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VIDEO: The Rise of Point of Care Ultrasound During COVID-19

Arun Nagdev, M.D., director of emergency ultrasound at the Alameda Health System, clinical associate professor, University of California San Francisco (UCSF) School of Medicine, and incoming president for the American College of Emergency Physicians (ACEP) ultrasound section, explains the rise in point-of-care ultrasound (POCUS) since the start of the COVID-19 pandemic. Nagdev has used cart-based and several hand-held systems to the emergency department to triage patients, help sort out COVID and non-COVID patients and identify patients that need more detailed radiology imaging or with issues that need immediate attention, such as pulmonary embolism, heart attacks and aortic aneurisms. 

Nagdev also serves as senior director of clinical education for start-up POCUS company Exo, which is developing a new chip-based, handheld ultrasound system with a high definition transducer.

Watch the related VIDEO: How to Image COVID-19 and Radiological Presentations of the Virus — Interview with Margarita Revzin, M.D.

More COVID-19 content can be found here

Radiology Imaging

Point-of-Care Ultrasound (POCUS) | May 13, 2022

Arun Nagdev, M.D., director of emergency ultrasound at the Alameda Health System, clinical associate professor, University of California San Francisco (UCSF) School of Medicine, and incoming president for the American College of Emergency Physicians (ACEP) ultrasound section, explains the rise in point-of-care ultrasound (POCUS) since the start of the COVID-19 pandemic. Nagdev has used cart-based and several hand-held systems to the emergency department to triage patients, help sort out COVID and non-COVID patients and identify patients that need more detailed radiology imaging or with issues that need immediate attention, such as pulmonary embolism, heart attacks and aortic aneurisms. 

Nagdev also serves as senior director of clinical education for start-up POCUS company Exo, which is developing a new chip-based, handheld ultrasound system with a high definition transducer.

Watch the related VIDEO: How to Image COVID-19 and Radiological Presentations of the Virus — Interview with Margarita Revzin, M.D.

More COVID-19 content can be found here

Computed Tomography (CT) | March 09, 2022

At RSNA 2021, Philips highlighted the launch of two new innovative CT systems – the multi-energy Spectral CT 7500 and the CT 5100 Incisive with embedded AI capabilities. ITN spoke with Wendy Winkle Lawless, CT Business Market Leader - North America, Philips, to learn more about these new systems.

Digital Radiography (DR) | March 01, 2022

At RSNA 2021, Konica Minolta introduced the mKDR Xpress Mobile X-ray system and the Aero DR Carbon flat panel detector. Also on display was nVoq’s cloud-based speech recognition and automation solution and new features for the Exa platform that automate common clinical and administrative tasks.

You can find more RSNA21 content here

Contrast Media | February 23, 2022

With the use of contrast agents and radiotracers on the rise, GE Healthcare has seen increases in demand across their pharmaceutical diagnostics business. At RSNA 2021, Marco Campione, General Manager, Pharmaceutical Diagnostics Americas, GE Healthcare, shared how recent investments are helping to meet this increased demand.

Find more RSNA21 content here

Magnetic Resonance Imaging (MRI) | February 09, 2022

At RSNA 2021, Fujifilm launched its new Velocity MRI system. It is designed to streamline workflow and enhance the patient experience with its open gantry, integrated RF coils and reconstruction techniques. Shawn Etheridge, Director, CT and MRI Marketing for Fujifilm, unveiled the system on the RSNA21 show floor.

Fujifilm Launches the Velocity MRI System at RSNA 2021

Additional RSNA21 content

Quality Assurance (QA) | January 31, 2022

Sun Nuclear highlighted two resources for CT Quality Assurance at RSNA 2021. ITN visited their booth to learn more about the Mercury 4.0 Phantom and the Multi-Energy CT Phantom from Thomas Webb, Global Product Marketing Manager

Find more RSNA news and videos

Digital Radiography (DR) | January 31, 2022

Agfa recently announced the launch of the new Valory digital radiography room, which was designed for health care facilities requiring a highly productive radiography solution. 

ITN stopped by the Agfa booth at RSNA 2021 to learn more about this new system from Georges Espada, Head of Digital Radiography, and Karol Wesolowski, Global Category Leader.

Coronavirus (COVID-19) | January 31, 2022

Marc Succi, M.D., an emergency radiologist at MGH and executive director of the MESH Incubator, an in-house innovation and entrepreneurship center, and  Ottavia Zattra, a fourth-year medical student at Harvard Medical School, explain a study they authored showing there might be higher cancer rates due to lower numbers of CT scans during COVID-19. They presented this study as a late-breaker at the Radiological Society of North America (RSNA) 2021 annual meeting.

COVID caused many people to delay seeing their doctors. Their study found a corresponding 82% drop in CT imaging for cancer screening. CT is also used for initial cancer workups, to monitor active cancer and post procedure surveillance, which all also showed decline since the start of the pandemic.

Read more about the study COVID-19 Fallout May Lead to More Cancer Deaths

Computed Tomography (CT) | January 28, 2022

Charlie Hamm, M.D., a radiology resident at the Charité University Hospital of Berlin, Germany, presented a late-breaking study at the Radiological Society of North America (RSNA) 2021 annual meeting on the use of computed tomography (CT) scans to investigate dinosaur bones non-destructively. In the process of examining a tyrannosaurus rex jaw bone that is more than 66 million years old, a bone tumor was found and clearly shown on the CT scans.

This feasibility study to determine if CT can be used to aid paleontology was done in collaboration with the Museum für Naturkunde Berlin. Dual-energy computed tomography (DECT) was used to provide information about tissue composition and disease processes not possible with single-energy CT.

Read more in the article CT Uncovers Bone Disease in Tyrannosaurus Rex Jaw

Find more RSNA news and video

 

 

Quality Assurance (QA) | January 28, 2022

Mahadevappa Mahesh, Ph.D., chief physicist, Johns Hopkins Hospital, and professor of radiology and radiological science, explains the basics involved in quality assurance (QA) of radiology imaging systems. He spoke to ITN at the Radiological Society of North America (RSNA) 2021 annual meeting.

He explains the role of the medical physicist in keeping X-ray imaging systems such as CT, angiography and mammography calibrated and checking the device output of radiation. This is performed by imaging phantoms that mimic a simplified representation of the human body. 

Artificial intelligence (AI) use is growing in imaging and medical physics and QA of these systems might also become a duty of the medical physicist in some AI imaging applications.  

Find more content on QA systems

Find more RSNA news and video

Computed Tomography (CT) | January 27, 2022

Cynthia McCollough, Ph.D., director of Mayo Clinic's CT Clinical Innovation Center,  explains how photon-counting computed tomography (CT) detectors work and why it is a better technology over conventional CT systems. She helped Siemens develop the Naeotom Alpha, the first photo-counting CT system to be approved by the FDA in the fall of 2021. She spoke to ITN at the Radiological Society of North America (RSNA) 2021 annual meeting.

Read more about the first commercial photon-counting scanner 

The device uses the emerging CT technology of photon-counting detectors, which can measure each individual X-ray photon that passes through a patient's body, as opposed to current systems which use detectors that measure the total energy contained in many X-rays at once. By "counting" each individual X-ray photon, more detailed information about the patient can be obtained and used to create images with less information that is not useful, such as image noise. 

Current CT technology uses a two-step conversion process to convert X-ray photons into visible light using a scintillator layer in the detector. Then, photo diode light sensors turn the visible light into a digital signal. Due to this intermediate step, important information about the energy of the X-rays is lost and no longer available to aid in diagnosis. Also, contrast is reduced and images are not as clear.

Photon-counting detectors use a single step of direct conversion of X-rays into electrical current, and skips the step of converting X-rays into visible light. This allows the energy thresholds of each pulse to be collected and binned based on different kilovolt (kV) energy levels. This creates data to improve contrast and enable dual-energy, spectral imaging. The direct conversion also helps improve image quality without information loss. This improves image sharpness and contrast.

Photon-counting detectors have already been used for several years in high-energy physics and nuclear imaging. However, these previously generation photon-counting detectors could not be used with a clinical CT scanner because they could not keep up with the high higher rate of photons reaching the detector. The detector on the Naeotom Alpha was designed for this increased speed.

Related Photon-counting CT Content:

Mayo Clinic Begins Use of Third-Generation Photon-counting CT Clinical Research Detector

VIDEO: New Advances in CT Imaging Technology — Interview with Cynthia McCollough, Ph.D.

VIDEO: Photon Counting Detectors Will be the Next Major Advance in Computed Tomography — Interview with Todd Villines, M.D.

Key Trends in Cardiac CT at SCCT 2020

GE Healthcare Pioneers Photon Counting CT with Prismatic Sensors Acquisition

Top Trend Takeaways in Radiology From RSNA 2020

NeuroLogica Joins Forces with Massachusetts General Hospital to Pilot Photon Counting CT at the Patient’s Point-Of-Care Using OmniTom Elite CT

VIDEO: Advances in Cardiac CT Imaging — Interview with David Bluemke, M.D.

Computed Tomography (CT) | January 27, 2022

Cynthia McCollough, Ph.D., director of Mayo Clinic's Computed Tomography (CT) Clinical Innovation Center, explains how CT dose tracking software works and offers advice to centers that record this patient level and device information. She spoke to ITN at the Radiological Society of North America (RSNA) 2021 annual meeting.

Dose tracking software allows hospitals and imaging centers to track what levels of radiation they are using by exam type protocol. It can show technologists who are using higher than required doses that may need additional ALARA training. The radiation dose tracking systems also can help track the amount of radiation a patient has received over time.

Related Radiation Dose Tracking Systems:

Disputed EHR Dose Levels Could Keep Patients From Necessary Imaging Exams

Medical Imaging Radiation Exposure in U.S. Dropped Over Past Decade

VIDEO: Radiation From Medical Imaging in U.S. Dropped Over Past Decade

The Basics of Radiation Dose Monitoring in Medical Imaging

VIDEO: Radiation Dose Monitoring in Medical Imaging — Interview with Mahadevappa Mahesh, Ph.D.
 

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Magnetic Resonance Imaging (MRI) | January 24, 2022

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.

View more RSNA21 content here

Esaote North America Receives FDA Approval of the Magnifico Open MRI System

Magnetic Resonance Imaging (MRI) | January 18, 2022

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.

Related MRI Content:

Siemens Healthineers Announces First U.S. Installation of Magnetom Free.Max 80 cm MR Scanner

FDA Clears Siemens Healthineers Magnetom Free.Max 80 cm MR Scanner

Ohio State Researchers Help Design New MRI, Expanding Access to Life-saving Imaging

 

Enterprise Imaging | January 13, 2022

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.

Find more RSNA news and video

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
 

 

Coronavirus (COVID-19) | December 14, 2021

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.

Find more RSNA news and video

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

VIDEO: Large Radiology Study Reveals Spectrum of COVID-19 Brain Complications — Interview with Scott Faro, M.D.

FDA Adds Myocarditis Warning to COVID mRNA Vaccine Clinician Fact Sheets

Small Number of Patients Have Myocarditis-like Illness After COVID-19 Vaccination

Breast Imaging | December 13, 2021

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.

Related Breast Imaging Content:

COVID-19 Vaccine Can Cause False Positive Cancer Diagnosis

Help Spread Awareness of Potential COVID-19 Vaccine Imaging Side-effects

VIDEO: COVID Vaccine May Cause Enlarged Lymph Nodes on Mammograms — Interview with Constance "Connie" Lehman, M.D.

COVID-19 Vaccination Axillary Adenopathy Detected During Breast Imaging

VIDEO: COVID Vaccine Adenopathy Can Last Up to 10 Weeks — Interview with Yael Eshet, M.D.

VIDEO: Artificial Intelligence Trends in Medical Imaging — Interview with Signify Research

Technology Report: Artificial Intelligence in Radiology 2021

Find more RSNA news and video

Artificial Intelligence | December 08, 2021

Sanjay Parekh, Ph.D., Signify Research senior market analyst, explains some of the recent trends in the application of artificial intelligence (AI) in radiology at the 2021 Radiological Society of North America (RSNA) meeting.

He discusses three trends in AI at RSNA, including:
   • AI-based critical care team tools for rapid communication and assessment of patient imaging. This is activated by an AI first pass review of the images. This includes response team alerts for pulmonary embolism (PE), stroke, aortic dissection and acute heart failure.
   • AI systems now offering numerous algorithms to perform multiple tasks, rather than a single function, adding greater valve for those AI apps.
   • Greater integration of AI apps into PACS so it fits into the radiology workflow.

Find more AI news

Find more RSNA news and video

Coronavirus (COVID-19) | December 06, 2021

Kate Hanneman, M.D., MPH, FRCPC, director of cardiac imaging research JDMI, and the medical imaging site director at Toronto General Hospital, Women’s College Hospital, was an author on a recent overview of cardiac MRI assessments of non-ischemic myocardial inflammation caused by the COVID-19 vaccine. She presented this study and other related data at the 2021 Radiological Society of North America (RSNA) meeting. 

The rare side effect from the COVID vaccine is seen mainly in young men between ages 12-29. It appears to resolve on its own after a couple days, but longer term monitoring is needed to show if there is any lasting cardiac damage. A small number of single cases with follow up MRI imaging so far have not shown long term damage. 

Hanneman noted the incidence of vaccine-related myocarditis is very rare and people have a much high probability of getting much more serious COVID-viral myocarditis is they are not vaccinated. She said so the risk-vs-benefit analysis currently shows it is better to get vaccinated to prevent or lessen the effects of COVID. 

Related COVID-19 Imaging Content:

VIDEO: COVID-19 Linked to Heart Inflammation in College Athletes — Interview with Jean Jeudy, M.D.

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

VIDEO: Large Radiology Study Reveals Spectrum of COVID-19 Brain Complications — Interview with Scott Faro, M.D.

FDA Adds Myocarditis Warning to COVID mRNA Vaccine Clinician Fact Sheets

Small Number of Patients Have Myocarditis-like Illness After COVID-19 Vaccination

 

Coronavirus (COVID-19) | December 03, 2021

Scott Faro, M.D., professor of radiology and neurology and director, division of neuroradiology, head and neck, at Thomas Jefferson University, is the lead author on a large late-breaking study at the Radiological Society of North America (RSNA) 2021 meeting showing the neurological impact of COVID-19 on patients' brains. 

The 38,000-patient neurological imaging study showed about 10% of hospitalized COVID patients will have central nervous system (CNS) complications. These include cerebrovascular accident (CVA) such as ischemic strokes (62% of CNS cases reported), intracerebral hemorrhage (ICH - in 37% of cases) , encephalitis (5%), sinus venous thrombosis (SVT - 2%), acute disseminated encephalomyelitis (ADEM - 2%), posterior reversible encephalopathy syndrome (PRES - 2%), and vasculitis (0.5%).

Read more on this study 

Find more RSNA news and video

Radiation Therapy | November 15, 2021

Siemens and Philips demonstrated examples of new imaging software to convert MRI datasets into synthetic computed tomography (CT) datasets at the American Society of Radiation Oncology (ASTRO) 2021 meeting. The synthetic CT datasets can be used for radiotherapy treatment planning. This eliminates the need for a separate CT scan, reducing time and cost in patient care. 

The technology uses an algorithm to convert the MRI dataset into a CT grayscale Hounsfield units. The Hounsfield units correlate with the densities of the various tissues and are used to calculate the doses required and beam routes needed in radiotherapy to treat a patient.

Photo Gallery of Technologies at ASTRO 2021

Radiation Oncology Research Featured at ASTRO 2021

Find more radiation oncology technology news

Coronavirus (COVID-19) | October 19, 2021

An example of popliteal artery thrombosis formation caused by COVID-19 (SARS-CoV-2). Coronavirus often caused thrombus formation in the body, leading to numerous types of complications, including pulmonary embolism, stroke, heart attack, deep vein thrombosis (DVT) and ischemia or infarcts in various organs.

Related COVID ultrasound video clips: 

VIDEO: COVID Lung Ultrasound B-lines and Pleural Thickening

VIDEO: COVID Pneumonia Lung Consolidation on Ultrasound

This video clip is part of the examples from an RSNA journal Radiographics article on the radiology presentations and complications of the COVID virus and which modalities can best image these features. Here are links to the two articles:

Manifestations of COVID-19, Part 1: Viral Pathogenesis and Pulmonary and Vascular System Complications. 

Multisystem Imaging Manifestations of COVID-19, Part 2: From Cardiac Complications to Pediatric Manifestations

The video is from the study lead-author Margarita Revzin, M.D., MS, FSRU, FAIUM, associate professor of radiology and biomedical imaging, Yale University School of Medicine, abdominal and emergency imaging, radiologist. She explains more details in the VIDEO: Overview COVID-19 Imaging Techniques Using X-ray, CT, MRI and Ultrasound.

 

Find more COVID medical imaging in the PHOTO GALLERY: How COVID-19 Appears on Medical Imaging

Coronavirus (COVID-19) | August 31, 2021

Several radiology IT vendors at 2021 Healthcare Information Management Systems Society (HIMSS) conference demonstrated computed tomography (CT) imaging advanced visualization software software to help automatically identify and quantify COVID-19 pneumonia in the lungs. These tools can help speed assessment of the lung involvement and serial tracking can be used to assess the patient's progress in the hospital and during long-COVID observation. 

Examples of COVID analysis tool shown in this video include clips from booth tours at: 
   • Fujifilm
   • Siemens Healthineers 
   • Canon (Vital)

Canon received FDA clearance for its tool under and emergency use authorization (EUA).

Siemens said its tool was part of its lung analysis originally developed for cancer but modified and prioritized to aid in COVID assessments. 
 

HIMSS Related Content:

Advances in CVIS and Enterprise iImaging at HIMSS 21

Photo Gallery of New Technologies at HIMSS 2021

VIDEO: Importance of Body Part Labeling in Enterprise Imaging — Interview with Alex Towbin, M.D.

VIDEO: Coordinating Followup for Radiology Incidental Findings — Interview with David Danhauer, M.D.

VIDEO: Cardiology AI Aggregates Patient Data and Enables Interactive Risk Assessments

VIDEO: Example of Epsilon Strain Imaging Deep Integration With Siemens CVIS

 

Enterprise Imaging | August 06, 2021

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.

Related enterprise imaging content:

Talking Trends with Konica Minolta

BLOG: Zero-footprint Viewer with Server-side Rendering Pushes Imaging Forward During Pandemic

BLOG: Exa Gateway Offers a New Way to Deliver Teleradiology 

BLOG: Artificial Intelligence for Clinical Decision Support and Increased Revenues

BLOG: The Power of the Next Generation of RIS

 

Coronavirus (COVID-19) | May 11, 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:

COVID-19 Vaccine Can Cause False Positive Cancer Diagnosis

Help Spread Awareness of Potential COVID-19 Vaccine Imaging Side-effects

VIDEO: COVID Vaccine May Cause Enlarged Lymph Nodes on Mammograms — Interview with Constance "Connie" Lehman, M.D.

COVID-19 Vaccination Axillary Adenopathy Detected During Breast Imaging

PHOTO GALLERY: How COVID-19 Appears on Medical Imaging

CMS Now Requires COVID-19 Vaccinations for Healthcare Workers by January 4

Find more radiology related COVID content 

References:

1. Yael Eshet, Noam Tau1, Yousef Alhoubani, Nayroz Kanana, Liran Domachevsky, Michal Eifer. Prevalence of Increased FDG PET/CT Axillary Lymph Node Uptake Beyond 6 Weeks after mRNA COVID-19 Vaccination. Radiology. Published Online:Apr 27 2021https://doi.org/10.1148/radiol.2021210886.

2. Constance D. Lehman, Leslie R. Lamb, and Helen Anne D'Alessandro. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach American Journal of Roentgenology. 10.2214/AJR.21.25688.

3. Can Özütemiz, Luke A. Krystosek, An L. Church, Anil Chauhan, Jutta M. Ellermann, Evidio Domingo-Musibay, Daniel Steinberger. Lymphadenopathy in COVID-19 Vaccine Recipients: Diagnostic Dilemma in Oncology Patients. Radiology. Published Online:Feb 24 2021https://doi.org/10.1148/radiol.2021210275.

 

Point-of-Care Ultrasound (POCUS) | April 01, 2021

Here are two quick clinical examples of point-of-care ultrasound (POCUS) lung imaging and cardiac imaging using a GE Vscan Air device. The examples show an abnormal lung image with B-lines. The second clip shows a healthy heart in a parasternal color Doppler image.

The GE Healthcare Vscan Air is a cutting-edge, wireless pocket-sized ultrasound that provides crystal clear image quality, whole-body scanning capabilities, and intuitive software. The pocket-sized ultrasound system was originally introduced in 2010, and as of early 2021, there are over 30,000 Vscan systems in use. The new Vscan Air features a wireless ultrasound probe.

Read more in the article GE Healthcare Unveils Vscan Air Wireless Handheld Ultrasound

Find more POCUS news and video

Breast Imaging | March 26, 2021

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.

 

Related Medical Imaging of COVID Content:

COVID-19 Vaccination Axillary Adenopathy Detected During Breast Imaging

CMS Now Requires COVID-19 Vaccinations for Healthcare Workers by January 4

PHOTO GALLERY: How COVID-19 Appears on Medical Imaging

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS) — Interview with Mike Stone, M.D.

VIDEO: Use of Teleradiology During the COVID-19 Pandemic — Interview with John Kim, M.D.

Find more radiology related COVID content 

 

Reference:

1. Constance D. Lehman, Leslie R. Lamb, and Helen Anne D'Alessandro. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach American Journal of Roentgenology. 10.2214/AJR.21.25688

 

 

Magnetic Resonance Imaging (MRI) | March 19, 2021

Darryl B. Sneag, M.D., a radiologist and director of peripheral nerve MRI at the Hospital for Special Surgery (HSS) in New York City, explains how artificial intelligence (AI) magnetic resonance imaging (MRI) reconstruction algorithms have cut imaging times by 50 percent. This has enabled his facility to maintain the same number of patients as it did prior to the pandemic, while still having time to sterilize the scanners after each patient. 

Many radiology departments are now experiencing a backlog of cases due to COVID-19 shutdowns in 2020 and the limits on the number of patients that can be in the hospital for imaging exams due to pandemic containment precautions. Sneag said AI is now playing a role in helping streamline workflow.

HSS has 19 GE Healthcare MRI scanners and uses the Air Recon DL AI image reconstruction algorithm. This allows for shorter scan times, so the same number of patients as pre-pandemic can be imaged per day, even with deeper cleaning of the MRI bore. Sneag explains the algorithm has greatly helped with patient throughput, but the trade off is sometimes getting a ringing artifact on images.

HSS also uses GE's Air Coil flexible pad MRI coils. These can wrap around the patient to improve comfort and get the coils closer to the anatomy being imaged.

 

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Find more COVID radiology-related content

 

Coronavirus (COVID-19) | November 15, 2020

Margarita Revzin, M.D., MS, FSRU, FAIUM, associate professor of radiology and biomedical imaging, Yale University School of Medicine, abdominal and emergency imaging, radiologist, explains how different medical imaging modalities are used to image manifestations of the COVID-19 (SARS-CoV-2) virus in patients. She is the lead author on a two-part article in the RSNA journal Radiographics that provides a comprehensive overview of coronavirus imaging. 

The articles offer numerous case images from X-ray, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). Revzin also discusses some of the radiology presentations and complications of the virus and which modalities can best image these features. Here are links to the two articles:

Manifestations of COVID-19, Part 1: Viral Pathogenesis and Pulmonary and Vascular System Complications. 

Multisystem Imaging Manifestations of COVID-19, Part 2: From Cardiac Complications to Pediatric Manifestations

Although COVID-19 predominantly affects the respiratory system, other organs can also be involved. The authors of the articles said imaging plays an essential role in the diagnosis of all manifestations of the disease, as well as its related complications, and proper utilization and interpretation of imaging examinations is crucial. As the virus continues to spread, a comprehensive understanding of the diagnostic imaging hallmarks, imaging features, multisystemic involvement, and evolution of imaging findings is essential for effective patient management and treatment. Only a few articles had been published that comprehensively describe the multisystemic imaging manifestations of COVID-19 prior to this article series, published in the fall of 2020. The authors provide an inclusive system-by-system image-based review of this life-threatening and rapidly spreading infection. In part 1 of this article, the authors discuss general aspects of the disease, with an emphasis on virology, the pathophysiology of the virus, and clinical presentation of the disease. Part 2 focuses on key imaging features of COVID-19 that involve the cardiac, neurologic, abdominal, dermatologic and ocular, and musculoskeletal systems, as well as pediatric and pregnancy-related manifestations of the virus.

Most of the images in the video are from the articles. Find more COVID medical imaging in the PHOTO GALLERY: How COVID-19 Appears on Medical Imaging.

VIDEO: Example of COVID Thrombosis on Ultrasound Imaging

 

Coronavirus (COVID-19) | February 09, 2021

Margarita Revzin, M.D., MS, FSRU, FAIUM, associate professor of radiology and biomedical imaging, Yale University School of Medicine, abdominal and emergency imaging, radiologist,  explains how different medical imaging modalities are used to image manifestations of the COVID-19 (SARS-CoV-2) virus in patients. She is the lead author on a two-part article in the RSNA journal Radiographics that provides a comprehensive overview of coronavirus imaging.

The articles offer numerous case images from X-ray, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). Revzin also discusses some of the radiology presentations and complications of the virus and which modalities can best image these features. Here are links to the two articles:

Manifestations of COVID-19, Part 1: Viral Pathogenesis and Pulmonary and Vascular System Complications. 

Multisystem Imaging Manifestations of COVID-19, Part 2: From Cardiac Complications to Pediatric Manifestations

Although COVID-19 predominantly affects the respiratory system, other organs can also be involved. The authors of the articles said imaging plays an essential role in the diagnosis of all manifestations of the disease, as well as its related complications, and proper utilization and interpretation of imaging examinations is crucial. As the virus continues to spread, a comprehensive understanding of the diagnostic imaging hallmarks, imaging features, multisystemic involvement, and evolution of imaging findings is essential for effective patient management and treatment. Only a few articles had been published that comprehensively describe the multisystemic imaging manifestations of COVID-19 prior to this article series, published in the fall of 2020. The authors provide an inclusive system-by-system image-based review of this life-threatening and rapidly spreading infection. In part 1 of this article, the authors discuss general aspects of the disease, with an emphasis on virology, the pathophysiology of the virus, and clinical presentation of the disease. Part 2 focuses on key imaging features of COVID-19 that involve the cardiac, neurologic, abdominal, dermatologic and ocular, and musculoskeletal systems, as well as pediatric and pregnancy-related manifestations of the virus

Most of the images in the video are from the articles. Find more COVID medical imaging in the PHOTO GALLERY: How COVID-19 Appears on Medical Imaging.

 

Related Medical Imaging of COVID Content:

VIDEO: What Does COVID-19 Look Like in Lung CT Scans 

PHOTO GALLERY: How COVID-19 Appears on Medical Imaging

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS) — Interview with Mike Stone, M.D.

VIDEO: COVID Vaccine May Cause Enlarged Lymph Nodes on Mammograms — Interview with Constance "Connie" Lehman, M.D., Mass General Hospital

VIDEO: Use of Teleradiology During the COVID-19 Pandemic — Interview with John Kim, M.D.
 

VIDEO: Radiology Industry Responding to COVID-19 — Interview with Jeffrey Bundy, Ph.D.

CT in a Box Helps Rapidly Boost Imaging Capability at COVID Surge Hospitals

VIDEO: How China Leveraged Health IT to Combat COVID-19 — Interview with Jilan Liu, M.D.

Find more radiology related COVID content 

Coronavirus (COVID-19) | January 26, 2021

This is an example of a COVID-19 (SARS-CoV-2) positive patient's lung computed tomography (CT) scan. The video scrolls through the image slices of the scan and shows the typical white, ground glass opacities (GGO) caused by COVID pneumonia. The pneumonia typically appears along the walls of each lobe of the lung, especially the chest wall and the lower portions of the lungs. This scan is from a Canon Aquilion Prime SP CT scanner and used Advanced intelligent Clear-IQ Engine (AiCE), an artificial intelligence-driven image reconstruction software to improve image quality of lower-dose scans. This was shown by Canon Medical as an exmaple of CT image quality for the virus at the 2020 Radiological Society of North American (RSNA) meeting. 

Read more about this system and its launch in 2020 to address COVID, Canon Medical Launches CT Solution for Patients with Viral Infectious Diseases.

VIDEO: How to Image COVID-19 and Radiological Presentations of the Virus interview with Margarita Revzin, M.D., associate professor of radiology and biomedical imaging, Yale School of Medicine.

Find more radiology clinical images of coronavirus in this photo gallery.

Find more radiology related COVID news and video

PET-CT | December 04, 2020

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. 

Find more RSNA news

 

Artificial Intelligence | December 02, 2020

Kirti Magudia, M.D., Ph.D., an abdominal imaging and ultrasound fellow at the University of California San Francisco, explains how an automated deep learning analysis of abdominal computed tomography (CT) images can produce a more precise measurement of body composition and better predicts major cardiovascular events, such as heart attack and stroke, better than overall weight or body mass index (BMI). This was according to a study she presented at the 2020 Radiological Society of North America (RSNA) virtual meeting.

Unlike BMI, which is based on height and weight, a single axial CT slice of the abdomen visualizes the volume of subcutaneous fat area, visceral fat area and skeletal muscle area. However, manually measuring these individual areas is time intensive and costly. A multidisciplinary team of researchers, including radiologists, a data scientist and biostatistician, developed a fully automated artificial intelligence (AI) method to determine body composition metrics from abdominal CT images.

Statistical analysis demonstrated that visceral fat area was independently associated with future heart attack and stroke. BMI was not associated with heart attack or stroke. 

Read more about this study

Find more RSNA news

Information Technology | December 01, 2020

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.

Remote Viewing Systems | November 28, 2020

Konica Minolta’s theme for RSNA 2020 is Depth of Vision. ITN recently talked with David Widmann, President and CEO of Konica Minolta Healthcare Americas, about this focus and their key messages for customers and RSNA attendees.

X-Ray | November 28, 2020

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. 

Enterprise Imaging | November 23, 2020

Fujifilm's next generation secure server-side viewer platform extends across enterprise imaging areas to bring together radiology, mammography and cardiology into a single zero footprint platform. Bill Lacy, vice president of medical informatics for Fujifilm Medical Systems USA recently talked with ITN about their Synapse 7x platform.

Coronavirus (COVID-19) | November 20, 2020

This video shows a computed tomography (CT) scroll through showing bowel ischemia and perforation (see arrows) due to superior mesenteric artery (SMA) thrombus in COVID-19 (SARS-CoV-2) patient. Mesenteric artery thrombosis (MAT) is a condition involving occlusion of the arterial vascular supply of the intestinal system and is a severe and potentially fatal illness. 

Superior mesenteric artery thrombosis (Red arrow) complicated by bowel ischemia and perforation in a 54-year-old man who presented to the emergency department with abdominal pain and was diagnosed with COVID-19. Contrast-enhanced CT images of the abdomen and pelvis show mucosal hyperenhancement involving the small bowel (green arrows).

Read more in the article Multisystem Imaging Manifestations of COVID-19, Part 1: Viral Pathogenesis and Pulmonary and Vascular System Complications.

Case example from Margarita Revzin, M.D., associate professor of radiology and biomedical imaging, Yale School of Medicine.

VIDEO: How to Image COVID-19 and Radiological Presentations of the Virus — Interview with Margarita Revzin, M.D.,

See more medical imaging of COVID-19 in the photo gallery How COVID-19 Appears on Medical Imaging.

 

Related COVID Radiology Content:

VIDEO: COVID-19 Pneumonia Chest CT Scan Scroll Through

CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia

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VIDEO: Use of Teleradiology During the COVID-19 Pandemic — Interview with John Kim, M.D.
 

 

 

Artificial Intelligence | November 11, 2020

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

 

 

 

 

 

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