This is a walk through of the ViewRay MRIdian MRI-guided radiotherapy system installed at Henry Ford Medical Center — Cottage. The system has been in service for about two years. The walk through shows the entry way into the vault and the warnings about entering an MRI environment. Anyone who enters the treatment room must undergo a metal detector scan first to make sure all ferrous metal is removed.
VIDEO: Use of Telemedicine in Medical Imaging During COVID-19
Regina Druz, M.D., FASNC, a member of the American Society of Nuclear Cardiology (ASNC) Board of Directors, chairwomen of the American College of Cardiology (ACC) Healthcare Innovation Section, and a cardiologist at Integrative Cardiology Center of Long Island, N.Y., explains the rapid expansion of telemedicine with the U.S. spread of novel coronavirus (COVID-19, SARS-CoV-2).
Druz spoken on the unprecedented expansion of telemedicine in the U.S., which more use in the last two weeks since states started calling for shelter in place orders, as opposed to the past two decades. The Centers for Medicare and Medicaid Services (CMS) previously only reimbursed for Telehealth in rural areas it determined had a shortage of doctors. However, in early March 2020, CMS dropped the geographic requirements and allowed Telehealth usage across th country as a way to mitigate person-to-person contact and keep vulnerable, older patients at home for routine check ups with doctors.
Druz has subspecialty certifications in nuclear cardiology, adult echocardiography and cardiac computed tomography (CT) and explains how Telehealth can be used to pre-screen patients and get patient sign off on procedures prior to coming in for an exam, helping speed the process in the hospital and limit personal contact.
Concerns about the rpaid spread of COVID-19 also has driven many radiology departments to convert to wider use of teleradiology to allow more radiologists to work from home and reduce person-to-person contact within the hospitals.
Watch the related VIDEO: Use of Teleradiology During the COVID-19 Pandemic — an interview with John Kim, M.D., chairman, Department of Radiology, THR Presbyterian Plano, Texas, and chief technology officer at Texas Radiology Associates.
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VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS) — Interview with emergency physician Mike Stone, M.D.,
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This is a quick look inside the magnetic resonance imaging (MRI) neuro-interventional suite at Henry Ford Hospital in Detriot, Mich. This neuro-procedure room connects through a door to a traditional operating room and the patient can be transferred using a trolley cot system to move between the two rooms. The MRI is a Philips 1.5T Achieva and the MRI suite includes MRI-safe surgical instruments, furniture and anesthesia system.
This is a quick walk-around video showing the Siemens Healthineers Multix Impact digital radiography (DR) room X-ray system at RSNA 2018. The system offers an intuitive operating system to help improve productivity. The in-room touch user interface on the tube allows the technologist to remain at the patient’s side. And when unable to be at the patient’s side, the technologist is able to monitor and optimize positioning from the control room via the system’s patient positioning camera, potentially reducing repeat imaging and unnecessary patient dose. Lights at the top of the X-ray system automatically indicate it the patient anatomy is aligned properly with the exam type the technologist chose for optimal imaging to reduce the need for retakes.
The Multix Impact also offers an intuitive user interface and graphical organ program selection. The positioning guide display on both the in-room touch user interface and the workstation supports precise, consistent patient positioning. Advanced motorization and tracking reduce the physical exertion of technologists and help prevent repetitive stress injuries.
This is an example of how virtual reality is being used in neuro-radiology to better evaluate patients using advanced imaging. This dataset shows a patient's brain MRI with fused tractography imaging for pre-operative planning. This was part of a 2018 Radiological Society of North America (RSNA) hands-on session by Vinodh Kumar, M.D., and Komal Shah, M.D., associate professors of radiology at MD Anderson Cancer Center.
Watch the VIDEO: Using Virtual and Augmented Reality to Examine Brain Anatomy and Pathology — an interview with Vinodh Kumar, M.D., and Komal Shah, M.D.
Read the related article Virtual Reality Boosts Revenues and Patient Understanding.
Dee Dee Wang, M.D., director of structural heart imaging, Henry Ford Hospital, Detroit, Mich., explains how patient survival depends on keeping the left ventricular outflow track (LVOT) clear and using 3-D imaging to predict what the neo-LVOT will look like prior to transcatheter mitral valve replacement (TMVR) procedures. The close proximity between the aortic and mitral valves in the left ventricle anatomy makes it critical to assess any mitral valve overhang that will obstruct blood flow out of the left ventricle. This issue has been raised in several cardiovascular imaging structural heart intervention planning sessions at conferences over the past two years, most notably at the Society of Cardiovascular Computed Tomography (SCCT).
Read the related article Interventional Imagers: The Conductors of the Heart Team Orchestra, which Wang helped author.
Watch the related VIDEO: Overview of the Henry Ford Hospital Structural Heart Program.
In a keynote lecture at the Society of Breast Imaging (SBI)/American College of Radiology (ACR) 2019 Symposium, Diana Miglioretti, Ph.D., dean’s professor of biostatistics at UC Davis Health, discussed risk-stratified breast cancer screening and its potential to improve the balance of screening benefits to harms by tailoring screening intensity and modality to individual risk factors.
Read the article "How Risk Stratification Might Affect Women’s Health"
At the Society of Breast Imaging (SBI)/American College of Radiology (ACR) 2019 Symposium, Rasu Shrestha, M.D., MBA, chief strategy officer for Atrium Health, discusses his new role with Atrium, the hype cycle of artificial intelligence (AI) and the key elements of getting AI in radiology — and in healthcare — right.
Listen to the podcast Is Artificial Intelligence The Doom of Radiology?, a discussion with Shrestha.
Wendie Berg, M.D., Ph.D., FACR, chief scientific advisor to DenseBreast-info.org and professor of radiology at University of Pittsburgh School of Medicine/Magee-Women’s Hospital of UPMC, spoke with ITN Editorial Director Melinda Taschetta-Millane about some of the proposed amendments to the language being used for mammography reporting and quality improvement.
William Pinsky, M.D., a pediatric cardiologist and CEO of the Educational Commission for Foreign Medical Graduates (ECFMG), and Mandeep Mehra, M.D., medical director of the Brigham and Women’s Hospital (BWH) Heart and Vascular Center and professor of medicine at Harvard Medical School, explain the U.S. doctor shortage and how foreign doctors help fill the gap.
According to 2017 data provided by the Association of American Medical Colleges (AAMC), 40 percent of interventional cardiologists, 30 percent of cardiovascular disease specialists, and 26 percent of pediatric cardiologists in the United States are international medical graduates (IMGs). However, as the physician shortage continues to impact primary care doctors, psychiatrists, OB/GYNs, among others, the U.S. also expects to see a shortage of cardiologists within the next 10 years, according to a spotlight cardiology study issued by the professional services firm PYA, which specialized in healthcare consulting.
Deborah Levine, M.D., professor of radiology at Harvard Medical School and vice chair for academic affairs in the Department of Radiology at Beth Israel Deaconess Medical Center, Boston, describes scenarios where magnetic resonance imaging (MRI) could be more useful than ultrasound in issues with the female pelvis.
Magid Awadalla, MBBS, is an advanced cardiac imaging research fellow at Massachusetts General Hospital. He has been involved in an imaging study of cardiac changes from photon radiotherapy in breast cancer patients using serial cardiac magnetic resonance imaging (MRI). The radiotherapy beams used to treat breast cancer pass close to the neighboring heart, which can cause cardiac cell damage leading to issues like heart failure later on. He spoke on the topic of cardio-oncology at the American College of Cardiology (ACC) 2019 meeting.
Raza Alvi, M.D., a research fellow in radiology at Massachusetts General Hospital, has been involved in a study of a positron-emission tomography (PET) FDG radiotracer agent to image sarcoidosis. The inflammatory disease affects multiple organs and usually include abnormal masses or nodules (granulomas) consisting of inflamed tissues that can form in the heart. Alvi presented on this topic at American College of Cardiology (ACC) 2019 meeting.
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At RSNA 2018, iCad showed how its ProFound AI for digital breast tomosynthesis technology might help in the interpretation of tomosynthesis exams. Rodney Hawkins, vice president of marketing for iCad, discusses how this technology can better help detect the cancer.
Cree Gaskin, M.D., professor, vice chair and associate chief medical officer, University of Virginia Health System, explains how new technology can be used to improve radiology reports without additional workload. His health system uses a new generation integrated RIS/PACS system that allows URL links and new graphical data presentations to be embedded into radiology reports to make them more interactive. This information can include quantifications, key images from the exam, access to full datasets, 3-D reconstructions and ability to immediately link to prior exams. He spoke is sessions on this topic at the 2019 Healthcare Information Management and Systems Society (HIMSS) conference.
This is an example of a new endoscopic virtual peritoneal inflation tool on the patient's computed tomography (CT) imaging to aid in pre-procedural planning of endoscopic procedures. This is a new software feature on Fujifilm's Synapse 3D advanced visualization software released at the Healthcare Information Management and Systems Society (HIMSS) 2019 meeting. The software also enables 3-D imaging for surgical pre-procedural planning to assess the best entry points and angles.
This is an example of a 3-D printed pelvis that had multiple hip fractures and a second printed pelvis is from a post surgical repair CT scan, showing the pins and plates in pink. This was on display at the GE Healthcare booth at the Healthcare Information Management and Systems Society (HIMSS) 2019 conference. The files for printing were created from the CT datasets using the AW Advanced Visualization software.
This is an example of a new endoscopic 3-D imaging simulator created from a patient's computed tomography (CT) scan using Fujifilm's Synapse 3D advanced visualization software. The feature was released at the Healthcare Information Management and Systems Society (HIMSS) 2019 meeting. The software enables surgical pre-procedural planning to assess the best entry points and angles. The software also enables users to perform a virtual peritoneal inflation using the advanced imaging platform.
The software shows the anatomy color coded so structures are easier to identify and to aid navigation. In this example, a pancreatic tumor is highlighted in green, which is the target of this virtual simulation.
Andrew Deutsch, M.D., MBA, chairman and CEO of Renaissance Imaging Medical Associates (RIMA), an affiliate of Radiology Partners, describes RIMA’s use of an artificial intelligence (AI) based worklist workflow to manage reads across 70 sites and load balance between 120 radiologists. He spoke in sessions on this topic at the 2019 Healthcare Information Management and Systems Society at (HIMSS) conference.
Deutsch, a nationally respected expert in skeletal radiology and magnetic resonance imaging (MRI) and in addition to his roles at RIMA, serves as medical director of the imaging departments at Northridge Hospital Medical Center and Valley Presbyterian Hospital.
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This is a virtual heart with the same electrophysiology characteristics as the real patient unveiled by Siemens at the Healthcare Information Management and Systems Society (HIMSS) 2019 annual meeting in February. This "digital twin" technology is in development and will be able to create virtual, digital organs from a patient’s medical imnaging and other physiological data. In this case, the model was created using an ECG, MRI scan and other clinical data. It was shown as a way to help optimize cardiac resynchronization therapy (CRT) lead placement. CRT currently has a 30 percent nonresponder rate, which is mainly due to the placement of leads. This model allows virtual placement of the leads In various locations to test response prior to the implantation procedure. The green dot shows the location of the virtual lead. Siemens said the technology also might have applications for testing virtual ablations strategies to save procedure time when the patient is in the EP lab.
ITN Associate Editor Jeff Zagoudis speaks with Vinai Gondi, M.D., director of research and CNS neuro-oncology at the Northwestern Medicine Cancer Center, about the cutting-edge radiotherapy treatments and research being done at the Warrenville, Ill. center.
Watch the VIDEO: Multidisciplinary Treatment of Brain Tumors, part 2 of the interview with Gondi.
This is an example of an arterial venous malformation (AVM) in the brain imaged on a Canon Alphenix Alpha angiography system. It shjows a contrast injection highlighting the vessels, which have been color coded to show the position of the veins and arteries involved in this vascular defect.
Gregory Videtic, M.D., staff physician in radiation oncology at the Cleveland Clinic, and David Johnstone, M.D., professor of surgery at the Medical College of Wisconsin, discuss the factors in deciding how to treat patients with marginally operable non-small cell lung cancer at the 2018 Radiological Society of North America (RSNA) annual meeting.
ITN Editor Dave Fornell takes a tour of some of the most interesting new artificial intelligence (AI) imaging technologies on the expo floor of 2018 Radiological Society of North America (RSNA) annual meeting.
Watch the related VIDEO: Editor's Choice of the Most Innovative New Technology at RSNA 2018.
Related AI Imaging Technology Content:
VIDEO: Managing a Multi-site Radiology Practice With AI-based Workflow — Interview with Andrew Deutsch, M.D.
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VIDEO: RSNA Post-game Report on Artificial Intelligence — ITN editors Dave Fornell and Greg Freiherr discuss the AI trends they saw at RSNA 2018
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ITN Editor Dave Fornell takes a tour of some of the most interesting new medical imaging technologies displayed on the expo floor at the 2018 Radiological Society of North America (RSNA) meeting. The video includes new technologies for fetal ultrasound, CT, MRI, mobile DR X-ray, a new generation of fluoroscopy systems, MRI contrast mapping to better identify tumors, and a new technique to create moving X-ray images from standard DR imaging.
Watch the related VIDEO: Editor’s Choice of the Most Innovative New Artificial Intelligence Technologies at RSNA 2018. This includes a tour of some of the recently FDA-cleared AI technologies for medical imaging at RSNA 2018.
Supplemental screening with ABUS helps personalize breast care for women with dense breasts and offers advanced clinical confidence for radiologists. ABUS can play an important role in early diagnosis of small, node negative, invasive cancers. Hear from Georgia Giakoumis Spear, M.D., from NorthShore University HealthSystem in the Chicagoland Area of Illinois as she speaks with Lucas Delaney, general manager for ABUS at GE Healthcare. As an early adopter of ABUS, she discusses the clinical need and her results with ABUS. She also provides her impressions of the newly introduced Invenia ABUS 2.0, and demonstrates a case utilizing the coronal view.
ITN Contributing Editor Greg Freiherr discusses how advances in digital technology are giving new meaning to the term dynamic imaging in his conversation with Konica Minolta President and CEO David Widmann.
Robert Quaife, M.D., director of advanced cardiac imaging, University of Colorado Hospital, explains why advanced imaging techniques are required to tackle complex transcatheter procedures and structural heart interventions. The University of Colorado Hospital helped develop the Philips EchoNavigator live image fusion technology, and this video offers an overview of how it came to be and where the technology is going.
Watch the related VIDEO: Evolution of Transcatheter Mitral Valve Repair at the University of Colorado, which shows exaplmes of the navigation technology is use during a MitraClip procedure.
Cyrus A. Raji, M.D., Ph.D., assistant professor of radiology at the Mallinckrodt Institute of Radiology at the Washington University School of Medicine in St. Louis, explains how diffusion tensor imaging (DTI), a form of magnetic resonance imaging (MRI), could help identify individuals earlier who are likely to develop Alzheimer's disease.
Enhao Gong, Ph.D., founder of Subtle Medical, an artificial intelligence (AI) company that develops products to help medical imaging, explains how AI might be used to reduce the amount of gadolinium contrast needed for magnetic resonance imaging (MRI) exams.
Based on Mindray’s Living Technology, the Resona 7 (Sapphire), ZS3 (Diamond) and TE7 (Crystal) new ultrasound upgrades offer significant enhancements in support of the company’s commitment to providing state-of-the-art ultrasound imaging. Maher Elhihi, director of marketing, North America Ultrasound, summarizes the key benefits included in the company's Gem Series introduction.
This is a walk around of the new Spectrum Dynamics Veriton SPECT-CT nuclear imaging system introduced at the 2018 Radiological Society of North America (RSNA) meeting.
This is a walk around of an innovative new SPECT-CT nuclear imaging system shown at the Radiological Society Of North America (RSNA) 2018 meeting this week. It's CT system with comes in 16, 64 or 128 slice configurations. It has 12 SPECT detector robotic arms that automatically move toward the patient and use a sensor to stop a few millimeters from the skin to optimize photon counts and SPECT image quality. It also uses more sensitive CZT digital detectors, which allows either faster scan times, or use of only half the radiotracer dose of analog detector scans.
Stamatia Destounis, M.D., FACR, associate professor, University of Rochester School of Medicine, and attending radiologist, Elizabeth Wende Breast Care, explains the details of a new study showing the benefits of mammography in elderly women at the Radiological Society of North America (RSNA) 2018 annual meeting.
Accuray's philosophy is to personalize treatments to exactly fit the patient. Senior Director of Marketing Andrew Delao explains this philosophy in a conversation with Greg Freiherr at ASTRO 2018.
This is an example of the FDA-cleared OpenSight augmented reality (AR) system for surgical planning from NovaRad at the Radiological Society Of North America (RSNA) 2018 meeting. It uses a Hololens headset to register an overlay of the patient’s MR or Ct scan in the patient. The operator can use hand movements to slice through and manipulate the images.
The vendor gained an FDA indication for AR to be used in surgical planning in 2018. NovaRad is working with the FDA for a second indication for use of the AR in the operating room during procedures.
This video is jerky, slightly misaligned and the hand movements did not always respond because itwas shot with an iPhone inside the visor. The image quality and hand movements are much better when actually wearing it on your head and aligned for the specific user.
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This is an example of moving X-ray images displayed by Konica Minolta today at the Radiological Society Of North America (RSNA) 2018 meeting. This Dynamic Digital Radiography (DDR) technology shoots 15 frames per second for 20 seconds. The resulting 300 images are stitched together by the software to create a cine loop
This is an example of the new Fetal HQ heart and vascular software from GE Healthcare for fetal ultrasound. The software, for the Voluson E10, helps evaluate the fetal heart shape, size and contractibility. A feature called Radiant Flow shows the blood flow in a 3-D view. It can also help show slow-flow blood, such as neuro-vascular circulation. This was shown for the first time at the 2018 Radiological Society of North America (RSNA) meeting.
Here is an example of how artificial intelligence (AI) is helping radiologists with faster workflow to improve care. This example from the Philips Illumeo system shows a spine CT and how the radiologist can use the tool bar to gain one-click, immediate access to three prior CT studies that will open with the exact slate slice view and orientation as the current exam. This was shown at the 2018 Radiological Society of North America (RSNA) meeting.