This year's keynote speaker, Nancy M. Cappello, Ph.D., founder and director of Are You Dense and Are You Dense Advocacy, Inc., expands on her keynote presentation "Why I Talk to Strangers About My Breasts."
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With the recent launch of the Magnifico Open, Italian company Esaote has entered the open MRI whole body space. ITN had a conversation with Franco Fontana, CEO of Esaote, at RSNA21.
Magnifico Open, which adds to the range of Esaote products unveiled in 2021, is an open magnetic resonance system with the latest technology. The wide choice of receiver coils and state-of-the-art MRI technology offer the user excellent image quality, while the permanent magnet makes it easy to use and lowers operating costs. The open magnet and the easy-to-access patient table also facilitate, speed up and make patient positioning more comfortable, ideal for both the claustrophobic and for children.
Orlando Simonetti, Ph.D., professor, cardiovascular medicine, worked with Siemens to help develop a new, lower-field magnetic resonance imaging (MRI) system, the Magnetom Free.Max. It can scan patients that previously may have been contraindicated because of implantable medical devices. One of the first systems installed in the U.S. is at The Ohio State University Wexner Medical Center. It has a much lower magnetic field and a larger patient opening, removing barriers to MRI imaging for many patients.
Simonetti and his colleagues developed new techniques to boost the signal-to-noise ratio in MRI machines, which allowed the creation of a machine with a lower magnetic field strength that still enables high quality images.
The system gained FDA clearance in July 2021 and was featured by Siemens at the Radiological Society of North America (RSNA) 2021 meeting.
The interview and footage was provided by The Ohio University State University Wexner Medical Center.
Read more in the articles New FDA-approved MRI Expands Access to Life-saving Imaging and Ohio State Researchers Help Design New MRI, Expanding Access to Life-saving Imaging.
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Siemens Healthineers Announces First U.S. Installation of Magnetom Free.Max 80 cm MR Scanner
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Ohio State Researchers Help Design New MRI, Expanding Access to Life-saving Imaging
Here are two examples of artificial intelligence (AI) driven pulmonary embolism (PE) response team apps featured by vendors Aidoc and Viz.AI at the 2021 Radiological Society of North America (RSNA) 2021 meeting.
The AI scans computed tomography (CT) image datasets as they came off the imaging system and looked for evidence of PE. If detected by the algorithm, it immediately sends an alert to the stroke care team members via smartphone messaging. This is done before the images are even loaded into the PACS. The radiologist on the team can use a link on the app to open the CT dataset and has basic tools for scrolling, windowing and leveling to determine if there is a PE and the severity. The team can then use the app to send messages, access patient information, imaging and reports. This enabled them all to be on the same page and can communicate quickly via mobile devices, rather than being required to use dedicated workstations in the hospital.
Both vendors showed similar apps for stroke at RSNA 2019. That idea for rapid alerts, diagnosis and communications for acute care teams has now expanded to PE and also for aortic dissection and abdominal aortic aneurysms (AAA). AI.Viz and Aidoc are looking at expanding this type of technology for other acute care team rolls, including heart failure response.
Read more about this technology in the article AI Can Facilitate Automated Activation of Pulmonary Embolism Response Teams.
Steve Holloway, company director at Signify Research, explains the trends he has seen over the past couple years in enterprise imaging. He spoke to ITN at the 2021 Radiological Society of North America meeting.
Holloway shared how medical imaging systems are expanding to include all departments in healthcare system enterprises that generate data, images and waveforms, so these items can be stored in a central location, rather than disparate silos or in separate systems requiring multiple logins or specific workstations. Most of these systems are are web enabled or web based, allowing users to work from anywhere as long as they have an internet connection. Most enterprise imaging systems also use a web-based vendor neutral archive, allowing DICOM and non-DICOM images to be stored there. All of these features allow easier and faster access to patient information and images.
He said these systems are becoming more inclusive of ologies outside of radiology and cardiology. Most notably is digital pathology, which was featured by many enterprise imaging vendors at RSNA 2021.
Enterprise imaging systems are also accepting point-of-care ultrasound (POCUS), which has exploded in use over the past two years with COVID, Holloway said.
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With the recent launch of the Magnifico Open, Italian company Esaote has entered the open MRI whole body space. ITN had a conversation with Franco Fontana, CEO of Esaote, at RSNA21.
Magnifico Open, which adds to the range of Esaote products unveiled in 2021, is an open magnetic resonance system with the latest technology. The wide choice of receiver coils and state-of-the-art MRI technology offer the user excellent image quality, while the permanent magnet makes it easy to use and lowers operating costs. The open magnet and the easy-to-access patient table also facilitate, speed up and make patient positioning more comfortable, ideal for both the claustrophobic and for children.
Integrated Speech recognition solutions are becoming a necessary part of radiology reporting platforms. Konica Minolta recently announced a partnership with nVoq to integrate a speech to text solution into their Exa Platform.
ITN recently spoke with Kevin Borden, Vice President of Product, Healthcare IT for Konica Minolta and Chad Hiner, Vice President of Customer Experience for nVoq, to talk about how this integration is improving the Exa user experience.
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Treating cancer effectively often includes a combination of patient therapies. In recent years, technology advancements have led to a more efficient and personalized approach to treatment. Andrew Wilson, President of Oncology Informatics at Elekta, discussed the latest software advancements with ITN.
Agfa is looking to transform X-ray with new advancements in volumetric imaging, and with new mobile concepts and implementation of intelligent tools. ITN had a conversation with Georges Espada on Transforming X-ray with Intelligent Tools.
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This is an overview of trends and technologies in radiology artificial intelligence (AI) applications in 2021. Views were shared by 11 radiologists using AI and industry leaders, which include:
• Randy Hicks, M.D., MBA, radiologist and CEO of Reginal Medical Imaging (RMI), and an iCAD Profound AI user.
• Prof. Dr. Thomas Frauenfelder, University of Zurich, Institute for Diagnostic and Interventional Radiology, and Riverain AI user.
• Amy Patel, M.D., medical director of Liberty Hospital Women’s Imaging, assistant professor of radiology at UMKC, and user of Kios AI for breast ultrasound.
• Sham Sokka, Ph.D., vice president and head of innovation, precision diagnosis, Philips Healthcare.
• Ivo Dreisser, Siemens Healthineers, global marketing manager for the AI Rad Companion.
• Bill Lacey, vice president of medical informatics, Fujifilm Medical Systems USA.
• Karley Yoder, vice president and general manager, artificial intelligence, GE Healthcare.
• Georges Espada, head of Agfa Healthcare digital and computed radiography business unit.
• Pooja Rao, head of research and development and co-founder of Qure.ai.
• Jill Hamman, world-wide marketing manager at Carestream Health.
• Sebastian Nickel, Siemens Healthineers, global product manager for the AI Pathway Companion.
There has been a change in attitudes about AI on the expo floor at the Radiological Society of North America (RSNA) over the last two years. AI conversations were originally 101 level and discussed how AI technology could be trained to sort photos of dogs and cats. However, in 2020, with numerous FDA approvals for various AI applications, the conversations at RSNA, and industry wide, have shifted to that of accepting the validity of AI. Radiologists now want to discuss how a specific AI algorithm is going to help them save time, make more accurate diagnoses and make them more efficient.
With a higher level of maturity in AI and the technology seeing wider adoption, radiologists using it say AI gives them additional confidence in their diagnoses, and can even help readers who may not be deep experts in the exam type they are being asked to read.
With a myriad of new AI apps gaining regulatory approval from scores of imaging vendors, the biggest challenge for getting this technology into hospitals is an easy to integrate format. This has led to several vendors creating AI app stores. These allow AI apps to integrate easily into radiology workflows because the apps are already integrated as third-party software into a larger radiology vendors' IT platform.
There are now hundreds of AI applications that do a wide variety of analysis, from data analytics, image reconstruction, disease and anatomy identification, automating measurements and advanced visualization. The AI applications can be divided into 2 basic types — AI to improve workflow, and AI for clinical decision support, such as diagnostic aids.
On the workflow side, several vendors are leveraging AI to pull together all of a patients' information, prior exams and reports in one location and to digest the information so it is easier for the radiologist to consume. Often the AI pulls only data and priors that relate to a specific question being asked, based on the imaging protocol used for the exam. One example of this is the Siemens Healthineers AI Clinical Pathway and Siemens AI integrations with PACS to automate measurements and advanced visualization.
AI is also helping simplify complex tasks and help reduce the reading time on involved exams. One example of this is in 3-D breast tomosythesis with hundreds of images, which is rapidly replacing 2-D mammography, which only produces 4 images. Another example is automated image reconstruction algorithms to significantly reduce manual work. AI also is now being integrated directly into several vendors' imaging systems to speed workflow and improve image quality.
Vendors say AI is here to stay. They explain the future of AI will be automation to help improve image quality, simplify manual processes, improved diagnostic quality, new ways to analyze data, and workflow aids that operate in the background as part of a growing number of software solutions.
Several vendors at RSNA 2020 noted that AI's biggest impact in the coming years will be its ability to augment and speed the workflow for the small number of radiologists compared to the quickly growing elder patient populations worldwide. There also are applications in rural and developing countries were there are very low numbers of physicians or specialists.
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In Artificial Intelligence at RSNA 2019, ITN Contributing Editor Greg Freiherr offers an overview of artificial intelligence (AI) advances at the Radiological Society of North America (RSNA) 2019 annual meeting.
In Enterprise Imaging at RSNA 2019, ITN Contributing Editor Greg Freiherr offers an overview of enterprise imaging advances at the Radiological Society of North America (RSNA) 2019 annual meeting.
In Artificial Intelligence 2018: What Radiologists Need to Know About AI, ITN Contributing Editor Greg Freiherr offers an overview of artificial intelligence (AI) advances at the Radiological Society of North America (RSNA) 2018 annual meeting.
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Radiation Oncology View all 129 items
Jeffrey T. Chapman, a medical student at the University of Texas Southwestern Medical Center, Explains how watching movies can be used to help sedate pediatric radiation therapy patients. He presented the results of the Pediatric Radiation Oncology With Movie Induced Sedation Effect (PROMISE) study at the 2021 American Society of Radiation Oncology (ASTRO) annual meeting.
Children usually have to be sedated with anesthesia to keep them immobile each day for weeks for their daily fractions of radiotherapy. This presents problems because the child will have side effects from the anesthesia and face issues with eating only at certain times. UTSW developed a system where the child can watch a movie and if they move the movie and the radiation beam both immediately shut off. This trains the child to stay still during treatments without the need for anesthesia.
Photo Gallery of Technologies at ASTRO 2021
Ana Kiess, M.D., Ph.D., assistant professor of radiation oncology and molecular radiation sciences, Johns Hopkins University, explains the current state of patient-centered radiopharmaceutical therapy at the American Society of Radiation Oncology (ASTRO) 2021 meeting.
She discusses development and use over the past decade of Radium-223 dichloride and Lutetium-177 dotatate. Kiess also expects there will be targeted injectable radiopharmaceuticals for nearly all solid tumor types in the next decade. She said her center is currently investigating the use of radiopharma agents to treat oligometastatic metastatic cancers.
Photo Gallery of Technologies at ASTRO 2021
The Elekta Harmony radiotherapy system gained FDA clearance in the summer of 2021 and was on display for the first time at the American Society of Radiation Oncology (ASTRO) 2021 meeting. It offers fast treatments and the ability to track and treat multiple metastases at the same time.
It has a large round screen on the machine so the patient's information is immediately available table side. It uses facial recognition to verify the correct patient is in the room for treatment.
The speed of the treatment delivery increased over that of prior systems, so the time a patient spends in the treatment room for lung SBRT went from 30 minutes down to less than 2 minutes. SBRT prostate went down from 5 minutes to 90 seconds. It also can perform hypofractionation lung therapy in a single 20 minute treatment.
Read more on the Harmony system.
Photo Gallery of Technologies at ASTRO 2021
This is a model of the Toshiba ion beam radiation therapy system at the American Society of Radiation Oncology (ASTRO) 2021 meeting. It shows the cyclotron, beam lines and two treatment rooms, one with a fixed beam and second with a rotating gantry.
Photo Gallery of Technologies at ASTRO 2021
Radiology Imaging View all 373 items
With the recent launch of the Magnifico Open, Italian company Esaote has entered the open MRI whole body space. ITN had a conversation with Franco Fontana, CEO of Esaote, at RSNA21.
Magnifico Open, which adds to the range of Esaote products unveiled in 2021, is an open magnetic resonance system with the latest technology. The wide choice of receiver coils and state-of-the-art MRI technology offer the user excellent image quality, while the permanent magnet makes it easy to use and lowers operating costs. The open magnet and the easy-to-access patient table also facilitate, speed up and make patient positioning more comfortable, ideal for both the claustrophobic and for children.
Orlando Simonetti, Ph.D., professor, cardiovascular medicine, worked with Siemens to help develop a new, lower-field magnetic resonance imaging (MRI) system, the Magnetom Free.Max. It can scan patients that previously may have been contraindicated because of implantable medical devices. One of the first systems installed in the U.S. is at The Ohio State University Wexner Medical Center. It has a much lower magnetic field and a larger patient opening, removing barriers to MRI imaging for many patients.
Simonetti and his colleagues developed new techniques to boost the signal-to-noise ratio in MRI machines, which allowed the creation of a machine with a lower magnetic field strength that still enables high quality images.
The system gained FDA clearance in July 2021 and was featured by Siemens at the Radiological Society of North America (RSNA) 2021 meeting.
The interview and footage was provided by The Ohio University State University Wexner Medical Center.
Read more in the articles New FDA-approved MRI Expands Access to Life-saving Imaging and Ohio State Researchers Help Design New MRI, Expanding Access to Life-saving Imaging.
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Siemens Healthineers Announces First U.S. Installation of Magnetom Free.Max 80 cm MR Scanner
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Steve Holloway, company director at Signify Research, explains the trends he has seen over the past couple years in enterprise imaging. He spoke to ITN at the 2021 Radiological Society of North America meeting.
Holloway shared how medical imaging systems are expanding to include all departments in healthcare system enterprises that generate data, images and waveforms, so these items can be stored in a central location, rather than disparate silos or in separate systems requiring multiple logins or specific workstations. Most of these systems are are web enabled or web based, allowing users to work from anywhere as long as they have an internet connection. Most enterprise imaging systems also use a web-based vendor neutral archive, allowing DICOM and non-DICOM images to be stored there. All of these features allow easier and faster access to patient information and images.
He said these systems are becoming more inclusive of ologies outside of radiology and cardiology. Most notably is digital pathology, which was featured by many enterprise imaging vendors at RSNA 2021.
Enterprise imaging systems are also accepting point-of-care ultrasound (POCUS), which has exploded in use over the past two years with COVID, Holloway said.
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Jean Jeudy, M.D., professor of radiology and vice chair of informatics at the University of Maryland School of Medicine, presented a late-breaking study at the 2021 Radiological Society of North America (RSNA) meeting on COVID-19 linked myocarditis in college athletes.
A small but significant percentage of college athletes with COVID-19 develop myocarditis, a potentially dangerous inflammation of the heart muscle, that can only be seen on cardiac MRI, according to the study Jeudy presented. Myocarditis, which typically occurs as a result of a bacterial or viral infection, can affect the heart’s rhythm and ability to pump and often leaves behind lasting damage in the form of scarring to the heart muscle. It has been linked to as many as 20% of sudden deaths in young athletes. The COVID-19 pandemic raised concerns over an increased incidence of the condition in student-athletes.
For the new study, clinicians at schools in the highly competitive Big Ten athletic conference collaborated to collect data on the frequency of myocarditis in student-athletes recovering from COVID-19 infection. Conference officials had required all athletes who had COVID-19 to get a series of cardiac tests before returning to play, providing a unique opportunity for researchers to collect data on the athletes’ cardiac status.
Thirty-seven of the athletes, or 2.3%, were diagnosed with COVID-19 myocarditis, a percentage on par with the incidence of myocarditis in the general population. However, an alarmingly high proportion of the myocarditis cases were found in athletes with no clinical symptoms. Twenty of the patients with COVID-19 myocarditis (54%) had neither cardiac symptoms nor cardiac testing abnormalities. Only cardiac MRI identified the problem.
Read more details in the article COVID-19 Linked to Heart Inflammation in College Athletes.
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Molecular Imaging View all 32 items
Ana Kiess, M.D., Ph.D., assistant professor of radiation oncology and molecular radiation sciences, Johns Hopkins University, explains the current state of patient-centered radiopharmaceutical therapy at the American Society of Radiation Oncology (ASTRO) 2021 meeting.
She discusses development and use over the past decade of Radium-223 dichloride and Lutetium-177 dotatate. Kiess also expects there will be targeted injectable radiopharmaceuticals for nearly all solid tumor types in the next decade. She said her center is currently investigating the use of radiopharma agents to treat oligometastatic metastatic cancers.
Photo Gallery of Technologies at ASTRO 2021
Walter Curran, Jr. M.D., FACR, FASCO, GenesisCare global chief medical officer, discusses three technologies that are helping advance radiation oncology care during the American Society of Radiation Oncology (ASTRO) 2021 meeting. These technology advances include:
• Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging for prostate cancer.
• MRI-linear accelerator (Linac) systems that allow real-time imaging during radiation therapy.
• Remote treatment planning to help radiation treatment centers that are in rural areas.
Prostate cancer is one of the most common cancers in men. The new PSMA PET imaging is expected to significantly improve how prostate cancer is detected and treated. The FDA approved the drug for PET nuclear imaging of PSMA-positive lesions in men with prostate cancer. 68Ga-PSMA-11 is a radioactive imaging agent that binds to prostate cancer cells to help localize prostate cancer cells.
Photo Gallery of Technologies at ASTRO 2021
Yael Eshet, M.D., MSc, a diagnostic radiology specialist at Sheba Medical Center in Israel, was the lead author on a recent study that showed COVID-19 (SARS-CoV-2) vaccine adenopathy can persist more than 6 weeks. This swelling of lymph nodes is similar to what is seen cancer and infections and the new findings show it can last longer than 7-10 weeks. The current recommended time people should delay medical imaging is 6 weeks after receiving a COVID vaccine to avoid a misdiagnosis,[2] but this new study shows there is increased inflammation shown on PET-CT imaging for much longer.
These were the findings in the Radiology published study "Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination."[1]
Researchers using fluorodeoxyglucose (FDG)-positron emission tomography (PET) have found increased FDG uptake in the lymph nodes of patients 7-10 weeks past their second mRNA-based Pfizer-BioNTech COVID-19 vaccination. This new information indicates a persistent immune response that could be mistaken on imaging exams for serious conditions like lymphoma over a much longer period of time.
Recent recommendations for post-vaccine lymphadenopathy advise scheduling routine imaging, such as screening mammography, before, or at least 6 weeks after, the final vaccination dose to eliminate false positive results. However, this new research showed that avid axillary lymph node uptake was present beyond 6 weeks after the second vaccination in more than 29% of the patients in the study cohort.
The authors stated “This study shows that avid axillary lymph node uptake on FDG PET/CT can be detected in more than a quarter of our patient population even beyond 6 weeks after the second dose of the mRNA-based COVID-19 vaccination. Compared to a previous study showing normalization of FDG uptake within 40 days of receiving an inactivated H1N1 influenza vaccine, we found uptake persistence even at 70 days. Physicians should be aware of this potential pitfall.”
Some images in this video are from another Radiology study, which showed PET tracer uptake at the COVID vaccine injection site and other examples of axillary adenopathy.[3]
Related COVID Vaccine Axillary Adenapathy Content:
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References:
This is an example of Canon's Advanced intelligent Clear-IQ Engine (AiCE) AI-driven image reconstruction software that is now being used to improve image quality on the Canon Celesteion Prime PET/CT nuclear imaging system. The deep learning is used to enhance the iterative reconstruction used to reduce noise and sharped high contrast resolution on positron emission tomography (PET) images from the digital PET detector used on the system.
This example is a whole-body FGD PET scan of a patient with a large BMI with lung cancer.
The Cartesion Prime PET/CT is the industry’s only air-cooled digital PET/CT, provides variable bed time (vBT) acquisition as a standard feature. This and the new FDA 510(k)-pending AiCE technology were highlighted at the 2020 Radiological Society of North America (RSNA) virtual meeting.
Conference Coverage View all 495 items
With the recent launch of the Magnifico Open, Italian company Esaote has entered the open MRI whole body space. ITN had a conversation with Franco Fontana, CEO of Esaote, at RSNA21.
Magnifico Open, which adds to the range of Esaote products unveiled in 2021, is an open magnetic resonance system with the latest technology. The wide choice of receiver coils and state-of-the-art MRI technology offer the user excellent image quality, while the permanent magnet makes it easy to use and lowers operating costs. The open magnet and the easy-to-access patient table also facilitate, speed up and make patient positioning more comfortable, ideal for both the claustrophobic and for children.
Here are two examples of artificial intelligence (AI) driven pulmonary embolism (PE) response team apps featured by vendors Aidoc and Viz.AI at the 2021 Radiological Society of North America (RSNA) 2021 meeting.
The AI scans computed tomography (CT) image datasets as they came off the imaging system and looked for evidence of PE. If detected by the algorithm, it immediately sends an alert to the stroke care team members via smartphone messaging. This is done before the images are even loaded into the PACS. The radiologist on the team can use a link on the app to open the CT dataset and has basic tools for scrolling, windowing and leveling to determine if there is a PE and the severity. The team can then use the app to send messages, access patient information, imaging and reports. This enabled them all to be on the same page and can communicate quickly via mobile devices, rather than being required to use dedicated workstations in the hospital.
Both vendors showed similar apps for stroke at RSNA 2019. That idea for rapid alerts, diagnosis and communications for acute care teams has now expanded to PE and also for aortic dissection and abdominal aortic aneurysms (AAA). AI.Viz and Aidoc are looking at expanding this type of technology for other acute care team rolls, including heart failure response.
Read more about this technology in the article AI Can Facilitate Automated Activation of Pulmonary Embolism Response Teams.
Steve Holloway, company director at Signify Research, explains the trends he has seen over the past couple years in enterprise imaging. He spoke to ITN at the 2021 Radiological Society of North America meeting.
Holloway shared how medical imaging systems are expanding to include all departments in healthcare system enterprises that generate data, images and waveforms, so these items can be stored in a central location, rather than disparate silos or in separate systems requiring multiple logins or specific workstations. Most of these systems are are web enabled or web based, allowing users to work from anywhere as long as they have an internet connection. Most enterprise imaging systems also use a web-based vendor neutral archive, allowing DICOM and non-DICOM images to be stored there. All of these features allow easier and faster access to patient information and images.
He said these systems are becoming more inclusive of ologies outside of radiology and cardiology. Most notably is digital pathology, which was featured by many enterprise imaging vendors at RSNA 2021.
Enterprise imaging systems are also accepting point-of-care ultrasound (POCUS), which has exploded in use over the past two years with COVID, Holloway said.
VIDEO: Trends in Radiology IT seen at RSNA 2021 — Interview with Jef Williams, Paragon Consultants
VIDEO: Artificial Intelligence Trends in Medical Imaging — Interview with Sanjay Parekh, Ph.D, from Signify Research
VIDEO: Examples of Improved PACS Workflow to Aid Speed and Efficiency
VIDEO: The New Normal of Home Workstations, Teleradiology and Remote Reading — Interview with Elizabeth Hawk, M.D.
Technology Report: Artificial Intelligence in Radiology 2021
Technology Report: Enterprise Imaging 2019
Jean Jeudy, M.D., professor of radiology and vice chair of informatics at the University of Maryland School of Medicine, presented a late-breaking study at the 2021 Radiological Society of North America (RSNA) meeting on COVID-19 linked myocarditis in college athletes.
A small but significant percentage of college athletes with COVID-19 develop myocarditis, a potentially dangerous inflammation of the heart muscle, that can only be seen on cardiac MRI, according to the study Jeudy presented. Myocarditis, which typically occurs as a result of a bacterial or viral infection, can affect the heart’s rhythm and ability to pump and often leaves behind lasting damage in the form of scarring to the heart muscle. It has been linked to as many as 20% of sudden deaths in young athletes. The COVID-19 pandemic raised concerns over an increased incidence of the condition in student-athletes.
For the new study, clinicians at schools in the highly competitive Big Ten athletic conference collaborated to collect data on the frequency of myocarditis in student-athletes recovering from COVID-19 infection. Conference officials had required all athletes who had COVID-19 to get a series of cardiac tests before returning to play, providing a unique opportunity for researchers to collect data on the athletes’ cardiac status.
Thirty-seven of the athletes, or 2.3%, were diagnosed with COVID-19 myocarditis, a percentage on par with the incidence of myocarditis in the general population. However, an alarmingly high proportion of the myocarditis cases were found in athletes with no clinical symptoms. Twenty of the patients with COVID-19 myocarditis (54%) had neither cardiac symptoms nor cardiac testing abnormalities. Only cardiac MRI identified the problem.
Read more details in the article COVID-19 Linked to Heart Inflammation in College Athletes.
Related COVID-19 Imaging and Myocarditis Content:
Overview of Myocarditis Cases Caused by the COVID-19 Vaccine
COVID-19 Linked to Heart Inflammation in College Athletes — RSNA 2021 late-breaker
Cardiac MRI of Myocarditis After COVID-19 Vaccination in Adolescents
Large International Study Reveals Spectrum of COVID-19 Brain Complications - RSNA 2021 late-breaker
COVID-19 During Pregnancy Doesn’t Harm Baby’s Brain
FDA Adds Myocarditis Warning to COVID mRNA Vaccine Clinician Fact Sheets
Small Number of Patients Have Myocarditis-like Illness After COVID-19 Vaccination
Information Technology View all 275 items
Here are two examples of artificial intelligence (AI) driven pulmonary embolism (PE) response team apps featured by vendors Aidoc and Viz.AI at the 2021 Radiological Society of North America (RSNA) 2021 meeting.
The AI scans computed tomography (CT) image datasets as they came off the imaging system and looked for evidence of PE. If detected by the algorithm, it immediately sends an alert to the stroke care team members via smartphone messaging. This is done before the images are even loaded into the PACS. The radiologist on the team can use a link on the app to open the CT dataset and has basic tools for scrolling, windowing and leveling to determine if there is a PE and the severity. The team can then use the app to send messages, access patient information, imaging and reports. This enabled them all to be on the same page and can communicate quickly via mobile devices, rather than being required to use dedicated workstations in the hospital.
Both vendors showed similar apps for stroke at RSNA 2019. That idea for rapid alerts, diagnosis and communications for acute care teams has now expanded to PE and also for aortic dissection and abdominal aortic aneurysms (AAA). AI.Viz and Aidoc are looking at expanding this type of technology for other acute care team rolls, including heart failure response.
Read more about this technology in the article AI Can Facilitate Automated Activation of Pulmonary Embolism Response Teams.
Steve Holloway, company director at Signify Research, explains the trends he has seen over the past couple years in enterprise imaging. He spoke to ITN at the 2021 Radiological Society of North America meeting.
Holloway shared how medical imaging systems are expanding to include all departments in healthcare system enterprises that generate data, images and waveforms, so these items can be stored in a central location, rather than disparate silos or in separate systems requiring multiple logins or specific workstations. Most of these systems are are web enabled or web based, allowing users to work from anywhere as long as they have an internet connection. Most enterprise imaging systems also use a web-based vendor neutral archive, allowing DICOM and non-DICOM images to be stored there. All of these features allow easier and faster access to patient information and images.
He said these systems are becoming more inclusive of ologies outside of radiology and cardiology. Most notably is digital pathology, which was featured by many enterprise imaging vendors at RSNA 2021.
Enterprise imaging systems are also accepting point-of-care ultrasound (POCUS), which has exploded in use over the past two years with COVID, Holloway said.
VIDEO: Trends in Radiology IT seen at RSNA 2021 — Interview with Jef Williams, Paragon Consultants
VIDEO: Artificial Intelligence Trends in Medical Imaging — Interview with Sanjay Parekh, Ph.D, from Signify Research
VIDEO: Examples of Improved PACS Workflow to Aid Speed and Efficiency
VIDEO: The New Normal of Home Workstations, Teleradiology and Remote Reading — Interview with Elizabeth Hawk, M.D.
Technology Report: Artificial Intelligence in Radiology 2021
Technology Report: Enterprise Imaging 2019
Jef Williams, MBA, PMP, CIIP, managing partner, Paragon Consulting Partners LLC, explains trends he saw at the 2021 Radiological Society of North America (RSNA) meeting. These include radiology IT trends in the evolution of enterprise imaging, increasing use of artificial intelligence (AI) and the movement to web-based systems.
VIDEO: Artificial Intelligence Trends in Medical Imaging — Interview with Sanjay Parekh, Ph.D, from Signify Research
VIDEO: Trends in Enterprise Imaging From Signify Research — Interview with Steve Holloway, Signify Research
Technology Report: Artificial Intelligence in Radiology 2021
Technology Report: Enterprise Imaging 2019
VIDEO: Examples of Improved PACS Workflow to Aid Speed and Efficiency
VIDEO: The New Normal of Home Workstations, Teleradiology and Remote Reading — Interview with Elizabeth Hawk, M.D.
VIDEO: Mammography Trends and Advances at RSNA 2021 — Interview with Stamatia Destounis, M.D.
Elizabeth Hawk, M.D., Ph.D., director of innovation Engagement at Rad Partners, a regional president for Matrix Teleradiology, and assistant professor of medicine at Stanford, explains how the COVID-19 pandemic has helped advance home reading and changed radiology.
While teleradiology and remote reading is not new, its expansion was greatly accelerated in 2020-2021 due to COVID. Early in the pandemic, hospitals tried to get as many of their employees as possible to work remotely, and radiologists who wanted to read from home were allowed to do so in large numbers. The past two years has taught many people that remote reading from home is possible and it also can aid the balance between work and family life. Hawk said remote reading will likely be the new normal even after the pandemic.
Hawk presented in a session on this topic at the 2021 Radiological Society of North America (RSNA) annual meeting. She said many radiologists from her practice were already reading from home prior to the pandemic, so they had the experience to quickly ramp up expansion during COVID. She offers advice to hospitals that want to introduce or expand home radiology reading.
Women's Health View all 78 items
Stamatia Destounis, M.D., FACR, chief of the American College of Radiology (ACR) Breast Commission, managing partner, Elizabeth Wende Breast Care, Rochester, N.Y., explains some of the key trends in breast imaging at the 2021 Radiological Society of North America (RSNA) meeting.
She discusses the trends of 3D mammography seeing rapid growth, adoption of synthetic 2D breast images from the tomosynthesis datasets, contrast-enhanced mammography, and breast MRI to help women with dense breast tissue. Destounis also discusses the use of artificial intelligence (AI) to help radiologists with finding what they needs with larger datasets in 3D mammography, and to help act as a second set of eyes.
Early in 2021, with the roll out of the COVID vaccines, one of the biggest headlines in radiology was that the vaccine can show false positives for cancer because it may cause inflammation of lymph nodes. Destounis explains this issue and how women's health centers have largely overcome this by asking patients about their vaccination status and planning imaging around the vaccination dates.
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Yael Eshet, M.D., MSc, a diagnostic radiology specialist at Sheba Medical Center in Israel, was the lead author on a recent study that showed COVID-19 (SARS-CoV-2) vaccine adenopathy can persist more than 6 weeks. This swelling of lymph nodes is similar to what is seen cancer and infections and the new findings show it can last longer than 7-10 weeks. The current recommended time people should delay medical imaging is 6 weeks after receiving a COVID vaccine to avoid a misdiagnosis,[2] but this new study shows there is increased inflammation shown on PET-CT imaging for much longer.
These were the findings in the Radiology published study "Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination."[1]
Researchers using fluorodeoxyglucose (FDG)-positron emission tomography (PET) have found increased FDG uptake in the lymph nodes of patients 7-10 weeks past their second mRNA-based Pfizer-BioNTech COVID-19 vaccination. This new information indicates a persistent immune response that could be mistaken on imaging exams for serious conditions like lymphoma over a much longer period of time.
Recent recommendations for post-vaccine lymphadenopathy advise scheduling routine imaging, such as screening mammography, before, or at least 6 weeks after, the final vaccination dose to eliminate false positive results. However, this new research showed that avid axillary lymph node uptake was present beyond 6 weeks after the second vaccination in more than 29% of the patients in the study cohort.
The authors stated “This study shows that avid axillary lymph node uptake on FDG PET/CT can be detected in more than a quarter of our patient population even beyond 6 weeks after the second dose of the mRNA-based COVID-19 vaccination. Compared to a previous study showing normalization of FDG uptake within 40 days of receiving an inactivated H1N1 influenza vaccine, we found uptake persistence even at 70 days. Physicians should be aware of this potential pitfall.”
Some images in this video are from another Radiology study, which showed PET tracer uptake at the COVID vaccine injection site and other examples of axillary adenopathy.[3]
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References:
Constance "Connie" Lehman, M.D., Ph.D., chief of breast imaging, co-director of the Avon Comprehensive Breast Evaluation Center at the Massachusetts General Hospital, and professor of radiology at Harvard Medical School, explains issues and suggested guidelines for women who receive the COVID-19 vaccine and need to get a mammogram. In the first three months since the vaccines have been released, there have been numerous case reports of the vaccine causing swollen lymph nodes. This is would usually raise a red flag for breast cancer, but is normal for many women receiving the vaccine as their body's immune system gears up against the virus.
Lehman said cases reports of axillary adenopathy have been identified on breast imaging after coronavirus disease (COVID-19) vaccination and are rising. Lehman et al. proposed a pragmatic management approach in a recent article in the American Journal of Roentgenology (AJR).[1]
In the settings of screening mammography, screening MRI and diagnostic imaging work-up of breast symptoms, with no imaging findings beyond unilateral axillary adenopathy ipsilateral to recent (prior six weeks) vaccination, they report the adenopathy as benign with no further imaging indicated if no nodes are palpable six weeks after the last vaccine dose.
For patients with palpable axillary adenopathy in the setting of ipsilateral recent vaccination, clinical follow-up of the axilla is recommended. In all these scenarios, axillary ultrasound is recommended if clinical concern persists six weeks after vaccination.
In patients with recent breast cancer diagnosis in the pre- or peri-treatment setting, prompt recommended imaging is encouraged as well as vaccination (in the thigh or contralateral arm). The recommendations align with the ACR BI-RADS Atlas and aim to: 1) reduce patient anxiety, provider burden, and costs of unnecessary evaluation of enlarged nodes in the setting of recent vaccination, and 2) avoid further delays in vaccinations and breast cancer screening during the pandemic.
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Reference:
Artificial Intelligence (AI) is becoming more common place in radiology practices, and emerging technologies are providing radiologists with sophisticated detection software to aid their reading and provide support for a busy workflow. With the progression of AI technology, vendors must look not only at what AI can do for the radiologist, but how the radiologist and the technician interact with that technology – the goal should be increasing accuracy while also positively improving workflow. GE Healthcare is working to improve radiology AI workflow in its Centricity Universal Viewer.
Three key opinion leaders offers their views on what is needed to make AI more valauble and accessible to radiologists. These include:
• Amy Patel, M.D., breast radiologist, medical director, Liberty Hospital Women's Imaging, assistant professor of radiology, University of Missouri-Kansas City.
• Prof. Dr. Thomas Frauenfelder, M.D., vice chairman and professor of thoracic radiology, Institute for Diagnostic and Interventional Radiology, University of Zurich.
• Randy Hicks, M.D., chief executive officer, Regional Medical Imaging.
Learn more about the Centricity Universal Viewer in the VIDEO: How GE Healthcare’s Zero Footprint Remote Image Viewer Supports Clinical Care