Virtual Trials and Certified Reads

“At this point, you’re better off with a mask and a rabbit’s foot to rub than with a CT.”

A Twitter comment on how CT’s role in COVID-19 diagnosis has changed since March.


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  • Healthcare Administrative Partners – Empowering radiology groups through expert revenue cycle management, clinical analytics, practice support, and specialized coding.
  • Hitachi Healthcare Americas – Delivering best in class medical imaging technologies and value-based reporting.
  • Nuance – AI and cloud-powered technology solutions to help radiologists stay focused, move quickly, and work smarter.
  • Riverain Technologies – Offering artificial intelligence tools dedicated to the early, efficient detection of lung disease.

The Imaging Wire



Virtual COVID Trials

Virtual imaging trials could play a key role in evolving COVID-19 imaging practices, potentially helping to dial-in modalities, improve screening and follow-up protocols, and train new AI tools. That’s from a new Duke-led AJR study, and here are some details:

  • What is a Virtual Imaging Trial? – Virtual imaging trials use computational models of patients (in this case models of COVID-19 patients) to emulate imaging experiments and improve/speed-up research.
  • The Case for COVID Virtual Imaging Trials – Even with all the research on COVID-19 imaging so far (there’s been plenty), the researchers believe “interpretations, analysis, and imaging acquisitions have not yet been optimized to differentiate COVID-19 from other lung abnormalities.”
  • The Duke COVID Models – The researchers manually segmented 20 CT scans to show the size and shape of COVID-19 abnormalities and then incorporated them into a 4D imaging phantom to create a COVID imaging model. They then modified the model to match the COVID-19 properties observed in the different CT images and modified them again to simulate X-ray scans, all of which were found to be realistic.
  • The Takeaway – This is an advanced topic to many of us, but the takeaway is that the Duke team proved that virtual imaging trials are possible for COVID-19. For those who believe we have room to improve COVID-19 imaging, this is a good sign.

The Wire

  • Covera & Premera: Radiology clinical analytics firm, Covera Health and Northwest U.S. insurer, Premera Blue Cross, announced a collaboration to add radiology to Premera’s Centers of Excellence program, connecting its customers with radiology practices that are “certified” by Covera for their diagnostic accuracy. Covera made headlines last year when Walmart began requiring its employees to receive imaging services at Covera-certified providers, and this deal marks Covera’s first insurer client.
  • Flexible Scintillator: A Florida State research team developed new flexible X-ray detector technology that is less harmful to the environment and cost less than current X-ray technology. The new manganese halide-based X-ray scintillators avoid the toxic components of other scintillators (lead or heavy metals), can be easily manufactured (reducing costs), and can be used as a powder that mixes with a polymer to create a flexible composite (expanding its potential applications).
  • Lost Images: Cook Children’s Medical Center (Ft. Worth, TX) is “unable to locate” a box of disks holding over 1,700 patients’ medical images. The potentially exposed images are only viewable with special medical imaging software, but the disks also contain a long list of patient data that is accessible (names, birth dates, medical record, patient numbers, service dates, type of scan, and more).
  • Ultrasound Blood Pressure Monitor: A Japanese research team developed a new ultrasound -based blood pressure monitoring system that uses a tiny ultrasound probe (28mmx26mm, 10g) and an AI algorithm to measure changes in artery dimensions in real time. The potential alternative to compression-based monitoring (can be inconvenient and ineffective) was able to read patients’ systolic and diastolic within AAMI accuracy guidelines.
  • Mindray Chooses Amazon: Mindray North America announced a partnership with Amazon Business that will make its medical devices and accessories (including ultrasounds) available to healthcare providers through the ecommerce and logistics giant. It can be easy to overlook this story, but if you consider that Amazon Business already works with 84 of the top 100 U.S. health systems, it’s worth keeping an eye on how Amazon Business evolves its healthcare portfolio to more sophisticated medical devices.
  • $10.83M for GBCA Brain Damage: A Pennsylvania jury awarded $10.83m to a 45-year-old man who suffered a severe gadolinium allergic reaction during a 2016 MRI scan that led to brain damage. The hospital didn’t have an alarm or emergency epinephrine in its MRI room and was unable to get the man care in time to address his cardiac arrest or prevent his brain damage.
  • MDs Over DOs: Radiology residents believe selection committees view allopathic (MDs) applicants more favorably than osteopathic (DOs) applicants, according to a survey published in Current Problems in Diagnostic Radiology. Out of 268 residents (202 MDs and 66 DOs), nearly 90% of respondents felt this way. DOs also said their degree type altered their medical careers and that they were steered away from radiology.
  • GE Sells Radiopharmacy Biz: GE Healthcare sold its U.S. radiopharmacy network to Radioisotope Life Science (RLS) for an undisclosed sum, representing GE’s latest move to streamline its healthcare business (following GE’s BioPharma & Value-Based Care divisions in 2019). RLS will continue to supply GE’s molecular imaging products for the next 10 years and take on 500 former GE employees.
  • Tech Art: An Indiana radiologic technologist made the local news for her paintings of her coworkers as they contributed to the COVID fight. A painter of 20 years, the woman shifted from landscape pictures—some inspired by medical images—to inspirational portraits of technologists “caring for each other and helping each other on the job.”
  • Ultrasound for FAP: Using ultrasound to measure the wrist’s median nerve cross-sectional area (CSA) could help diagnose familial amyloid polyneuropathy (FAP) by differentiating idiopathic carpal tunnel syndrome (CTS) from FAP-related CTS. The Italian researchers evaluated 62 patients with the TTR gene mutation that causes FAP and 21 CTS-affected hands from 16 participants without polyneuropathy, and then compared them with 1,669 hands from 1,196 people with idiopathic CTS, confirming that ultrasound can indeed differentiate the two.
  • TeraRecon’s Subscription: TeraRecon launched its new Intuition Titanium subscription service, combining its range of its visualization and AI solutions (including 3rd party) plus any future enhancements within a single per-department subscription. Like other subscription offerings (inside and outside of imaging), Intuition Titanium is built to help customers scale up. However, this program is also intended to help current customers ‘scale out,’ giving them access to TeraRecon’s entire portfolio at an unchanged TCO. TeraRecon plans to transition its entire customer base (900) to the Intuition Titanium platform by 2022.
  • Weight Bearing MRI for Herniated Disks: A Danish research team discovered morphological changes in herniated disks when patients are standing, including size increases in the axial plane and increased nerve root compression grades, encouraging weight-bearing MRI for these patients. The researchers analyzed 37 patients’ herniated discs in three positions (standing, conventional supine with relative lumbar flexion, and supine with forced lumbar extension), finding changes while the patients were standing that were not evident in the other positions.
  • UK Funds AI: The UK government added £50m ($66.6m) in funding to scale up the country’s digital pathology and imaging artificial intelligence centers of excellence, following an initial £50m round when the centers launched in 2018. The new funds will mainly go to three centers to develop solutions focused on: 1) using imaging to allow earlier diagnosis and to automate radiology reporting; 2) creating a pathology collaborative; and 3) creating a pathology data lake using NHS data to develop commercial AI solutions.
  • Next-Gen Azurion: Philips announced its second-generation Azurion image-guided therapy platform, highlighted by its integration of all “essential” interventional lab systems and tools. The new platform includes Philips’ range of imaging, physiology, hemodynamic, and informatics applications, adds tableside gantry control, and introduces Philips’ new SmartCT 3D imaging solution.

The Resource Wire

– This is sponsored content.

  • In its latest Q&A Nuance’s Diagnostics leader, Karen Holzberger, sat down with Dr. Irena Tocino from Yale New Haven Health System to learn about how Nuance solutions helped YNHHS overcome the challenges brought by the COVID-19 pandemic.
  • Acknowledging the pressures that hospitals and imaging centers are under during the COVID-19 emergency, Hitachi’s latest blog details the equipment financing programs have become most in demand and unveils its new post-COVID programs launched in partnership with Key Equipment Finance.
  • In this Bayer Radiology video, East Texas Medical Center Radiology Director, Bill Tobin, details how they used Bayer’s MEDRAD Stellant Smart Injector and contrast dose management to reduce contrast volumes and repeat scans.
  • 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.
  • Radiology will see a significant cut in Medicare reimbursement in 2021 if the MPFS Proposed Rule is applied without a change to the budget neutrality requirement in the law. Get all the details in this Healthcare Administrative Partners blog post.
  • This Riverain Technologies case study details how Duke University Medical Center integrated ClearRead CT into its chest CT workflows, reducing read times by 26% and improving nodule detection by 29%.

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