The areas rads should be keeping an eye on this year: from AI to liquid biopsy, you’ll be seeing a lot more of these technologies in the near future.
Be it films, digital images, or integrated file-sharing systems, radiology has historically been the leader in applying technological advancements to workflow and patient care. That trend shows no slackening.
According to industry leaders, 2019 will again be a year where you’ll be introduced to new technologies and see wider-spread implementation of new tools to enhance the way you work and provide services to your patients.
Here are several technologies to consider investing in this year and beyond.
1. Liquid biopsy
Perhaps the most innovative technology you should investigate this year is one that will be used with pathology, says Eliot Siegel, MD, professor of diagnostic radiology and nuclear medicine and vice chair of information systems at the University of Maryland School of Medicine. It’s liquid biopsy, and it could completely change how you diagnose cancer.
It’s a simple blood draw to screen for various biomarkers that indicate cancer and lead to more personalized treatment, he says.
“It’s not on most radiologists’ radar because we don’t really talk about this topic much in our meetings, but I think liquid biopsy could be one of the biggest game changers in radiology in many years,” Siegel says. “Compared to taking a needle, putting it into a tumor, and pulling out tumor cells, this is a much less invasive technology that looks for biomarkers just circulating in the blood.”
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Additionally, liquid biopsy could be used with focused ultrasound to gather samples from brain tumors, leading to more accurate diagnoses and staging. Work is also underway to pair liquid biopsy with radiomics - the extraction and analysis of quantitative features from diagnostic images. The goal is creating an imaging biobank to support your clinical decision-making.
With these potential benefits, Siegel says, he anticipates liquid biopsy to gain traction this year and grow steadily into the standard-of-care over the next five to seven years.
Provider impact: Providers could diagnose cancer far earlier than is currently possible. The biopsy requires far fewer cells than are currently necessary to detect cancer.
Patient impact: Early diagnoses can translate into easier courses of treatment with, potentially, better outcomes.
Financial benefit: According to Siegel, liquid biopsy from a standard blood draw could be inexpensive compared to other, more invasive, cancer screenings with reimbursement rates to be determined later.
On the market: Although liquid biopsy isn’t routinely used in radiology yet, there are several companies already offering the technology: Biocept, Roche, and Guardant Health have liquid biopsies available.
2. Deep learning
Interest in and hype around artificial intelligence (AI) has swirled in radiology for several years. Although actual implementation was slow, it’s beginning to pick up with MRI, PET, CT, and nuclear medicine. Siegel also anticipates greater AI use with ultrasound in 2019.
The greatest deep learning advance, however, will be with improved image quality, he says. By processing collected raw data, new AI tools can improve contrast and spatial resolution, allowing for faster scan times, higher quality images, and potential dose reductions.
“This is going to have a huge impact on imaging times and imaging dose,” he says. “We’re already seeing reports at the major radiology meetings. This technology hasn’t gotten out to all radiologists yet, but this is really a call to arms.”
He did offer a word of caution-always investigate and ensure the data used to train your AI system is diverse enough to provide you with accurate guidance.
Provider impact: These AI advances could reduce the noise in the images you read, improving your ability to render accurate, timely diagnoses. It can also increase the number of scans you’re able to complete in a given timeframe. Improvements to diagnostic sensitivity and specificity will also come in time, he says.
Patient impact: It reduces the need for any repeat scan to replace studies with low quality images, and it shortens the amount of time a patient must spend for the scan to be complete. And, for individuals exposed to radiation, this technology could limit their dose.
Financial impact: If implemented successfully, this AI application could increase your bottom line by allowing you to complete more patient scans daily.
On the market: Subtle Medical offers SubtlePET, an AI-powered tool that enhances images collected from faster scans. It’s currently in pilot use at several hospitals nationwide. ContextVision’s Altumira enhances digital radiography, addressing concerns over varying exposure and dose, as well as all anatomy type requirements. Medic Vision’s iQMR (Intelligent Quick MRI) is vendor-agnostic and enhances noisy images. Research presented at the American Society of Neuroradiology revealed it can cut MRI brain scan time by 30% with no adverse image effects.
3. Computing platforms
These platforms are designed to give you access to the various AI applications you need for your daily office and patient care functions.
“These types of tools are very much like the App Store on your iPhone,” says Mert Sahin, chief marketing officer for GE Healthcare. “You’ll have ease of accessibility to the AI applications from which you want to choose.”
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Being able to select which applications will be most beneficial to your practice and could fundamentally change how PACS vendors produce systems, Siegel adds. It could push them to create their own computing platforms with applications already included.
Some of these applications, such as natural language processing, can greatly augment your workflow, he says. For example, a computer can limit your dictation time and catch your mistakes.
Provider impact: You can save time with dictating reports or accomplishing other operational tasks by investing in properly-trained AI tools, improve your diagnostic accuracy, and identify emergent cases quickly, triaging patients for the best outcomes.
Patient impact: Using AI tools for communication and workflow efficiency can improve patient safety, Siegel says.
Financial impact: By catching your dictation mistakes or highlighting potential problems, AI tools can help you avoid any malpractice accusations.
On the market: GE Healthcare offers Edison, a vendor-agnostic AI platform with a myriad of embedded applications. Using aggregated data, Edison can assist with clinical, operational, and financial decisions. Additionally, Nuance offers its AI Marketplace, a one-stop-shop that lets you purchase apps and gives you access to 70% of all radiologists in 5,500 health facilities. MEDNAX MDR-AI Incubator is also designed to foster the AI solution development to enhance clinical care.
4. Patient comfort
Technology touches more than your daily workflow and operations. It’s important to increasing patient comfort and satisfaction. Consequently, many vendors are taking steps toward improvements, particularly in mammography.
“Many patients have said mammograms are cold, uncomfortable, and painful,” Sahin says. “Companies are listening to that feedback and are developing solutions that address those concerns without sacrificing the image quality that is critical for diagnosis.”
Investing in patient comfort technology can put your practice ahead of the pack when patients are searching for the right radiologist to conduct their studies, he says.
Provider impact: Your patient satisfaction scores are likely to increase if you offer modalities designed to increase a patient’s comfort level during an exam.
Patient impact: Patients experience less stress and anxiety about their studies and their visits to your office when they know their diagnostic imaging will cause as little discomfort as possible.
Financial impact: In addition to the increased reimbursement tied to higher patient satisfaction scores, your bottom line could also grow as word spreads that you offer machines that cater to patient needs, enticing more patients to your practice.
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On the market: Siemens improved patient comfort with its MAMMOMAT Revelation system through soft-edge compression paddles and automatic compression slow-down for individualized pressure. GE Healthcare’s Senographe Pristina mammography machine includes arm rests and a thinner detector that isn’t as cold, and it limits pain by controlling compression levels. Hitachi Sofia 3D breast ultrasound allows women to say covered during the exam, and, as a face-down study, it uses body weight for compression.
Overall, Sahin says, 2019 will be a year of increased technological advances designed to help you grow your practice.
“Vendors are constantly working on developing tools to help radiologists keep their practices at the forefront,” he says. “We’re looking to create systems and products that provide the best outcomes for our customers and their patients.”
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