Feature | RSNA | November 28, 2023 | Christine Book

News of innovation-driven business partnerships, anticipated BI-RADS updates and a Plenary session speaker driving home the vital role of collaboration made for an action-packed Monday during day two of the Radiological Society of North America Scientific Assembly and Annual Meeting at McCormick Place in Chicago, IL.

News of innovation-driven business partnerships, anticipated BI-RADS updates and a Plenary session speaker driving home the vital role of collaboration made for an action-packed Monday during day two of the Radiological Society of North America Scientific Assembly and Annual Meeting at McCormick Place in Chicago, IL.

November 28, 2023 — By early Monday morning, on the second day of RSNA 2023, there were significant news announcements of collaborations among major players across the medical imaging and healthcare delivery space. Toward the goals of advancing innovation, focusing on patient outcomes, optimizing efficiencies and supporting workflow, the new partnerships forged set the scene for a full day of forward-thinking imaging experts driving progress in radiology. Here's a summary of news and notes prepared by our editorial team from the Radiological Society of North America Scientific Assembly and Annual Meeting, being held Nov. 26-30 at Chicago's McCormick Place. 

Top Newsmakers

Three major stories among so much news coming our way, included: Canon Medical and Cleveland Clinic. Annalise.ai and Mass Gen. Paige and Nuance, a Microsoft company. Each has its own capabilities, each with unique goals in sight, and each featured separately in our day-to-day news updates. Notably, they offer a collective sense that the combination of human intel, like-minded leaders and forward-thinking applications that leverage artificial intelligence are poised to drive change. Unintended as the irony may be, the biggest business stories of the day kept the spotlight on the theme of RSNA 2023: Leading Through Change.

What follows are additional highlights from a highly-anticipated status report on updated breast imaging guidelines, vendor visits, and another impactful Plenary session.

BI-RADS 6th Edition Update in Review

A panel of breast imaging experts who have been working tirelessly on the American College of Radiology (ACR) Committee on the Breast Imaging and Data System (BI-RADS) 6th Edition presented an important, image-rich session on the status of anticipated updates. As noted by the ACR, BI-RADS is described as “a comprehensive guide providing standardized breast imaging terminology, report organization, assessment structure and a classification system for mammography, ultrasound and MRI of the breast. BI-RADS reporting enable radiologists to communicate results to the referring physician clearly and consistently, with a final assessment and specific management recommendations. Through a medical audit and outcome monitoring, the system provides important mechanisms for peer review and quality assurance data to improve the quality of patient care. Standardized results permit maintenance and analysis of demographic and outcome data.”

The panelists included: Stamatia V. Destounis, MD (Mammography); Wendy B. DeMartini, MD (MRI); Jessica Wai Ting Leung, MD (Ultrasound); and Donna M. Plecha, BA, MD (Auditing and Outcomes Monitoring). Each offered a comprehensive overview of in-process changes to their specific modality, and participated in a robust question and answer session.

When asked by Imaging Technology News to summarize the key takeaways from the presentation, Destounis offered the following comprehensive but concise summary:

“This afternoon we went over the update for the BI-RADS sixth edition revision. We discussed mammography changes, so we'll include descriptor changes for masses for calcifications and for asymmetry. We also discussed that we've included tomosynthesis throughout the lexicon and the guidance chapter, and multiple findings including lymph nodes as normal or abnormal,  mastectomy patients and also how to characterize gynecomastia. Also, what breast density basically causes, which is the masking effect, so we may miss a cancer in the more dense tissue but also the inherent risk and the odds ratio when you compare it to a patient that has a more fatty pattern, the more scattered pattern easier to look at and the inherent risk with that. In addition, ultrasound revealed some new descriptors, non mass descriptors and also the echogenic rhine. Also, MRI went through all their updates about focus will be coming out some new changes on their descriptors, and also what they consider a full diagnostic protocol versus an abbreviated protocol. More inclusion in descriptors, more inclusion for lymph nodes, when they're normal or abnormal. And certainly the audit section included things before BiRads 3 x the probably benign findings and what to audit, as well as what not to audit and what we call a diagnostic versus a screening examination and how to audit that.”

When asked to characterize where the Committee is now with the forthcoming changes, she offered this summary status update: “We're at the stage where each subcommittee has done their reviews. The subcommittee chairs have reviewed all the sections. And now we're waiting for outside experts, and we're retrieving images and those will have to be approved. Then, we'll have to put it all together in a final document, so we're hoping sometime in late 2024.”

Plenary Speaker Offers Insights into Intelligence — Human and Artificial, Leadership and Change

Opening with the use of generative AI to share a warning about the unintended consequences the technology can produce, Elizabeth S. Burnside, MD, MPH, MS, FACR, delivered an engaging presentation, “Leading through Technology: Valuing Human and Artificial Intelligence.” Burnside is considered an esteemed authority in applying data-driven decisioning to population health. She is Senior Associate Dean, and Deputy Director, Institute of Clinical Translational Science at University of Wisconsin-Madison School of Medicine and Public Health, and has been at UW-M for her entire career.

This plenary session was dedicated to the memory of James E. Youker, MD (1928-2023) who, as noted by RSNA 2022-2023 President Matthew Mauro, MD, FSIR, FACR, FAHA, won the RSNA Gold Medal in 2000, and was heralded by the radiology community for his life’s work. Youker’s son also commented on the commitment and passion his father had for working with his colleagues in support of advancing patient care, and received a memorial plaque in his honor on behalf of the family.

Key points presented by Burnside focused on the concerns about an over-reliance on AI many in the imaging community hold, and shed light on the importance of situational leadership, especially as it relates to the fast pace of change brought on with new uses for both generative and artificial intelligence. Repeatedly, she illustrated ways that served as a warning to show the potential for unintended consequences from generative AI. One example, placing President Abraham Lincoln and his team of rivals together, first on a baseball field and then in an office solving problems together. The message pivoted to exemplify the ways in which Lincoln embraced those with divergent approaches, who surrounded himself with people who did not agree with him, but from whom he wanted to gain input. Urging her audience to do the same drove home the value of embracing change through a leadership lens, and realizing the benefits of collaboration.

Burnside offered an imaging chain and delved into the ways it crosses the paths of the health system, referring physician, technologist/scribe, and the radiologist, with an overarching concern for the patient.

Further, she noted a study her UW-Madison colleagues conducted over the past month, as-yet unpublished as data is still being analyzed, which found three key priorities which radiologists identified as benefits to AI in their work lives: Quality and Efficiency, Burnout, and Equity.

In guiding the radiology audience to ways to navigate the path ahead, she referred to an article published in the RSNA journal Radiology in December 2022 by Dania Daye, MD, PhD, Interventional Radiologist at Mass Gen and Harvard Medical School faculty member, and esteemed co-authors, "Implementation of Clinical Artificial Intelligence in Radiology: Who Decides and How?" She noted this important work offers a rubric for the implementation of AI. It urges a focus on making sure about local performance, reviewing scientific evidence, keep bias in mind, knowing the costs, the value and the impact on workflow and patients served. It talks about governance, collaboration and listening to stakeholders. Any educator who is interested in having a framework might want to consider using this.

In her closing comments, Burnside offered this: “Leadership is incredibly difficult, especially in times of radical change. Leadership, I want to emphasize, is really sitting in your seat. You have an important role to play, in both the tame and the wicked problems. Keep those in mind and that’s my mantra: proudly tackle the tame, while always keeping an eye on the wicked. We are better when we disagree, we are better when we talk things out and make decisions based on an understanding, a truly human characteristic.”

RSNA Events, Topics, Tech and Trends in the Spotlight

The large volume of educational sessions, Plenary sessions and special programs, technical exhibit booth visits over just the first two days of RSNA 2023 have kept the ITN editorial team busy covering all aspects of the meeting. Exhibit stops lead to enlightening discussions with executive leaders on latest products and features in the spotlight include, but are not limited to: Agfa, FUJIFILM, Bracco, Guerbet, Riverain, ClariPi, 4D Medical, Canon Medical, OpenRad, Esaote, Konica Minolta, Siemens Healthineers, Carestream, LG, Philips, Bayer, Quibim, CQ Medical, with more on the docket.

Don’t miss the full coverage of each of those breaking news items, as well as a plethora of updates and products being showcased by exhibitors which have been shared by ITN editorial team throughout each day. In addition to special sessions being offered in the Discovery Theater, RSNA Gold Medalists honored and special recognition awards today and over the week, ITN will be covering RSNA 2023 throughout the coming months to provide a thorough rundown of news on technology, imaging trends, clinical trials and more. The team will also be sharing insight from our team’s interviews and editorial videos with subject matter experts on healthcare IT trends, such as Paragon Consulting, Signify Research, among others.

Find and follow ITN’s continuing coverage of RSNA 2023 news here.

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