Preparing for New Normal | Fast Times with US

“Ultrasound . . . is becoming indispensable during this pandemic in ways that will impact patient care for decades to come.”

Thomas Jefferson University Hospital’s Resa E. Lewiss, MD on the benefits of ultrasound for diagnosing and managing CV19.


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

Preparing for New Normal

A new paper in Radiology: Imaging Cancer detailed radiologists’ dual challenge of operating during the CV19 crisis and preparing for a future that might be different from what we currently consider “normal.” Here are some of the challenges that cancer imaging leaders have experienced during CV19 and some insights into what they expect once we emerge.

  • Cancer Study Cancellations – During CV19, many institutions rescheduled nonurgent cancer imaging until May-June, made semi-urgent imaging decisions on a case-by-case basis, but still scanned urgent cases without any delays.
  • Rescheduling Timeline – Depending on CV19’s own timeline, we’ll see rescheduled imaging appointments start happening in May. However, the CV19 hangover (e.g. continued social distancing, patients losing their coverage, large backlogs) might mean many of these rescheduled patients aren’t scanned for another 6 to 12 months.
  • The Imaging Surge – The backlog of postponed / rescheduled imaging studies will create an imaging surge that will tax both radiology teams and equipment, causing some intuitions to consider extending their operating hours/days or even shortening imaging protocols. Even with these efforts, patients may face “weeks to months” of rescheduling wait times.
  • Future Cancer Imaging Impact – CV19’s future impact on cancer imaging will be influenced by patient mentality and availability of healthcare coverage. Patients may be hesitant to adopt their normal screening cadence depending on wait times and exposure concerns, so appointment reminders and safe practices will be important to keep these patients going. Of course, the massive unemployment spike will reduce the number of covered patients.
  • Future Research Impact – For now, researchers are taking advantage of their #stayhome time by working on manuscripts and grant proposals, or even working on retrospective studies. However, the authors are concerned about CV19’s impact on cancer research, given the lost data points in ongoing studies, concerns about maintaining social distancing in a lab environment, and a shift in research attention/funding to fighting COVID-19.

The Wire

  • Fast Times For CV19 Ultrasound: Point-of-Care ultrasound’s COVID-19 advantages were introduced to fastcompany.com’s millions of readers last week. The very pro-ultrasound article described how POCUS became a key tool in the diagnosis and management of CV19 due to its speed, its familiarity in the ED, and its advantages over other imaging modalities, while suggesting that ultrasound is “becoming indispensable during this pandemic in ways that will impact patient care for decades to come.”
  • Imaging Access Gaps: A new survey from Hyland Healthcare and HIMSS Media identified a number of shortcomings in healthcare interoperability. The survey’s imaging-related questions revealed a number of issues with image access, as 18% of images are captured offline and not integrated with core clinical systems (even though 90% of respondents view it as important), while only 11% of respondents connect with a VNA for DICOM and non-DICOM images.
  • PET/CT Superior for HL: New research in RSNA Radiology found that PET/CT is superior to CT for the prediction of Hodgkin lymphoma survival. The study reviewed 45 Hodgkin lymphoma patients who underwent PET/CT and CT scans ~2 months after they were treated with nivolumab, finding that PET/CT categorized 6.5-times more patients as complete responders than CT during early assessments and 2-times more in secondary assessments.
  • Frost on CV19’s Healthcare Impact: A new report from Frost & Sullivan detailed how COVID-19 could impact the healthcare industry, forecasting a new focus on telemedicine, an emphasis on hospital agility, an increased importance of interoperability and analytics, and a rise in diagnostic testing at retail clinics. On the imaging side of the industry, the report forecast a surge in teleradiology infrastructure / service and increased use of imaging AI.
  • Butterfly’s New TeleGuidance: Butterfly Network released its new TeleGuidance tool, which allows clinicians to collaborate remotely, and is currently available to beta users. TeleGuidance livestreams the user’s ultrasound and camera images to a remote collaborator, who can remotely adjust the device’s preset, mode, gain, depth, and capture images or cines. The tool also allows the collaborators to communicate over two-way audio and video.
  • RADLogics Goes Global: RADLogics highlighted the global adoption of its new CT image analysis algorithm for CV19, revealing deployments in China, Russia, Italy, Serbia, and Brazil over the last month. The company specifically emphasized its deal with the Moscow Department of Healthcare’s Diagnostics and Telemedicine Center, which is planning to scale the algorithm system-wide.
  • 74 Mammo Decision Aid: New research in JAMA Internal Medicine found that providing women above the age of 74 with a mammography “decision aid” made them more knowledgeable and potentially less likely to continue screenings. In the study of 546 asymptomatic women, the 284 women who received a decision aid were more likely to discuss mammography with their PCP and 9% less likely to continue screenings than women who didn’t receive a decision aid.
  • Median’s €15M: Median Technologies landed a €15m loan (could be up to €35m) that it will use to expand its iBiopsy technology, which uses imaging biomarkers for the early detection of certain diseases (starting with hepatic fibrosis and hepatocellular carcinoma) or measure the effectiveness of certain treatments (starting with immuno-oncology treatments).
  • CT and CV19 Outcomes: Despite all the criticism against CT for CV19 diagnosis, new research from Italy reveals that visual or software quantification of CT scans at the time of admission accurately predicts ICU admission and death. The study of 236 patients found that patients with well aerated lung parenchyma below 73% (using visual quantification) or under 71% (using software quantification) were more likely to be admitted into the ICU or die from the virus (5.4 and 3.8 odds ratios).
  • McGuinness to MSFT: Tom McGuiness wrapped up his nearly 4-year career at GE Healthcare (most recently as GE Imaging’s president and CEO), becoming Microsoft’s Global Healthcare Corporate Vice President. Microsoft of course has some big healthcare ambitions and McGuiness will have a big job developing and executing Microsoft’s Healthcare strategy. No word yet on McGuiness’ replacement at GE.
  • Genetesis & TDK: Biomagnetic medical imaging startup, Genetesis, landed new funding from TDK Ventures, revealing plans to leverage TDK’s global reach and technical expertise (magnetics, sensors, etc.) to help develop Genetesis’ cardiac diagnostics technology. Genetesis has done well with big name investors, as it first found its way into The Imaging Wire after completing a 2019 Series A round led by Dallas Mavericks owner & Shark Tank shark, Mark Cuban.
  • A Photoacoustic Milestone: Johns Hopkins researchers provided new evidence that photoacoustic imaging could someday rival or replace fluoroscopy. The researchers used photoacoustic imaging to perform cardiac catheterization on two live pigs without damaging the pigs’ cardiac tissue, representing the first time that the technology has been used in a live animal heart that is similar in size/anatomy to a human heart.

The Resource Wire

  • ClearRead Xray from Riverain Technologies includes the first FDA-cleared software solution to transform a chest x-ray into a soft-tissue image, providing unprecedented clarity for efficient, accurate, early detection of lung disease. Learn more.
  • Nuance’s latest blog reveals how the COVID-19 pandemic could be the catalyst behind the UK NHS’ digital healthcare transformation.
  • This Healthcare Administrative Partners blog article details how physicians are now eligible to receive additional funding during the COVID-19 pandemic thanks to the CARES Act.
  • The Focused Ultrasound Foundation is now accepting abstract submissions related to the use of image-guided focused ultrasound for its 7th International Symposium in November.
  • This Qure.ai blog post details how it repurposed its qXR chest X-ray AI tool to detect signs of COVID-19, creating a CV19 detection tool that is now in use at 28 global sites.

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