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Nines AI | COVID Baselines | Miner Bias

“This is really just the tip of the iceberg,”

University of Illinois Chicago professor, Lee Friedman, PhD, after revealing that radiologists rarely diagnose positive black lung cases when they’re paid by mining companies to assess workmans’ comp claims. That would make the rest of the “iceberg” all other workmans’ comp scenarios.



I’m thrilled to welcome Canon Medical Systems as an Imaging Wire sponsor. Canon’s imaging solutions and services are helping thousands of clinicians and patients each day and it’s going to be great to share their message with you.



Quick note – The next newsletter will hit your inboxes on Tuesday morning (not Monday). Have a great weekend everyone!


Imaging Wire Sponsors

  • Arterys – Reinventing imaging so you can practice better and faster.
  • Bayer Radiology – Providing a portfolio of radiology products, solutions, and services that enable radiologists to get the clear answers they need.
  • Canon Medical Systems – Delivering innovative imaging solutions and services through industry leading partnerships to improve the quality of life for all people.
  • GE Healthcare – Enabling clinicians to make faster, more informed decisions through intelligent devices, data analytics, applications and services.
  • 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.
  • Novarad – Transformational imaging technologies that empower hospitals and clinicians to deliver clinical, operational and fiscal excellence.
  • 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.
  • Siemens Healthineers – Shaping the digital transformation of imaging to improve patient care.
  • United Imaging – Our mission, Equal Healthcare for All, pushes us beyond conventional boundaries to help clinicians expand modern, digital, intelligent care to more people within their communities.
  • Zebra Medical Vision – Transforming patient care with the power of AI.




The Imaging Wire


Nines AI

Teleradiology startup, Nines, took another step towards its goal to “redefine radiology” with the FDA clearance of its NinesMeasure AI tool. We cover AI approvals in just about every Imaging Wire issue, so here’s why this one is different:

  • Nines is Different – Nines emerged in 2019 with a unique emphasis on integrating software development with its reading operations, placing more public focus on its engineering strategy than we’ve ever seen from a teleradiology provider.
  • About NinesMeasure – NinesMeasure helps radiologists measure pulmonary nodules on chest CT scans, improving long and short axes measurement efficiency (3 seconds vs. 30 seconds manually) and supporting inter-study consistency throughout patients’ treatment programs.
  • Nines’ AI Portfolio – NinesMeasure is Nines’ second FDA-cleared AI tool, joining the 10-month old NinesAI head CT solution (triages intracranial hemorrhage and mass effect).
  • Integrated Engineering – In the announcement, Nines consistently emphasized how it pairs its radiologists with in-house engineers to continuously develop new solutions and streamline its workflows. This is how they developed NinesMeasure as well as other non-AI enhancements that allowed Nines to improve its clinical efficiency by 40% during the last three months.
  • The Takeaway – Nines is far from the only venture-backed radiology practice developing its own AI, but a lot of what Nines is doing is unique and worth watching.

The Wire

  • COVID’s New-Baselines: A Clinical Imaging paper encouraged physicians to perform “new-baseline” chest X-rays on higher-risk COVID-19 patients at the time of their hospital discharge or clinical recovery. The authors suggest that post-COVID baseline scans could help diagnose these patients in the future if they experience a COVID-19 relapse, reinfection, or a secondary viral infection.
  • Bracco On-Demand: Bracco Diagnostics and CardioNavix launched a new service that will provide Bracco’s CardioGen-82 system (generates Rubidium Rb 82 for cardiac PET labs) on an as-needed basis. The new Bracco Mobile Isotope Service represents a notable change from the traditional Rb 82 generator business model (requires “significant upfront and ongoing costs”) and should make the CardioGen-82 system more accessible for providers with lower cardiac PET volumes (e.g. community hospitals, physician practices, imaging centers).
  • Fetal CMRI Effective: Fetal cardiovascular MRI provides “clinically useful information” that isn’t available through fetal echocardiography, suggesting that CMRI could be a valuable tool for more challenging congenital heart defect cases. That’s from a new JAMA study (n = 31) that found CMRI provided additional information that led to changes in patient management and/or parent counseling in 84% of cases.
  • Butterfly Financials: Butterfly Network just released its 2020 financials (its first ever), revealing $46.3m in revenue (vs. $27.6m in 2019) and a $162.7m net loss (vs. -$99.7m in 2019). Butterfly’s revenue numbers are lower than many might have expected considering it’s $3.46b market cap and its notable POCUS mindshare. That’s also a testament to how much of the wireless handheld ultrasound segment’s buzz is based on long-term growth potential (handhelds w/ every clinician, across developing regions, used in homes, etc.) rather than immediate business opportunities.
  • Periodontal MRI: MRI can detect early signs of periodontitis (severe gum infection that can lead to tooth loss) in patients’ jawbones even before extensive bone loss occurs. That’s from a new German study that performed MRI scans on 42 patients with periodontitis and 34 healthy patients, revealing that bone edema captured in the MRI scans had a “highly significant correlation” with standard clinical tests for periodontitis (probing depth, probing bleeding). That finding suggests that bone edema could be used as an periodontitis MRI marker.
  • UK’s AI Standards: The Royal College of Radiologists just published a new set of AI integration standards for UK radiology departments. Here are some highlights from the RCR’s new (and very detailed) AI standards document: 1) AI implementations must not increase radiologist burden; 2) Info about AI accuracy and limitations should be shared with relevant clinicians; 3) AI findings must be communicated to the RIS and PACS using current global standards (HL7 & DICOM); 4) AI analysis has to be available on the PACS before radiologists begin image interpretation.
  • GE StarGuide SPECT/CT: GE Healthcare announced the European launch of its new StarGuide SPECT/CT system, calling it their “most advanced” SPECT/CT system and a “breakthrough in the world of SPECT.” The StarGuide backs-up those accolades with GE’s latest 12 CZT Digital Focus Detector, which performs 3D imaging and supports Theranostic procedures (for therapy delivery & disease monitoring), as well as advancements to its user workflow, gantry, image quality, and its ability to use multiple tracers at once.
  • Virtual Care’s Transformative Influence: Frost & Sullivan forecast that virtual care will have a transformative influence on the global healthcare market through 2025 and drive ongoing digital health demand (particularly telehealth and remote patient monitoring). This shift is big enough to require all established healthcare vendors to “redefine their visions and strategies” to embrace virtual care, while creating growth opportunities for new business models and new healthcare players.
  • Black Lung Bias: A University of Illinois Chicago study found that physicians who interpret coal miners’ chest X-rays for workers’ compensation claim assessments are “alarmingly” biased in favor of whoever is paying them. The UIC researchers analyzed 63,780 classifications made by 264 Black Lung Program physicians (known as B-readers). The B-readers who were hired by mine employers classified far more scans as negative for black lung (84.8%) than physicians hired by the Department of Labor (63.2%) or the miners (51.3%).
  • GE’s Venue Fit: GE Healthcare continued its point-of-care ultrasound expansion, launching the compact Venue Fit, as a small-size and scaled-back addition to the cart-based Venue Family. The Venue Fit offers many of the features found in GE’s related Venue Go and Venue models, while combining its slightly smaller form factor with a 14” screen (vs. 15.6” & 19”), two probe ports (vs. 3 & 4), one hour battery life (vs. 2 & 4), and presumably a lower price tag.
  • GE’s POCUS AI: GE Healthcare added a trio of new AI tools to its Venue POCUS family, including RealTime EF (calculates real-time ejection fraction), Lung Sweep (panoramic view of the entire lung), and Renal Diagram (intelligent documentation tool to support kidney infection follow-up). This is the second addition to the Venue family’s AI toolset and a sign that GE Healthcare will continue to focus on enhancing its POCUS lineup with AI going forward.
  • IRs’ Preference Variations: The cost of procedures performed by interventional radiologists can vary widely, and these variations are often dictated by the materials that individual physicians prefer to use. That’s from a new JVIR study (n = 9 IRs, 11 procedure types, 2.1k procedures, 44.6k expendable items) finding that procedure costs can vary by up to 56.6% (radioembolization administration) and suggesting that this inconsistency could have value-based care implications.
  • CaRi-Heart Approved: Caristo Diagnostics’ CaRi-Heart heart attack risk detection tool just gained European regulatory approval. CaRi-Heart uses AI to analyze coronary CT angiograms (CCTAs) for cardiac blood vessel inflammation, using those measurements to produce a Fat Attenuation Index Score (FAI-Score). In a clinical trial (n=4k), patients with abnormal FAI scores were up to nine-times more likely to die of a heart attack within nine years compared to patients with normal FAI readings.

The Resource Wire

– This is sponsored content.

  • Take the AiCE challenge and see why half the radiologists in a recent study “had difficulty differentiating” images from Canon Medical Systems’ Vantage Orian 1.5T MR using its AiCE reconstruction technology compared to standard 3T MRI images.
  • Easy access to patient records, reduced inefficiencies and costs, improved collaboration and compliance, and enhanced security. These are just a few of the benefits of Novarad’s enterprise imaging solution detailed right here.
  • Check out this Imaging Wire Q&A, where Arterys CEO John Axerio-Cilies, PhD discusses medical imaging’s AI and cloud evolution and how Arterys works with its Center of Excellence partners to make AI real.
  • Live Site Planning Sessions are one of United Imaging’s favorite collaboration moments. Their team comes on-site to take as-built measurements of the Medical Imaging suite and then creates a preliminary drawing for live discussion, giving customers and their design team a chance to adjust equipment placement, make changes to the floor plan, and review equipment specifications in a live virtual environment, saving time in the preliminary drawing process.
  • Tune in to Nuance’s Fireside chat (today 4/1 at 2PM ET) when Asheville Radiology Associates’ COO, Joseph Guiffrida, will share how the practice uses Nuance’s mPower Clinical Analytics to make sure it closes-the-loop with patients who require follow up.
  • This Bayer Radiology case study details how Einstein Healthcare Network reduced its syringe costs, enhanced its syringe loading, and improved its contrast documentation when it upgraded to the MEDRAD Stellant FLEX CT Injection System.
  • CMS continues to modify the Quality Payment Program (QPP) and MIPS policies due to the COVID-19 public health emergency, but the changes and their timelines can be hard to manage. Check out this Healthcare Administrative Partners post detailing how radiology QPP and MIPS policies have changed and how radiology practices should react.
  • This Hitachi Healthcare blog outlines the criteria providers should consider for their image and reporting platforms, and how the Hitachi VidiStar platform’s features, service, and vendor collaboration meet providers’ needs.

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