Amol Karnick, President & CEO of KA Imaging writes……
As we dive deep into 2022, healthcare preparedness seems to be a major topic of discussion. If there is a single thing that we can learn from the pandemic, it is that we must be ready for whatever comes next. And what is the impact for an imaging department? How can it be prepared? I would say that there are two approaches: (1) through solutions that can be easily deployed and provide accurate images; (2) through solutions that help radiologists (and other physicians) read fast and with confidence. As expected, these approaches don’t work separately, but complement each other benefiting the entire chain.
Mobile imaging has been on the rise in the past years. Recent market research shows that there is still room to grow. It is a modality that is definitely easily deployed. Nevertheless, most people working on Emergency Departments, for example, know that it historically has poor quality. And yet it’s the most used imaging modality in that setting. Good mobile X-ray is crucial, not only for Emergency Departments but also for other applications like critical care units and long-term wards. COVID-19 has shown us that taking every single patient for a CT scan is impractical, as there are too many patients while machines, staff, and time are variables that are limited. The radiation dose of a CT scan is also higher, which limits – or should limit – its clinical uses to specific cases. General radiography remains paramount because it is widely available globally, far more than other modalities, at a lower cost in terms of radiation.
Artificial Intelligence (AI) is also a hot topic for 2022. This is a solution that seems to address the requirements of ease of access, quality, and speed. However, since AI is premised on data, an AI is only as good as the data it works with, or the algorithms it’s optimized for. The development of AI algorithms has had considerable improvements in the past few years, especially for chest and musculoskeletal applications. And yet, AI is a subject that is still shrouded in suspicion by many radiologists. Hopefully, the recent advances can contribute to consolidating its use in the imaging field.
The question that manufacturers – like ourselves – should ask is “how can I help?”. From our perspective, dual-energy subtraction (DES) X-ray has an underestimated value.
For those who are unfamiliar with this technology, dual-energy subtraction has been used for more than 30 years. Along with the traditional Digital Radiograph, it also provides two supplementary images: one highlighting the bones, and another highlighting the soft tissue. The problem with older Dual-Energy systems is that they can’t be used in mobile applications and can result in images with motion artifact – issues that our engineers have recently been able to overcome. Because of those issues, DES has been restricted to some particular use cases, notably chest nodules.
However, studies show that DES has considerable clinical benefits not only to find lung nodules, but for other diseases, like pneumonia, pneumothorax, and even cardiac calcifications. Likewise, lines and tubes can be more easily seen thanks to the supplementary dual-energy images. That is, dual-energy doesn’t have to be a niche product. As long as any technical limitations are resolved, it can replace, or rather upgrade, virtually any DR system.
Recent enhancements in DES technology made it possible to use it in portable/mobile settings. The emergence of a single-exposure dual-energy solution also eliminated motion artifacts. This means we are finally able to introduce a new use for this technology. Emergency rooms, ICUs, long-term facilities… there are a number of different applications that can benefit from not only better DR, but from supplemental dual-energy images, which can help the physician better visualize lesions. It brings efficiency, quality and speed.
All these technological advances make single exposure DES an effective solution for all the different stakeholders involved. It is good for radiologists, who can access better DR as well as supplementary dual-energy X-ray images for faster and easier reading. It is good for imaging technologists, who can offer patients more comfort by bringing the detector to the point of care and getting high-quality images even in challenging settings such as emergency rooms and critical care units. It is good for administrators, who can optimize the use of other equipment across multiple departments, to avoid unnecessary diagnostics by early detection of various diseases. And it is especially good for patients, who have more comfort and early access to treatment for diseases that could go unnoticed until they become more serious.
As for AI, DES can also be a good lever for it. Currently, AI companies usually use one image to train their algorithms. Single Exposure Dual-Energy X-ray can train on six images per patient (native 3-spectral layers, composite DR, and subtracted images). This additional data results in better AI.
As the new chapters of 2022 unfold, we reiterate the need for preparedness as a key driver. Efficiency, quality, and speed go hand in hand, more than ever.
Editor’s Note:
Amol Karnick is a seasoned executive in the medical device industry. His experience covers the whole spectrum; from start-ups (Ultrasonix, Sentinelle Medical, Ventripoint) to large OEMs (GE Healthcare). Entering into the profession with a Bachelors in Engineering from the University of Waterloo and a Masters in Electrical Engineering from McGill, Amol spent 20 years in the medical imaging space to become a leader of multidisciplinary teams (sales, engineering, and operations). Amol is now poised to steer KA Imaging into a position of global leadership.