ECR 2022: TMC was there!

After 2 years of COVID-19 pandemic, ECR is back in Vienna, but for the first time ever, during summertime. The TMC Unilabs AI Centre of Excellence attended the largest radiology congress in Europe with two aims in mind: to strengthen the relationships with our current partners and get updates on the state-of-the-art AI solutions and catch glimpses of what’s coming next.

The attendance was quite small compared to previous years being this the middle of the holiday period. However, there was a silver lining to this: all the vendors were there and that meant more time for them to spend with us.

As soon as the congress started, we announced our partnership with Qure.AI. This project to help triage normal from abnormal Chest X-rays and help improve reporting efficiency, went live at the end of June. During the next months we will monitor the impact of this solution in our UK elective service, and we expect that for ECR 2023, we will be coming back to explain our successful collaboration.

Henrik Agrell, CEO of Telemedicine Clinic, was a panellist for the talk The Future of Radiology: AI or Teleradiology? He quickly stated that the “or” of the title should be changed into “and” as he believes that AI is the key to improve reporting workflows and deal with the ever-increasing volumes and the capacity shortages.

Thomas Lindahl, Unilabs Sweden Medical Director, spoke about our partnership with Subtle Medical, a healthcare technology company using artificial intelligence for faster and higher quality MRI, to further improve the quality and efficiency of our MRI imaging. The solution, which is already rolled out in Sweden having a significant impact in our work. More often than not, we talk about the promise of AI and the high expectations around it, but this time, we were happy to focus on the tangible evidence on what these solutions are doing for us. During the talk, Thomas presented the efficiency gains measured during the pilot trial and gave real examples on how the images are read by the radiologists after AI enhancement.  

As for what the future holds, what we have been able to see is an increasing trend on comprehensive AI solutions. This means, that during the coming years, more AI solutions will focus on detecting multiple pathologies instead of a specific acute one. These kinds of solutions have a huge potential for us, since they would allow us to quickly identify the cases that have no relevant abnormalities, clear them quickly, and dedicate more resources to complex cases with pathologies.

We have also noticed that AI vendors understand that the only way to deliver a well-rounded solution is a full, seamless integration. They understand our needs and are willing to tweak their solutions to adapt to what we need.

To sum it up, ECR 2022 was intense, warm, and fun! Plenty of action points and multiple follow-up meetings will be required, but the objective is very clear. Come back next year with more success stories to tell.

Perfusion CT – An Interview with Dr. Emily Clewett

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CT perfusion, along with CT angiography (CTA), can be a very important adjunct when treating strokes as opposed to conventional unenhanced CT brain imaging. Emily Clewett, Head of Section of Emergency Radiology Scandinavia, and the emergency senior clinical advisor for the AI Centre of Excellence has led her team to include CT perfusion in the routine workout of stroke patients for selected client hospitals in Sweden. Emily has been working on this project for a year now, so it is about time to ask her some questions about it:

What is Perfusion CT and why is it important in stroke diagnosis?

EC: In a stroke setting, it is vital to provide treatment as soon as possible – ‘time is brain’. We use several methods to find the cause of the patients’ symptoms, where the plain (non-contrast) CT head allows us to spot bleeds or established infarcts and the CT angiogram depicts the site of occlusion (blood clot).

The next level in stroke diagnostics is the CT perfusion, adding information about how much of the brain is at risk if the clot isn´t removed and helping the neuro-interventionists with selecting the patients who would best benefit from an endovascular procedure for the mechanic removal of the thrombus (some patients are treated only medically, with thrombus-dissolving medications). The perfusion scan is obtained after injection of intravenous contrast agent; the CT scanner acquires images of the same area of the brain at different timepoints, measuring the inflow of contrast agent and thus adding a temporal dimension.


Acute infarct on plain CT head


Occlusion (blood clot) on CT Angiogram


Perfusion scan showing established infarct (red, bottom right) vs area, which is ischaemic, but not yet infarcted, and thus salvable (yellow, bottom right)

 

Which role do Artificial Intelligence (AI) and post-processing software play in the interpretation of CT perfusion?

EC: The Emergency section has been an early adopter of AI-based diagnostic tools for the interpretation of CT head. A stroke with a bleed requires very different treatment from one with a blood clot, and it is vital that the radiologist identifies even the smallest of bleedings At Telemedicine Clinic, AI solutions help in ensuring this is done correctly

The images from a CT perfusion scan must be post-processed; this can be done manually or using special software with an automated workflow. There are AI software capable of processing perfusion scans, an emerging and exciting field in Sweden right now!

 

What challenges did you encounter when introducing this new diagnostic service? 

EC: While CT perfusion imaging has been around for quite some time, it is usually reported by highly specialized neuroradiologists. We have worked intensively to train our radiologist in this particular method. With the help of our Swedish client Örebro University Hospital which is pioneering the stroke care / teleradiology synergy, we created a portfolio of anonymised practice cases complete with reports and tutorials. To guarantee the highest level of quality and safety, we use prospective double reading for all stroke pathway cases, including those with CT perfusion images, which means all emergency reports are signed by two radiologists before being distributed.

 

Do you see this as a service that will become more popular and offered to more client hospitals?

EC: A couple of years ago new national guidelines were presented in Sweden, suggesting more stroke patients can benefit from endovascular mechanical clot removal. Perfusion scans are vital for patient selection, and we are currently seeing more frequent requests for this service. It is our goal to eventually be able to offer perfusion reporting to all our clients.

 

Dubai Health Forum 2022: The future is now

Dubai Health Forum 2022: The future is now

 

Ernest Montañà Ortiz, the TMC Unilabs AI Project Manager was invited to attend the 2022 Dubai Health Forum (DHF) in its fourth edition, sponsored by Unilabs Middle East and explains:

“Since its launch in 2017, the Dubai Health Forum has become an annual gathering for healthcare leaders, professionals, and the community. It gathers many international and local decision makers, healthcare leaders, industry experts, innovators, health institutions and organizations representing the wide spectrum of healthcare.

With a 2-day program, the forum holds several workshops, seminars, and discussion panels, where the participants will trace on a wide range of subjects like Dubai Care Model, Digital Health, Space Medicine, Value -based care and Health Economics.

Landing in Dubai feels like landing 100 years further in time, instead of 5000 km away from Barcelona. On March 2nd I had the chance to present the AI Centre of Excellence, our projects, and our approach to AI in front of the health authorities and professionals of Dubai. I decided to focus on real examples from our projects to bring the following message to the audience: AI is not just potential anymore, is a reality and is happening now in front of our eyes.

This idea was present at other health talks as well where other speakers, mostly doctors that use AI in their daily practice, spoke. It was reassuring that when they were discussing some of their cases, they were using several tools that we have already deployed, or we are planning to use soon.

On March 3rd we discussed how the landscape of the Health Sector is going to look like in 50 years. It is expected that by then, the fertility rates will go down significantly, people will massively move to the cities… Dubai has a very agile and hands-on approach to these changes: Let’s get there before the future catches up with us. AI is a crucial part of their strategy, and they are ready to start testing and deploying different solutions.

My stay here has been an amazing experience. I wish the days had lasted 50 hours, so much to do, so much to learn. Thanks a lot, to our Unilabs Middle East colleagues for inviting me and for making this work trip, a life experience.”

TMC secure even higher radiology quality with now 4 implemented AI solutions

Delivering quality healthcare in the 21st century requires state-of-the-art diagnostic solutions to ensure patients get access to the best treatment possible. TMC is proud of having implemented 4 AI solutions within the last year that augment the skill and experience of our radiologists and help to detect hard-to-find pathologies and thereby making the diagnoses even more reliable.

In the TMC Emergency section, Aidoc’s radiology AI solution sifts through CT images, automatically identifying potential critical findings, such as acute intracranial haemorrhages or acute/incidental pulmonary emboli. The solution has shown high accuracy and ease of use which leads to more accurate reports, increased reader confidence and potentially fewer missed pathologies. This is especially valuable as it can help to point to very subtle and critical findings that could be overlooked. Once the case has been processed by AI, the cases with findings are flagged in the reporting platform (Optemis) and the status of the exam is raised so that the case will be picked up sooner.

The industry-leading artificial intelligence from Aidence is supporting the TMC lung cancer screening service. Around three-quarters of lung cancer cases are diagnosed at a late stage in the UK and 10-year survival is poor (10%), but 79% is preventable (according to www.cancerresearchuk.org). The  AI tool from Aidence, Veye Lung Nodules, helps identify any suspected lung nodules (even nodules as small as 3mm). This AI solution facilitates early lung cancer detection and can thus help save patients’ lives.  Approximately 10,000 cases will be analysed by Aidence’s AI solution this year. It can be expected that about 10% of the patients will have a positive finding. (According to Gareth Davies, TMC UK Medical Director).

Aidence is marking a lung nodule in the images on the right (CT Thorax)

 

Aidoc highlightings a subdural haematoma (red color).

 

 

 

The Quest for Innovation: Addressing the Latest Trends in Imaging and Radiotherapy

Faithful to its goal to make TMC as human— as creative, inventive, caring, purpose-driven —as the wonderful human beings who work inside it, TMC is sponsoring a British Institute of Radiology cutting edge publication on the latest innovations in imaging and radiotherapy.

The British Institute of Radiology is the international membership organisation for everyone working in imaging, radiation oncology and the underlying sciences. Its vision is aligned with TMC. They support the work of their members and their colleagues to achieve professional excellence, they provide continuing professional development for their multidisciplinary community, they influence and connect with the wider professional sector, and they published research for their authors and readers across the world.

In their last publication, “Global Innovations in imaging and radiotherapy”, radiologists, radiographers, scientists, and other healthcare specialists across the world share their insights on how the Covid-19 pandemic has changed their way of working. They also elaborate on the role teleradiology will play in their countries in the coming years.

CLICK HERE to download the publication.

Innovations in imaging and radiotherapy - a more connected world

News from the Emergency Section: Australia celebrates the all-time high of 988 cases in one day

Fausto Labruto, the Director of Emergency Radiology of TMC remembers as if it were yesterday when the Emergency Section celebrated the milestone of 500 radiology cases in one day. He states:

This month we have been over 900 cases three times, including our all-time high of 988 cases in one day, just shy of the historical four digits figure. Most of our growth is due to the end of COVID-related restrictions in our client countries, however, since the beginning of the year, we have also started with new client hospitals in Denmark and UK, and increased coverage hours for several client hospitals.

Growth comes with challenges, first balancing demand with capacity and keeping up medical excellence in the face of increasing pressure. As volumes are increasing, we have managed to keep our turn-around-times, averaging over target (97% within one hour) for integrated clients and just shy of target (92% within one hour) for non-integrated clients. I wish to praise the work of Head of Section Marielle Kuijper and Emily Clewett Dahl and Supply Chain and Operations Manager Zane Laurent who are responsible for obtaining this.

With increasing volumes, we have found it more challenging to turn around hundreds of phone calls per day. Starting from this month, the Scandinavian Operations team has implemented a new system called “Critical Calls“, which has obtained excellent results in answering calls in a timely manner. We have already received praise from some of our largest clients on how effective this project has been: a true game-changer.

Our clients are also very impressed by our early adoption of AI tools in Emergency Radiology. We have now established AI-assistance for diagnosis of pulmonary embolism and intracranial bleedings, and more applications are being evaluated. I wish to thank the AI Centre of Excellence for putting us at the cutting edge of technology.

Speaking of technology in radiology, I am excited to announce that in two weeks the Swedish Emergency Radiology Team will start reporting emergency CT Perfusion performed on stroke patients at a University Hospital in Sweden. This is the first time we offer this special service, which places us in a special class among providers of Emergency Teleradiology.

New ISO 27701 certificate proves: TMC is on top of the GDPR requirements

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TMC cares about data protection and privacy. Especially nowadays, with the rise of cyber-attacks, data breaches, and the legal requirements to meet legislation, this topic cannot be left behind. Since the implementation of the General Data Protection Regulation (GDPR) in 2018, a lot has happened. As TMC wants to make sure personal data is protected and privacy information is managed most adequately (especially considering that we process patient data) we are proud to announce that we got the ISO 27701 certificate in March 2021. TMC is the first company in Unilabs to be certified in this ISO and hopes to be only the first great example but not the last.

The ISO 27701 standard will help us to stay on top of privacy within the organisation. This new ISO specifies the requirements and guides establishing, implementing, maintaining, and continually improving a PIMS (privacy information management system). It demonstrates compliance with our contractual and regulatory obligations and improves internal competence and processes to avoid breaches. Furthermore, this ISO will help us improve customer and business partner confidence.

The implementation of the standard was managed by the ISMS (Information Security Management system) manager Javier Castillo, and the Data Protection Coordinator Ida Anderman. Rosie Nunn, The Quality Manager, is responsible for the continuous review and audits of the ISO. While it is great news that we achieved this ISO, it was not a surprise as we have a well-implemented ISMS system in place (ISO 27001) since 2011 and excellent GDPR policies and procedures, which were rolled out by our Unilabs DPO Miroslava Greštiaková.

As TMC wants to make sure personal data is protected, the implementation of the ISO 27701 is a great milestone to assure individuals (patients and others) that their data is duly protected.