• 3 strategies to control wasteful imaging
  January 8, 2019
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3 strategies to control wasteful imaging
By: Subrata Thakar
Unnecessary imaging is a serious problem in the United States. So what can be done about it? A new analysis published in the Journal of the American Medical Association explored that very question.

The industry has combated unnecessary and wasteful diagnostic imaging by implementing appropriate use criteria and educating physicians, but more needs to be done. These are three strategies suggested by author John P. A. Ioannidis, MD, DSc, of the Stanford Prevention Research Center in California, and colleagues:
1. Educate patients
Healthy individuals and patients can be educated abut radiation risks, intravenous contrast and the possibility of incidental findings. The use of flowcharts and diagrams may illustrate the potential “detrimental effects” of further testing, the authors added.
“Instead of the current typical pretest conversation, which generally involves a clinician simply notifying the patient that imaging is ordered, a shared decision-making process requires comprehension of the likely gains versus the potential detrimental effects of testing, including the detection and investigation of unrelated findings,” the authors wrote.
Shared decision-making, the authors wrote, allows for improved transparency and decreased confusion regarding follow-up and treatment. Also, communicative interventions may need to occur at multiple times during a single patient interaction so that patient safety is adequately addressed.
2. Focus on the target
Lowering the image sensitivity of anatomy that is not the primary target could result in fewer unrelated findings, the researchers wrote. Some may argue that the limited image may not allow for the radiologist to make an accurate diagnosis. The authors said, however, that this may be true for more complicated cases, but not for most patients.
“Although this approach would not reduce the number of initial tests, it could potentially prevent the cascade of tests that follow an incidental finding,” the authors wrote.
3. Ask radiologists to serve as gatekeepers
Additionally, instead of just interpreting examinations, radiologists may also need to become “gatekeepers” to regulate what tests should be ordered or not ordered.
“This would require embedding radiologists more routinely as consultants in clinical encounters that contemplate ordering imaging tests,” Ioannidis and colleagues noted.



Source
Thakar, Subrata. “3 Strategies to Control Wasteful Imaging.” Radiology Business, 8 Jan. 2019, www.radiologybusiness.com/topics/quality/3-strategies-control-wasteful-imaging?utm_source=newsletter&utm_medium=rb_news.
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• Whole-body PET/MRI shows promise for staging high-risk prostate cancer patients
  December 13, 2018
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Whole-body PET/MRI shows promise for staging high-risk prostate cancer patients
Whole-body PET/MRI shows potential to provide physicians with a “one-stop-shop” for staging high-risk prostate cancer patients, according to new research published in the Journal of Nuclear Medicine.

The authors compared the performance of 68 Ga-PSMA-11 PET/MRI with clinical nomograms currently being used to determine risk by conducting a retrospective study on 73 patients. Two common prediction tools—Partin tables and the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram—and 68 Ga-PSMA-11 PET/MRI were used to predict each patient’s risk for advanced disease. Those predictions were then compared with various histopathologic results.

Overall, the whole-body PSMA-targeted PET/MRI imaging produced positivity rates comparable with both the Partin tables and the MSKCC nomogram.

“Our results showed that PSMA-targeted PET/MRI performed equally well to established clinical nomograms for preoperative staging in high-risk prostate cancer patients and provided additional information on tumor location” co-author Andrei Gafita, MD, of the Technical University of Munich in Germany, said in a news release from the Society of Nuclear Medicine and Molecular Imaging. “Translated into a clinical setting, the use of this imaging technique for preoperative staging might support treatment planning that may lead to improved patient outcomes.”

Source
Walter, Michael. “Whole-Body PET/MRI Shows Promise for Staging High-Risk Prostate Cancer Patients.” Radiology Business, 12 Dec. 2018, www.radiologybusiness.com/topics/care-delivery/whole-body-petmri-s-high-risk-prostate-cancer?utm_source=newsletter&utm_medium=rb_news.
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• Antiquated X-Ray Machine leads to Ben Rothlisberger returning to game
  December 12, 2018
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Antiquated X-Ray Machine leads to Ben Roethlisberger returning to game
On Sunday, December 19 NFL game between the Pittsburgh Steelers and Oakland Raiders, Steelers' quarterback Ben Roethlisberger was injured as a result of a sack by Raiders' defensive end Clinton McDonald. At half-time Roethlisberger had his ribs x-rayed. Because the X-Ray machine was out of date, the results were inconclusive, the team's General Manager Kevin Colbert delayed the quarterback's return to the game. Roethlisberger did end up returning to the game in which the Steelers lost.

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• 2 key trends driving the future of medical imaging (and 3 to keep an eye on)
  December 11, 2018
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2 key trends driving the future of medical imaging (and 3 to keep an eye on)
Artificial intelligence (AI) and blockchain are two titanic trends driving the future of medical imaging, according to an in-depth analysis published in the Journal of the American College of Radiology. The study’s authors also assessed other trends that continue to gain momentum.

“The medical device industry is undergoing rapid change as innovation accelerates, new business models emerge, and AI and the Internet of Things create disruptive possibilities in health care,” wrote author Alan Alexander, MD, and colleagues from the global consulting firm McKinsey & Company in New York City.

AI and blockchain: Leaders of the pack

Alexander et al. used data to explore the current state of the medical imaging industry and observed that AI and machine learning (ML) are, not surprisingly, the hottest ticket in town.

“This cluster has the greatest number of startups (32), the highest volume of investor transactions (more than $500 million), the greatest revenue, and strong investor interest and potential for further growth,” the authors wrote. “Furthermore, there has been keen interest from radiologists in improving work efficiency, given the number of specialty-specific publications, presentations, and opinion articles in this space.”

A lot of the companies in this space specialize in one specific modality, they added, with 22 percent of companies focused on CT and another 13 percent each focused on MRI and mammography.

“CT and mammography lend themselves most readily to AI because attenuation information can be used in the learning algorithms,” the authors wrote. “Other modalities present challenges: the interpretation of multisequence images in MRI, the user variability in ultrasound, and 2-D limitations in x-rays.”

AI and ML have the ability to help specialists interpret studies more quickly and some algorithms can even detect abnormalities “not readily visible to the human eye.” These technologies can also help with cost savings, the researchers noted, due to how they can prevent unnecessary readmissions and cut down on wasteful imaging.

Blockchain, on the other hand, is even newer than AI and ML. The authors noted numerous ways blockchain can help radiology.

“It could help prevent the kind of data breaches that have recently occurred in health care and, if breaches do occur, blockchain can enable continued functioning after the event,” they wrote. “The technology is likely to underpin further use cases for cyber- and data security in concert with data sharing, as well as AI computing through the use of ML algorithms across distributed ledgers. Blockchain will also support the distribution of graphics processing units to drive AI analysis and analytics and facilitate further ML endeavors.”

Another key reason blockchain is so important is that it can help imaging providers with the massive amount of data they are required to maintain and securely share with patients and other physicians. Blockchain has already helped the banking industry with its own “large data needs,” and it could do the same for medical imaging.

3 additional trends to keep an eye on
• 3D visualization, virtual reality and image-guided intervention: Startups in this space have been around for a long time and raised significant funds, the authors wrote. 3D printing, surgical simulation platforms and surgical prosthetics are just three examples of why these technologies are getting more and more attention throughout the industry.
• Intraoperative technologies: Alexander and colleagues warned all businesses serving imaging professionals that this is an area rapidly growing in importance. “Imaging is becoming a crucial aspect of intra-operative planning and execution, particularly for applications requiring extensive data acquisition in real time,” the authors wrote. “It can enhance precision during surgical interventions and improve outcomes. Intra-operative techniques span all modalities, including ultrasound, MRI, and fluoroscopy, and they often require portable capabilities.”
• Nuclear imaging: “As nuclear imaging grows and moves away from metabolic imaging for cancer localization to pathology-specific cancer diagnosis (for instance, the combining of ligands specific to prostate or breast cancer with radioisotopes for definitive diagnosis), imaging companies will have increasing opportunities to engage in cancer diagnostics, and potentially therapeutics as well,” the authors wrote.



Source
Walter, Michael. “2 Key Trends Driving the Future of Medical Imaging (and 3 to Keep an Eye on).” Radiology Business, 5 Dec. 2018, www.radiologybusiness.com/topics/healthcare-economics/2-key-trends-future-medical-imaging-ai-blockchain?utm_source=newsletter&utm_medium=rb_weekly.
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• RSNA 2018 Recap
  December 5, 2018
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RSNA 2018 Recap
The Annual Meeting of the Radiological Society of North America held it's meeting in Chicago's McCormick Place from November 25th - 30th. Here are some of the highlights from the show.

Shimadzu Medical Sytems
Shimadzu Medical Systems USA, a subsidiary of Shimadzu Corporation, presented theTrinias Unity C16, the Sonialvision G4, the RADspeed Pro EDGE Package, the RADspeed fit and the MobileDaRt Evolution MX8.

Shimadzu also presented the FLUOROspeed X1 (Work in Progress). This new addition to their fluoroscopic lineup will be an elevating conventional RF table, featuring a 650lb patient capacity, a large apperture for swallow studies, and have the ability to park deck in any any position.
See photos below.
Canon USA and Virtual Imaging
Canon USA and Virtual Imaging Showcase RadPRO® Digital Radiographic Systems at Radiological Society of North America Annual Meeting

CHICAGO, Nov. 21, 2018 /PRNewswire/ -- Canon U.S.A., Inc., a leader in digital imaging solutions, and Virtual Imaging, Inc., a wholly owned subsidiary of Canon U.S.A. announce today that they will showcase their lines of radiology offerings at the Radiological Society of North America (RSNA) 104th Scientific Assembly and Annual Meeting at McCormick Place, Chicago, IL, from November 25-30, 2018. Guests to South Hall, booth #1938 will have the opportunity to experience an array of RadPRO radiology solutions, which function on the Windows® 10 Operating System.

"We are pleased to share the latest innovations from Canon and Virtual Imaging with healthcare providers at the annual meeting of the Radiological Society of North America in Chicago," said Tsuneo Imai, Vice President and General Manager, Healthcare Solutions, Business Imaging Solutions Group, Canon U.S.A., Inc. and President, Virtual Imaging, Inc. "Precision, intuitive design and efficient workflow are critical to providing the best options for care, and Canon and Virtual Imaging keep these needs top of mind during the development of their products and services."

Ideal for radiology professionals who require proven technologies to aid performance, productivity and workflow, the RadPRO1 Mobile 40kW FLEX PLUS Digital X-Ray System will be on display. The System features a multi-touch supported monitor that when used with CXDI Control Software NE enables more intuitive touch operations, such as zoom, pan, double-tap zoom, WW/WL adjustment, laterality marker dragging and list scrolling – all of which are possible by using the operator's fingers in place of keyboard or mouse activity.

Additional system features include an LED status indicator light that assists the end user in confirming the system status, a CXDI Wireless Detector battery charger affixed to the mobile system, and the patented Enhanced Workflow Package and wireless Distributed Antenna System (DAS).

Attendees can also see and learn about the RadPRO OMNERA® 400A Auto-Positioning Digital Radiographic System. This system enables fast and effortless precision positioning thanks to its fully motorized auto-positioning that provides servo tracking to both the wall stand and table. An easy to operate overhead tube crane with 10-inch, touch-screen display helps make exams as simple as selecting a protocol and pressing a control. Additional features include detector charging in wall stand and table, and optional automatic stitching capability.

Additional products and systems on display include:
• DR Tablet Solution helps usher in the move to digital radiography. It consists of a tablet2 and choice of a CXDI Wireless Digital Radiography System which includes CXDI Control Software NE. The auto-detection mode of the detector allows for X-rays to be automatically detected at exposure without the use of a typical generator interface and cables.
• RadPRO URS Universal Radiography System provides motorized movements that can be controlled from three different locations for more operator flexibility. It has a small footprint for space-conscious facilities and its superb flexibility makes it easy and cost-effective to install and use without compromising imaging capability.
• RadPRO FM Floor-Mounted Radiography System offers a floor-mounted tube stand, 4-way float table, and chest stand, making it a robust solution ideal for most medical imaging applications. The freestanding tube stand requires no wall or ceiling supports for fast installation.
• CXDI-710C/810C/410C Wireless Digital Radiography Systems deliver high-resolution images at fast preview times, resulting in low radiation dose to the patient.
• CXDI Control Software NE v2.17 is a new feature release offering multi-touch support, Advanced Edge Enhancement, Multiple Image Processing, and other features.
See photos below

For more information about radiography solutions from Canon U.S.A. and Virtual Imaging, please visit https://www.usa.canon.com/dr.

About Virtual Imaging, Inc.
Virtual Imaging, Inc., a Canon company, combines unmatched experience, extensive resources and broad business functions. Virtual Imaging collaborates with large hospitals, imaging centers, private physician offices and government organizations to support them in becoming efficient, high-performance healthcare providers and professionals with the latest in digital radiography technology. Virtual Imaging assists in the forward advancement of its clients, from strategic planning to day-to-day operations, with a commitment to providing products and services for diagnostic equipment, imaging solutions and digital flat panel technology. In addition to healthcare organizations, Virtual Imaging also provides solutions to the U.S. veterinary market and to the security industry – a field deployable radiography system for military use and a full-body security screening system to help address certain security needs of jails, prisons and other high-security environments.

About Canon U.S.A., Inc.
Canon U.S.A., Inc. is a leading provider of consumer, business-to-business, and industrial digital imaging solutions to the United States and to Latin America and the Caribbean markets. With approximately $36 billion in global revenue, its parent company, Canon Inc. (NYSE: CAJ), ranks third overall in U.S. patents granted in 2017† and is one of Fortune Magazine's World's Most Admired Companies in 2018. Canon U.S.A. is committed to the highest level of customer satisfaction and loyalty, providing 100 percent U.S.-based service and support for all of the products it distributes in the United States. Canon U.S.A. is dedicated to its Kyosei philosophy of social and environmental responsibility. In 2014, the Canon Americas Headquarters secured LEED® Gold certification, a recognition for the design, construction, operations and maintenance of high-performance green buildings. To keep apprised of the latest news from Canon U.S.A., sign up for the Company's RSS news feed by visiting www.usa.canon.com/rss and follow us on Twitter @CanonUSA. For media inquiries, please contact pr@cusa.canon.com.
Konica Minolta
Konica Minolta Brings Motion to X-ray with Dynamic Digital Radiography at RSNA 2018

For the first time, radiologists will be able to view motion from standard X-ray images without fluoroscopy. Konica Minolta Healthcare is bringing digital radiography (DR) to life with the ability to visualize movement using conventional X-ray. Known as Dynamic Digital Radiography (DDR)* or X-ray in Motion™, this revolutionary new modality captures movement in a single exam and allows the clinician to observe the dynamic interaction of anatomical structures, such as soft tissue and bone, with physiological changes over time. The value of DDR in thoracic imaging is promising, allowing clinicians to observe chest wall, heart and lung motion during respiration. DDR goes beyond pulmonary function; Konica Minolta is exploring its use in orthopedic applications of the spine and extremities. This new capability will be showcased at the annual meeting of the Radiological Society of North America (RSNA), being held November 25-29 in Chicago, in Konica Minolta’s booth 1919.

“DDR may dramatically change the diagnostic and patient management paradigms for respiratory diseases and other pathologies including orthopedic injuries,” says Kirsten Doerfert, Sr. VP of Marketing, Konica Minolta Healthcare. “With X-ray images in motion, clinicians can see structures in a way they have never been able to see before, enhancing their ability to better manage patients based on individual characteristics and bringing precision medicine further into focus for radiology. The potential benefit is significant."

DDR is an enhanced version of a standard DR system that rapidly acquires up to 15 sequential radiographs per second for up to 20 seconds of physiological movement, resulting in 300 X-ray images with a dose equivalent to about two standard X-rays. Since the DDR system also performs all conventional X-ray studies as well as motion radiographic studies, it is a cost-effective solution that provides greater diagnostic capability in an economical package.

In the US, 74% of all radiologic studies are radiography1 and nearly 44 percent of hospital-based X-ray imaging exams are thoracic2. While access to CT, MR and nuclear medicine may be limited in regions throughout the world, X-ray is an essential primary diagnostic tool that is widely available in developed nations at a fraction of the cost. There are also potential cost savings for healthcare systems globally by reducing the need for more advanced, and more expensive, imaging techniques.

“We are enabling clinicians to see more than a static image," says Guillermo Sander, Director of Marketing, Digital Radiography, Konica Minolta Healthcare. "By digitally capturing movement, DDR may deliver quantifiable clinical information that has the potential to increase the quality and specificity of diagnosis. With DDR, clinicians may better understand the pulmonary effect of neuromuscular disorders, diagnose and manage patients with respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD), and evaluate post-operative changes in patients with lung cancer, lung cysts and other pathologies."

Konica Minolta developed DDR with the global healthcare goals of higher quality care, greater access and lower cost in mind, supporting clinicians throughout the world in making better decisions, sooner.

1 Herrmann TL, Fauber TL, Gill J, et al. Best practices in digital radiography. Radiol Technol. 2012 Sep-Oct;84(1):83-9.

2 IMV Market Research, 2017 X-ray/DR/CR Market Outlook, Sept. 2017.

*Dynamic Digital Radiography is not FDA cleared.

About Konica Minolta Healthcare Americas, Inc.

Konica Minolta Healthcare is a world-class provider and market leader in medical diagnostic imaging and healthcare information technology. With over 75 years of endless innovation, Konica Minolta is globally recognized as a leader providing cutting-edge technologies and comprehensive support aimed at providing real solutions to meet customer's needs and helping make better decisions sooner. Konica Minolta Healthcare Americas, Inc., headquartered in Wayne, NJ, is a unit of Konica Minolta, Inc. (TSE:4902). For more information on Konica Minolta Healthcare Americas, Inc., please visit www.konicaminolta.com/medicalusa.
Neusoft
2018 is a historic year for Neusoft Medical Systems, which marks the 20th anniversary. This year is its 19th participation in RSNA. It comes with latest products, which is Powerful and Proven.

The equipment, endowed with powerful functions and profound stability and consistency, and showcased at Neusoft’s booth, attracted a lot of attention. They can be utilized to increase patient care accessibility and reduce cost.

Neusoft employees from different countries made detailed introduction of newly released products to partners and customers.

Neusoft released new technology in all areas of diagnostic imaging at RSNA 2018. AI is not only a buzz word, it’s a reality for Neusoft.

On one hand, Neusoft’s AI (NeuAI) has received attention and recognition in the academic circle, and on the other hand, it has been implemented in Neusoft’s newly released products, including NeuViz Glory CT (*510k pending), NeuMR 1.5T (*510k pending), NeuAngio 30C DSA (*510k pending), NeuWise PET/CT (*510k pending) and Mobile CT Unit.
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