findings. The companies will also co-develop an AI-based automated workflow improvement tool intended to make Medica’s study allocation more efficient.
  • The Cost of Sub-50 Screening: New research in JAMA found that breast cancer screening of insured 40-49yr old women comes with a $2.1b annual cost, largely due mammography exams ($1.5b) but with substantial contributions from recalls ($337m) and “other” tests ($273m) as well.
  • Yizhun Funded: Chinese imaging AI firm, Yizhun Intelligent, completed a $14.4m Series B round (increasing its total to ~$20m) that it will use to fund portfolio expansion. Yizhun might not be a household name, but it has partnered with both GE and IBM in the past and has a range of AI solutions for lung and mammography imaging.
  • Interpretation Deadlines: radsresident.com explored the unexpectedly complex topic of interpretation deadlines, finding that there are a range of deadlines (institution, radiologist, legal, reimbursement) and the “official” deadline generally varies “depending on the eye of the beholder.”
  • Nanox & CureMetrix: Nanox announced a deal to integrate CureMetrix’s mammography AI solutions into its forthcoming Nanox.CLOUD platform. Although it’s unclear whether Nanox’s forthcoming imaging systems are intended for breast cancer screening, AI alliances like this appear to be necessary for its “end-to-end” Nanox.CLOUD platform. The announcement also continues Nanox’s impressive run of PR activity that landed it in seven Imaging Wire issues so far in 2020.
  • CT + CE-MRI for HCC: New research out of South Korea found that contrast-enhanced MRI (CE-MRI) led to lower mortality among patients with hepatocellular carcinoma (HCC), and the combination of CE-MRI with contrast-enhanced CT imaging was even more effective. The retrospective study reviewed imaging from 30,023 patients with HCC and found that patients who underwent treatment planning using CT + CE-MRI had a 4.8-year median survival rate, notably longer than patients scanned with CT + non-enhanced MRI (2.5yrs) or patients who were only scanned with CT (1yr). However, these CE-MRI advantages only applied to patients with localized HCC and the three imaging approaches were equivalent among patients with regional or distant metastases.
  • Carestream in Korea: Carestream signed JW Medical to sell its medical imaging portfolio in South Korea, giving JW Medical access to its X-ray portfolio and OnSight 3D Extremity CT system.
  • The PSMA PET-CT Advantage: A new study out of Australia found that Prostate-specific membrane antigen PET/CT (PSMA PET-CT) is more effective than conventional imaging (CT and bone scans) for identifying some prostate cancers due to its higher accuracy and ability to better-inform treatment decisions. The study scanned 302 men with prostate cancer with either PSMA PET-CT or conventional imaging, finding that PSMA PET-CT had far greater accuracy (92% vs. 65%), led to more treatment plan changes (28% vs. 15%), and resulted in fewer equivocal findings (7% vs. 23%).
  • Canon SPEEDER MR: Canon Medical announced the FDA approval of its Compressed SPEEDER technology, which reconstructs full resolution MR images from highly under-sampled data, allowing 4-times faster scans while maintaining resolution and signal to noise ratio. The new technology will initially be available with Canon’s Vantage Galan 3T system before expanding to the Vantage Orian 1.5T.
  • PM Unified Worklists Work: A new UPenn paper found that after-hours teams operate more effectively using a unified radiology worklist. The team found that by adopting a unified worklist during night shifts (vs. using 5 lists), inpatient chest x-ray study turnaround times were reduced by 18% (53 vs. 64 min.) and emergency chest x-ray turnarounds increased by 12.5% (41 vs. 36 min.) because ED imaging was previously over-prioritized.
  • EchoNous KOSMOS in EU: EchoNous announced the CE Mark approval of its KOSMOS Platform, which includes an 8oz handheld ultrasound system with embedded and synchronized ECG and digital auscultation, and its new Kosmos Bridge tablet. The under-$10k platform uses AI to improve users’ learning/confidence curves and perform diagnostic measurements (currently systolic heart function, more measurements in the future), all of which operate via the Kosmos Bridge tablet. The platform will add continuous & pulsed wave dopplers in the coming months.

The Resource Wire

This is sponsored content.

  • Healthcare Administrative Partners detailed how relaxed telemedicine rules during the COVID-19 Public Health Emergency could create an opportunity for radiologists to use telemedicine in their practice in this blog post.
  • Nuance is providing its healthcare customers with free add-on licenses to help them scale up during the COVID-19 emergency, including 90-day add-ons to its PowerScribe solutions.
  • This Caltech study details how that certain focused ultrasound frequencies can selectively kill cancer cells.
  • This GE Healthcare white paper details how its suite of point of care ultrasound AI tools simplify complex patient assessments, enable faster clinical decisions, and calculate precise results.
  • ClearRead CT from Riverain Technologies is the first FDA-cleared system for the automatic detection of all lung nodule types, allowing radiologists to reduce search and reporting time and improve nodule detection rates.

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