Philips' mission is to build intuitive, scalable and customizable products that can be easily adapted to customers' needs. This approach is the foundation for the new Philips IntelliSpace Enterprise Edition. For more information, visit www.usa.philips.com/healthcare/resources/landing/enterprise-imaging-solutions.
Technology Report: Artificial Intelligence in Radiology 2021
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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Tom Kloetzly, sales and marketing VP for Shimadzu Medical Systems USA, explains the evolution of Shimadzu Corporation since its founding 142 years ago. Kloetzly focuses on the Trinias Interventional X-ray lineshown at RSNA. Kloetzly states “A key feature of Trinias, is the ability to image from fingertip to fingertip during a transradial approach which makes for much shorter hospital stay with the patient up and moving almost immediately after the procedure. Features Like RSM-DSA, a type of motion correction subtraction, eliminates patient movement during acquisition while STENTVIEW, is an enhanced visualization during stent placement in real-time." For more information, visit www.shimadzu.com/med/products/angio/index.html
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Mitchell Goldburgh, enterprise imaging and analytics manager for NTT Data Services, formerly Dell Services, highlights how the company has transitioned clinical imaging from pure images into clinical intelligence at RSNA 2016.
Watch this video to gain an understanding of the strategic purpose and clinical value of the enterprise imaging platform. Gain control of the custody of multispecialty images being acquired and managed inconsistently throughout your health system today. Learn how to convert image and information silos into collaborative assets to advance your transformation to value-based, connected care.
Contributing Editor Greg Freiherr offers an overview of enterprise imaging advances at the Radiological Society of North America (RSNA) 2016.
Sectra provides industry-leading enterprise image management solutions comprising PACS for radiology, cardiology, and pathology, VNA and Cross Enterprise Workflow. Through 25 years of innovation and 1,700 installations, our experience in radiology has paved the way to deliver enterprise solutions that consolidate image handling and maintain workflow efficiency in the most image intense departments.
The next generation of ZONE Sonography Technology (ZST) has arrived and its living technology continues to evolve. Leveraging ZONARE’s revolutionary ZST and Mindray’s rich repertoire of workflow and user interface features, the Resona 7 is poised to become the new industry leader in premium ultrasound imaging platforms. The Resona 7 presents crystal clear B-mode imaging capabilities with unrivaled detail resolution and image uniformity across all radiology applications. Ultrasensitive Doppler modes and high-speed digital signal processing permit accurate display of hemodynamic states from skin line to depths up to 40 cm without compromising frame rate. An intuitive, customizable gesture-powered touchscreen enables logical and efficient workflow and enhanced user experience.
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Our newest release is the RadiForce RX660, a 30-inch 6 megapixel monitor ideal for multi-modality applications. With this monitor we’re introducing the new “Work-and-Flow” that benefits radiologists today in creating an efficient and cleaner workspace.
With the Work-and-Flow, you have access to two great features:
The “Hide-and-Seek” function enables users to easily hide the Picture-in-Picture window eliminating the need for an extra monitor while still being able to access reports, patient charts, and other information.
In another feature called the “Switch-and-Go”, users can move across two workstations.
The RX660 uses the DisplayPort 1.2 Daisy Chain Connectivity for a tangle-free, easy, single cable management – this means eliminating excess wires.
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The first case seen here demonstrates how Watson can arrive at a differential diagnosis of an aortic dissection by analyzing an abdominal computed tomography (CT) scan. The second case involves the discovery of a fibroadenoma of the breast from Watson’s analysis of a mammogram.
Watson first analyzes the text of the radiology report, identifying and pulling out key words or phrases that may indicate the potential diagnosis. It then examines the CT scan to locate relevant visible anatomic structures such as the heart, aorta and pulmonary artery. Each structure is examined for anomalies, which identifies a possible aortic dissection; the dissection is displayed within the context of the entire 3-D CT scan. Finally, Watson applies its existing clinical knowledge to the findings from the CT scan and the radiology report, establishing pathways to numerous possible conclusions until arriving at the right one.
See examples of real products using AI at RSNA 2017 in the VIDEO "Examples of How Artificial Intelligence Will Improve Medical Imaging." ITN also created an in-depth VIDEO: Technology Report — Artificial Intelligence at RSNA 2017, with interviews with numerous AI vendors.
Watch the VIDEO: “Development of Artificial Intelligence to Aid Radiology,” an interview with Mark Michalski, M.D., director of the Center for Clinical Data Science at Massachusetts General Hospital, explaining the basis of artificial intelligence in radiology.
Patricia Oliveira-Szejnfeld, M.D., and Fernanda Tovar-Moll, M.D., Ph.D., explain what radiologists should be looking for to aid early diagnosis of Zika virus. They were among the key investigators for the first large-scale, multimodality assessment of the Zika in Brazil, the epicenter of the 2016 Zika outbreak. They spoke to ITN at RSNA 2016 and neuro-imaging for Zika virus.
Mahadevappa Mahesh, MS, Ph.D., chief physicist and professor of radiology and radiological science at Johns Hopkins Hospital, explains the basics of medical imaging dose monitoring technologies. This includes radiation dose monitoring and recording software meet new Joint Commission requirements, state dose laws and to improve patient safety regarding X-ray radiation exposure.
Max Wintermark, M.D., professor of radiology and chief of neuroradiology, Stanford Hospital and Clinics, explains trends and recent advances in brain imaging at Radiological Society of North America (RSNA) 2016 meeting. He summerizes the lastest imaging technologies and hot topics in neoradiology in RSNA sessions. Wintermark has specific interest and expertise in stroke, traumatic brain injury, epilepsy, movement disorders and psychiatric disorders.
Emanuel Kanal, M.D., director of MRI services and professor of radiology and neuroradiology at the University of Pittsburgh Medical Center, explains what is known about MRI contrast retention in the brain and other MRI safety concerns. He spoke to ITN at RSNA 2016.
Gadolinium-based contrast agents have been used for diagnosis and treatment guidance in more than 100 million patients worldwide over the past 25 years. These agents enhance the quality of MR images by altering the magnetic properties of nearby water molecules in the body. By improving the visibility of specific organs, blood vessels or tissues, contrast agents help physicians diagnose and treat a wide variety of medical conditions. On its own, gadolinium can be toxic. Therefore, when used in contrast agents, gadolinium is bonded with a molecule called a chelating agent, which controls the distribution of gadolinium within the body.
Mark Michalski, M.D., director of the Center for Clinical Data Science at Massachusetts General Hospital, explains the basis of the utilization of artificial intelligence (aka deep learning and machine learning) in radiology. He also explains where things are at in development of these neuro networks at RSNA 2016. Watch the VIDEO “Examples of Artificial Intelligence in Medical Imaging Diagnostics.”
Tom Kloetzly, sales and marketing VP for Shimadzu Medical Systems USA, explains the evolution of Shimadzu Corporation since its founding 142 years ago. Kloetzly focuses on the Trinias Interventional X-ray lineshown at RSNA 2016. Kloetzly states, “A key feature of Trinias, is the ability to image from fingertip to fingertip during a Transradial approachwhich makes for much shorter hospital stay with the patient up and moving almost immediately after the procedure.Features Like RSM-DSA, a type of motion correction subtraction, eliminates patient movement during acquisition while STENTVIEW, is an enhanced visualization during stent placement in real-time.”
Sabrina Newell, MS, RCS, clinical analyst at healthcare consulting firm MD Buyline, explains some of the trends and new technology in ultrasound at RSNA 2016. For more information about cardiac ultrasound advances, watch the video "Trends and Advances in Echocardiography at ASE 2016."
Accuray recently unveiled the company’s newest innovation, the Radixact Treatment Delivery System, a uniquely smart, fully integrated treatment delivery, treatment planning and data management system. Hear from the Accuray team about this new, next-generation TomoTherapy platform, as well as how recent innovations to the CyberKnife platform reduce treatment time while providing leading-edge motion tracking and real-time beam adjustment. Discover how Accuray systems can help clinicians deliver precise tumor treatments with confidence.
ASTRO Chairman of the Board David C. Beyer, MD, FASTRO, discusses the current trends in radiation oncology, key trends presented at this year's conference, and achieving value, and opportunities to improve value, in the treatment of prostate cancer.
Rachael Bennett, clinical analyst for MD Buyline, discusses trends in radiation oncology at ASTRO 2016.
Contributing Editor Greg Freiherr offers an overview of digital radiography (DR) advances at the Association for Medical Imaging Management (AHRA) 2016 meeting. Read the article “The Coming Push for DR.” Watch a technology report sidebar video on new DR Systems technology.
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Interview with Jef Williams, managing partner, Paragon Consulting Partners, on the essential elements of building an enterprise imaging strategy, at the 2016 Association for Medical Imaging Management (AHRA) annual meeting in Nashville, Tenn. For more information on enterprise imaging technology, watch the video “Enterprise Imaging - RSNA 2015 Technology Report.”
How to turn your imaging center into a Swiss army knife to maximize ROI was a key radiology business session at the 2016 Association for Medical Imaging Management (AHRA) annual meeting in Nashville, Tenn. Robert Junk, AIA, and Tobias Gilk, M.Arch, of RAD-Planning, explain how radiology departments can assess their business model to make the most of their capital investments. Read the related article that include Junk and Gilk "Rethinking the Radiology Business Model."
Interview with Gerald Kolb, JD, president of The Breast Group in Bend, Ore. Kolb spoke at the 2016 AHRA meeting in Nashville about the challenges of multimodality breast screening, the need for more personalized screening programs and the impact of recent screening recommendations. Read about the lastest advances in breast imaging.
Interview with Kent Hutson, M.D., CPE, of Radiology Alliance in Nashville, Tenn., on the principles of data mining and how they can be used in radiology, at the 2016 Association for Medical Imaging Management (AHRA) annual meeting. For more information, read the article "Analytics: The Next Big Health IT Undertaking."