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.

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

Professor Christiane Kuhl, M.D., director of radiology, University Hospital Aachen, Germany, explains how breast magnetic resonance imaging (MRI) can be used to clearly identify breast cancers in women with dense breast tissue. In women with dense breasts, it can be very difficult to detect many cancers on standard mammograms because the cancers and dense tissue both appear white. MRI can help clearly define tumors and identify which nodules are cancer and which are benign, which can help greatly reduce the need for biopsies.

Kuhl is an expert in breast imaging and breast MRI. She helped develop an a shortened MRI protocol that allows breast MR images to be created in 3 minutes or less, rather than standard protocols that can take up to 30 minutes. In the interview she shows patient case examples of standard mammograms and the MRI supplemental imaging for the same patient to show the hidden tumors. 

She also explains the differences between standard 2-d mammography, the current standard of care, and the newer 3-D mammogram tomosythnesis technology, breast ultrasound and breast MRI technologies.

Read the related article Use of Breast MRI Screening in Women With Dense Breasts, which includes case examples comparing mammograms to the patients' breast MRIs.

Other video interviews with Dr. Kuhl:

VIDEO: Explaining Dense Breasts

VIDEO: The Impact of COVID-19 on Breast Imaging

Related Breast MRI Content:

Abbreviated MRI Outperforms 3-D Mammograms at Finding Cancer in Dense Breasts

VIDEO: Explaining Dense Breasts — Interview with Christiane Kuhl, M.D.

VIDEO: Use of Breast MRI Improved Cancer Detection in Dense Breasts in Dutch Study — Interview with Gillian Newstead, M.D.

Technologies to Watch in Breast Imaging

Screening MRI Detects BI-RADS 3 Breast Cancer in High-risk Patients

Rapid Breast MRI Screening Improves Cancer Detection in Dense Breasts

Breast MRI in Cancer Diagnosis
 

Professor Christiane Kuhl, M.D., director of radiology, University Hospital Aachen, Germany, explains what it means to have dense breasts and how density can hide cancers in mammograms. She offers an explanation describing dense breast tissue and that this occurs in about half of women. Density is itself a risk factor for breast cancer and the fact that dense tissue hides cancers on mammography means that supplemental imaging is needed to accurately diagnose these patients and avoid false positives, or needless tissue biopsies. Breast ultrasound and breast magnetic resonance imaging (MRI) can be used to see through dense tissue to better identify cancers and avoid the need for many biopsies.

Other video interviews with Dr. Kuhl:

VIDEO: Use of Breast MRI Screening in Women With Dense Breasts

VIDEO: The Impact of COVID-19 on Breast Imaging

Related Dense Breast Content:

Breast Density Explained

Animation to Bring Clarity to Dense Breasts

Improving Clinical Image Quality for Breast Imaging

Breast Imaging in the Age of Coronavirus

Abbreviated MRI Outperforms 3-D Mammograms at Finding Cancer in Dense Breasts

VIDEO: Use of Breast MRI Improved Cancer Detection in Dense Breasts in Dutch Study — Interview with Gillian Newstead, M.D.

Technologies to Watch in Breast Imaging

Screening MRI Detects BI-RADS 3 Breast Cancer in High-risk Patients

Advanced visualization company Medis recently purchased Advanced Medical Imaging Development S.r.l. (AMID), which developed software to automatically track and measure strain in echocardiograms. That technology is now being adapted for strain imaging in CT and MRI. Using this imaging data, the software also can noninvasively derive pressure gradient loops and curves, similar to using invasive pulmonary arterial (PA) hemodynamic pressure catheters. This information is useful in monitoring critically ill patients on hemodynamic support and to monitor worsening severity of heart failure. 

The technology was discussed at the 2020 Society of Cardiovascular Computed Tomography (SCCT) virtual meeting. Examples of this technology are presented in this video. 
 

Find more news and video from SCCT 2020

VIDEO: Photon Counting Detectors Will be the Next Major Advance in Computed Tomography

Todd Villines, M.D., FACC, FAHA, MSCCT, explains how artificial intelligence (AI) might be used in the near future to automatically calculate CT calcium scoring and and radiomic feature assessments. This was a key take away during the Society of Cardiovascular Computed Tomography (SCCT) 2020 virtual meeting. 

Villines is the Julian Ruffin Beckwith Professor of Medicine, Division of Cardiovascular Medicine, University of Virginia, editor-in-chief of the Journal of Cardiovascular CT (JCCT),  and SCCT past-president.

AI is already commercially used to improve CT image reconstruction to increase the diagnostic quality of the images, especially from low-dose scans. AI is now being applied to automate time-consuming tasks in CT image reads, such as manually calculated calcium scores and automated contouring and quantification of anatomy and function of the heart.

Another area that is seeing a lot of research in in radiomics, where AI is being used to sift through thousands of CT scans to look for subtle imaging traits that may indicate the early development or worsening of disease. These subtle changes may not be evident to radiologists reading the scans, but AI software can identify similarities in patients as a trend and alert researchers to look at that specific trait as a potential imaging biomarker.

Other Key Trends and Technology at SCCT:

Top 9 Cardiovascular CT Studies in Past Year 

VIDEO: Photon Counting Detectors Will be the Next Major Advance in Computed Tomography

VIDEO: Increased Use of Cardiac CT During the COVID-19 Pandemic

VIDEO: Coronary Plaque Quantification Will Become Major Risk Assessment

VIDEO: Key Cardiac CT Papers Presented at SCCT 2020

Low-attenuation Coronary Plaque Burden May Become Next Big Cardiac Risk Assessment

Impact of Cardiac CT During COVID-19

Todd Villines, M.D., FACC, FAHA, MSCCT, explains how coronary plaque assessment will become a new risk assessment tool in cardiac CT. This was a key take away during the Society of Cardiovascular Computed Tomography (SCCT) 2020 virtual meeting in July. He is the Julian Ruffin Beckwith Professor of Medicine, Division of Cardiovascular Medicine, University of Virginia; editor-in-chief of the Journal of Cardiovascular CT (JCCT), and SCCT past-president. 

While basic plaque assessments have been available for several years on CT vendor and third-party advanced visualization software, it lacked automation standardization for what various values meant and clinical evidence it was relevant. However, several speakers in SCCT sessions said that is now changing, with more specific analysis being tested clinically and automation using artificial intelligence. 

Several key opinion leaders in cardiac CT said this new information and automation lwill likely lead to a revision of the current CAD-RADS scoring system used by radiologists and cardiologists when assessing the coronary event risk of patients. They are calling for the new CAD-RADS 2.0 to include a detailed plaque assessment.  

Other Key Trends and CT Technology at SCCT:

Top 9 Cardiovascular CT Studies in Past Year 

VIDEO: Photon Counting Detectors Will be the Next Major Advance in Computed Tomography

VIDEO: Increased Use of Cardiac CT During the COVID-19 Pandemic

VIDEO: Coronary Plaque Quantification Will Become Major Risk Assessment

VIDEO: Key Cardiac CT Papers Presented at SCCT 2020

Impact of Cardiac CT During COVID-19

VIDEO: Artificial Intelligence to Automate CT Calcium Scoring and Radiomics

At this year’s RSNA ITN sat down with Dennis Durmis, Senior Vice President, Bayer Radiology to discuss Radiology trends. Discussion topics centered around three key areas where Bayer Radiology is responding to trends; including digitalization, workflow efficiencies and efforts to bring more focus to the Radiology patient experience. During the interview Dennis discussed Bayer’s digital strategy, features and benefits of their new injector, the MEDRAD® Stellant FLEX Injector and Bayer’s education efforts of the imaging needs of women with Dense Breast.

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.

Bill Lacy, vice president, Medical Informatics at FUJIFILM Medical Systems U.S.A., Inc. discusses Synapse 7x, a convergence of the company’s server-side technology designed to cover all the different areas of diagnostic visualization, as well as overall enterprise viewing, with ITN Consulting Editor Greg Freiherr. For more information on Fujifilm's Enterprise Imaging solutions, visit ei.fujimed.com. 

At RSNA19, GE Healthcare introduced its Edison Open AI Orchestrator. The software has been designed to operate smart algorithms that might save radiologists time. ITN Contributing Editor Greg Freiherr discusses its benefits with Karley Yoder, vice president and general manager of artificial intelligence for GE.

Related GE Edison Platform Content:

GE Healthcare Unveils New Applications and Smart Devices Built on Edison Platform

VIDEO: itnTV Conversations — What is Edison?

Imaging Technology News Contributing Editor Greg Freiherr interviewed Henry Izawa, vice president of modality solutions, Fujifilm Medical Systems U.S.A., Inc. about Fujifilm's latest innovations in mammography.

In this video, Izawa announces the latest imaging advancements available for the Aspire Cristalle digital mammography system with digital breast tomosynthesis, including S-View, a synthesized 2-D image reconstructed from DBT and other patient enhancements such as the comfort paddle to provide a noticeably more comfortable exam for the patient.

Watch the video to hear all about Fujifilm's updates.

To learn more, visit www.fujimed.com

ITN Editor Dave Fornell takes a tour of some of the most innovative new medical imaging technologies displayed on the expo floor at the Radiological Society of North America (RSNA) 2019 meeting in December. 

Technology examples include a robotic arm to perform remote ultrasound exams, integration of artificial intelligence (AI) to speed or automate radiology workflow, holographic medical imaging display screens, a new glassless digital radiography (DR) X-ray detector, augmented reality for transesophageal echo (TEE) training, moving DR X-ray images, 3-D printed surgical implants created from a patient's CT imaging, DR X-ray tomosynthesis datasets, radiation dose management and analytics software, and new computed tomography (CT) technologies.

Additional Medical Imaging Advances Content From RSNA 2019:

Photo Gallery of New Imaging Technologies at RSNA 2019

Advances in DR X-ray Technology at RSNA 2019

VIDEO: Key Radiology Technology Trends at RSNA 2019

3 High-impact AI Market Trends in Radiology at RSNA 2019

Find more videos and news from RSNA 2019

Karen Ordovas, M.D., MAS, professor of radiology and cardiology at the University of California San Francisco (UCFS) School of Medicine and a Society of Cardiac Magnetic Resonance (SCMR) board member, explains how cardiac MRI can help in women's heart disease and to better define complex congenital heart anatomy. She spoke at the 2019 Radiological Society of North America (RSNA) meeting. 

She specializes in cardiac and pulmonary imaging, and has particular expertise in using CT and MRI techniques in cardiovascular imaging and the differences of presentation in imaging between male and female cardiac patients. Ordovas is helping advance education around heart disease in women and bring great awareness of quality tools to diagnose heart disease and how heart MRI can help. She also is heavily involved in the use of heart MRIs for pregnant women, since there is no radiation,  and patients with congenital heart disease where detailed imaging of the complex anatomy is required.

The use of cardiac MRI in congenital heart disease is common in serial imaging of patients with Tetralogy of Fallot (TOF), one of the most common congenital heart diseases for which patients are referred for post-operative magnetic resonance (MR) imaging evaluation. In the past few decades, surgery has proved successful, but most patients require repeat imaging throughout their lives and MRI can offer more detailed soft tissue imaging without the use of radiation. 

Related Cardiac MRI Content:

VIDEO: Advances in Cardiac MRI Technology — Interview with James Carr, M.D.

Cardiac MRI Delivers Accurate Diagnosis for Frontline Chest Pain Evaluation

VIDEO: Dedicated Cardiac MRI Use at the Baylor Scott White Heart Hospital

Advantages and New Applications of Cardiac MRI

Will Cardiac MRI Expand?

The Arietta 850SE provides facilities with numerous features and functionality to get the most out of a system. The CMUT probe performs the role of multiple probes while the single-crystal C252 probe gets increased penetration. eFocusing simplifies scanning techniques and shearwave elastography provides unique feedback on tissue stiffness.

At RSNA19, David Widmann, president and CEO of Konica Minolta Healthcare Americas, discussed innovation, stressing the importance of academic relationships. 

This is a demo of the EOS orthopedic X-ray imaging system at the recent 2019 Radiological Society of North America (RSNA) meeting. The system allows for weight bearing exams. EOS Imaging System the first technology capable of providing full-body, 2-D and 3-D images of pediatric patients in a standing position at a low dose of radiation. The vendor said the scans are much lower dose than computed tomography (CT).

EOS captures bi-planar images with two perpendicular X-ray beams that travel vertically while scanning the patient from head to toe. In less than 20 seconds, the EOS exam produces simultaneous frontal and lateral, low dose images. The two resulting digital images are processed by EOS' proprietary sterEOS software to generate a 3-D model of the patient's spine and/or lower limbs. These detailed images with only 20 seconds of radiation were previously unachievable before EOS technology.

Read more about the system and a recent install

VIDEO: Editors Choice of the Most Innovative New Radiology Technology at RSNA 2019

Photo Gallery of New Imaging Technologies at RSNA 2019

Find more news and video from RSNA 2019

Gillian Newstead, M.D., director of global breast imaging and former professor at the University of Chicago, explains a large breast MRI screening study presented at the 2019 Radiological Society of North America (RSNA) meeting. 

The DENSE Trial Study Group included 40,000 women from the Netherlands who underwent standard mammography. Of these, 8,061 women were identified as having dense breasts and were offered supplemental MRI screening, and about half took advantage of the additional screening. Dense breast tissue which can obscure cancer on conventional mammograms but not on MRI. The MRI cancer-detection rate among the women who actually underwent MRI screening was 16.5 per 1,000 screenings.

The use of supplemental magnetic resonance imaging (MRI) screening in women with extremely dense breast tissue and normal results on mammography resulted in the diagnosis of significantly fewer interval cancers than mammography alone during a two-year screening period. The results were published in the Nov.  28, 2019, issue of The New England Journal of Medicine and presented earlier at the European Congress of Radiology (ECR) 2019.

Related Breast MRI and Dense Breast Content:

Breast Density Explained

Animation to Bring Clarity to Dense Breasts

Improving Clinical Image Quality for Breast Imaging

Breast Imaging in the Age of Coronavirus

Abbreviated MRI Outperforms 3-D Mammograms at Finding Cancer in Dense Breasts

VIDEO: Explaining Dense Breasts — Interview with Christiane Kuhl, M.D.

Technologies to Watch in Breast Imaging

Screening MRI Detects BI-RADS 3 Breast Cancer in High-risk Patients
 

Reference:

Bakker MF, de Lange SV, Pijnappel RM, et al. Supplemental MRI Screening for Women with Extremely Dense Breast Tissue. N Engl J Med 2019; 381:2091-2102. DOI: 10.1056/NEJMoa1903986.