Interview with Mike Stone, M.D., an emergency physician at Northwest Acute Care Specialists in Portland, Ore., director of point of care ultrasound education at Butterfly Network Inc., and and former chief of the division of emergency ultrasound at Brigham and Women's Hospital, Boston. He explains what clinicians look for in lung ultrasound to evaluate patients for plural wall thickening and areas of congestion inside the lung typical of pneumonia and seen in patients with novel coronavirus (COVID-19, also referred to clinically as SARS-COV-2). 

Small hand-held ultrasound systems may offer advantages over X-ray or computed tomography (CT), because the entire system can be contained inside a protective sheath, making it easier to disinfect the device rather than an entire imaging room. Point of care ultrasound (POCUS) systems also allow triage of patients in tents or other areas outside of the hospital where other imaging modalities are not available. 

Stone shares examples of COVID-19 ultrasound images from Butterfly Network POCUS system technology, which turns an iPhone into an FDA-cleared ultrasound device for multiple POCUS exam types. It is the first POCUS system reported to be used for triage and monitoring COVID-19 patients. 
 

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Find more related clinical content Coronavirus (COVID-19)

Additional COVID-19 Resources for Clinicians:

   ACC COVID-19 Hub page   

   Johns Hopkins Coronavirus Resource Center with inteavtive map of cases in U.S. and worldwide 

   World Health Organization (WHO) COVID-19 situation reports

   World Health Organization (WHO) coronavirus information page

   U.S. Food and Drug Administration (FDA) COVID-19 information page

   Centers for Disease Control (CDC) COVID-19 information page

   Centers for Medicare and Medicaid Services (CMS) frequently asked questions and answers (FAQs) for healthcare providers regarding COVID-19 related payments

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

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

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

To learn more, visit www.fujimed.com

Elizabeth M. Hecht, M.D., professor of radiology, Columbia University, New York, explains the latest advances to help visualize the difficult to image pancreas. She was a moderator of a session on pancreatic imaging advances at the 2019 Radiological Society of North America (RSNA) meeting.

She explained computed tomography is the front line imaging modality, followed by MRI for more detailed examination of the soft tissue details. MRI tissue elastography can also help to differentiate pancreatitis from pancreatic cancer. Hecht also said PET-CT and endoscopic ultrasound also play roles in pancreatic imaging. She said new software is helping automate measurements and artificial intelligence (AI) is in development to help improve pancreatic imaging and to find new radiomic markers that might be missed by the human eye to better detect disease or risk stratify patients.

Find more news and video from RSNA

An experienced technologist and two Agfa executives talk about what distinguishes the new Agfa 100s. Three key highlights include the quality of images that users can get out of the system for the certainty of the diagnostic; more flexibility that has been designed around the user; and its revolutionary platform.

Hitachi announced the FDA clearance of its newest CT – Scenaria View – at RSNA2019. The View offers an 80 cm wide bore, 550 lb table capacity and powerful 84 kW generator as well as a 200 mm lateral shifting table. Installs in Georgia, Ohio and Florida are underway with more to come in the new year.

In this Conversations video at AHRA, Ryan K. Lee, M.D., describes the harm extravasation can do and why using power injectors to administer saline beforehand increases patient safety based on his experiences at the Einstein Healthcare Network. 

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

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

Read more about the system and a recent install

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

Photo Gallery of New Imaging Technologies at RSNA 2019

Find more news and video from RSNA 2019

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

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

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

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

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Reference:

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

James Carr, M.D., chair of the Department of Radiology, Northwestern University, and incoming 2020 President of the Society of Cardiac Magnetic Resonance (SCMR), explains why MRI is an ideal cardiac imaging modality, at the 2019 Radiological Society of North America (RSNA) meeting.

Heart MRI offers advantages over computed tomography (CT) and echocardiography because of its excellent soft tissue delineation and its ability to offer information beyond anatomical imaging, such as perfusion, morphology and metabolism. MRI can be technically challenging and the exams requiring a long time, but recent advances have helped cur cardiac imaging times down significantly. Automation and artificial intelligence (AI) also is making post-processing and quantification mush faster, brining it closer to the time it takes to scan and post-process CT imaging.
 
Northwestern is was one of the early adopters of cardiovascular MRI. Carr said heart MRI was not common in regular clinical use until the past decade at some luminary centers. In 2005, Carr was given the opportunity to develop a clinical cardiac MRI program at Northwestern.
 
He said MRI scanners have improved, and now much faster than a decade ago. They are also more optimized for cardiac imaging. While heart MRI is well known in large hospital centers, Carr said it still needs to develop and expand to community hospitals and rural hospitals outside major population centers. 

Artificial intelligence is playing a significant role in cardiac MRI automation of speeding workflow and quantification. Carr said these technologies will become mainstream in the next few years. AI also will play an increasing role in risk prediction based on new image analysis algorithms in development.

For more information on cardiac MRI, visit SCMR's website www.heartmri.org.

This is an example of an augmented reality (AR) training system for transesophageal echo (TEE) created by the simulation company CAE. Rather than just looking at an overhead screen, this system allows the user to use a HoloLens visor to see the impact their probe manipulation has on the cardiac ultrasound imaging and better shows the orientation of the ultrasound probe, the 2-D ultrasound image slice and the relation to the anatomy. It was displayed at the 2019 Radiological Society Of North America (RSNA) meeting.

Read more about this technology.

Find more technology news and video from the RSNA meeting

Vieworks to present NEW DR detectors, VIVIX-S V series. This is a strategic model that will open up a new era of digital radiography. VIEW it now. You will know.

This is a lung cancer tumor radiotherapy treatment plan for the Accuray CyberKnife system demonstrated at the American Association of Physicists in Medicine (AAPM) 2019 meeting. The blue lines are the radiation beam lines that are shot from different positions to all intersect in the tumor to deliver the prescribed amount of radiation and prevent damage to surrounding healthy tissue. The beams also are planned around the critical structure organs near the target tumor to limit their dose. The organs are color coded to differentiate them on the treatment plan and to help with the estimated radiation dose each receives based on the plan. After the plan is optimized, it is fed into the radiotherapy treatment system computer to deliver the treatment once the patient is positioned on the treatment table exactly as they are in the CT scans used to create the plan. 

Find more news and video from AAPM

Shimadzu displayed the FluoroSpeed X1 conventional radiographic fluoroscopy (RF) system at the Association for Medical Imaging Management (AHRA) 2019 meeting in July. The system was pending U.S. Food and Drug Administration (FDA) approval at AHRA, but received FDA 510(k) clearance in early August 2019.

The system features a 33-inch aperture, large enough to place a wheelchair inside. It can be rotated 90 degrees in either direction and the deck can be parked in any position, making it easier for patients to get on and off the 660-pound weight table. The FluoroSpeed X1 offers controls that are ergonomic for technologists, with duplicate controls on each side for either a left- or right-handed tech. The machine also has a large aperture to allow swallow studies.

The FluoroSpeed X1 comes equipped with a 17 x 17-inch dynamic digital X-ray detector (FPD) in the table bucky, allowing it to both be used for fluoroscopy as well as radiographic exams.

Read more about the FluoroSpeed X1: Shimadzu Medical Systems Receives FDA 510(k) for FluoroSpeed X1 RF System

Interact with a 360 photo of a Shimadzu FluoroSpeed X1 Fluoroscopy imaging system
 

This is a quick walk around of the GE Healthcare Cardiographe dedicated cardiac CT system on display at the Society Of Cardiovascular Computed Tomography (SCCT) 2019 meeting. It was designed specifically for cardiac imaging and so has a very compact footprint so it can be used in an office setting or small room. It offers a fast gantry rotation speed to freeze cardiac motion and has large enough anatomical coverage to view the scan the entire heart in one rotation.

One of these systems was recently installed at St. Paul’s Hospital in Vancouver, Canada, where they have an extensive structural heart program. Read more about this intall.

Find more information on this system in these related articles:

New Cardiovascular CT Technology Entering the Market

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Pierre Qian, MBBS, cardiac electrophysiologist fellow, Brigham and Women's Hospital, explains how his facility is working with radiation oncology to use radio therapy to noninvasively ablate ventricular tachycardia (VT). He spoke on this topics during a joint electrophysiology session by the Heart Rhythm Society (HRS) and the Society of Cardiovascular Computed Tomography (SCCT) at the SCCT 2019 meeting.

Find more SCCT news and videos

Arthur Agatston, M.D., clinical professor of medicine, Florida International University, Herbert Wertheim College of Medicine, is the name-sake of the Agatston score used in CT calcium scoring. He explains the history of the scoring system from the early 1990s and the evolution of CT technology for cardiac imaging. The latest American Heart Association (AHA) 2018 cholesterol guidelines now include the use of CT calcium scoring, which was a big topic at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting.

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CT Calcium Scoring Becoming a Key Risk Factor Assessment

ACC and AHA Release Updated Cholesterol Guidelines for 2018

VIDEO: CT Calcium Scoring to Screen For Who Should Take Statins — Interview with Matthew Budoff, M.D.

Find more SCCT news and videos

Mahadevappa Mahesh, Ph.D., chief of medical physicist and professor of radiology and medical physics, Johns Hopkins University, Baltimore, and treasurer of the American Association of Physicists in Medicine (AAPM), explains some of the trends in medical physics and new features of the AAPM 2019 meeting. 

Watch the related VIDEO: Bridging Diversity in Medical Physics to Improve Patient Care — Interview with AAPM President Cynthia McCollough, Ph.D., at the 2019 AAPM meeting.
 

Find more news and videos from AAPM.

Ron Blankstein, M.D., director of cardiac computed tomography, Brigham and Women's Hospital, and associate professor of medicine and radiology, Harvard Medical School, offers an overview of the recent trends in cardiac CT and some of the new highlights at the Society of Cardiovascular Computed Tomography (SCCT) 2019 meeting. He said key topics included integration of artificial intelligence into CT systems, the integration of CT calcium scoring into the 2018 American Heart Association (AHA) cholesterol management guidelines, structural heart assessments for transcatheter valve and left atrial appendage (LAA) occlusion, and sessions with paertner societies that explain the roll of CT in interventional cardiology and electrophysiology.

Find more SCCT news and videos

Sudhen Desai, M.D., FSIR, interventional radiologist at Texas Children's Hospital, editor of IR Quarterly for the Society of Interventional Radiology (SIR) and on the Board of Directors for the Society of Physician Entrepreneurs, explained how artificial intelligence (AI) can assist in pediatric imaging and the pitfalls of training AI systems. He spoke at the 2019 Radiology AIMed conference. 

Deep learning algorithms require large amounts of patient case data to train the systems to read medical images automatically without human intervention. However, in pediatrics, there are often much lower numbers of normal and abnormal scans that can be used compared to vast amounts of adult exams available. This makes it difficult to train systems, so AI developers are coming up with innovative new ways to train their software. Compounding issues with training pediatric imaging AI is that the normal ranges change very quickly for young children due to their rapid development. He explained what is normal for a 2-year-old may not be normal for a 5-year-old.

Desai and other pediatric physicians who spoke at the conference said AI could have a big impact on pediatric imaging where there are not enough specialists for the increasing image volumes.

Related content:

VIDEO: Implementation of Artificial Intelligence Tools in Radiology Practice — Interview with Lawrence Tanenbaum, M.D.

VIDEO: AI That Second Reads Radiology Reports and Deals With Incidental Findings — Interview with Nina Kottler, M.D.

Technology Report: Artificial Intelligence at RSNA 2018

VIDEO: Implementation of Artificial Intelligence Tools in Radiology Practice

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.

Read more about the center's first year experience with the system.

Find more Henry Ford Hospital related content.