Medical Imaging Trends in 2020

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Four technology innovations that will shape the future of diagnostic imaging.

It’s a new year and a new decade – and time to look ahead at the innovations that will shape the future of medical imaging in 2020.

The overall healthcare industry is striving to make healthcare more effective. In medical imaging, this translates to improving diagnosis while keeping dose as low as possible; and increasing efficiencies to minimize costs.

In Medical Imaging Trends in 2020, we explore four significant technology innovations that will help improve diagnosis while keeping dose as low as possible. They are:

• Faster acquisition enables improved image quality
• Gains in optimal dose efficiency
• 2D image capture evolving to 3D
• AI as a supplemental lens for medical image analysis

In Part 2 of our series, we explore the medical imaging trends that will impact radiology administrators in 2020.

Trend 1: Faster acquisition enables improved image quality

An ever-present goal of digital radiology is to acquire the most information possible. In 2020, the capability for faster acquisition is enabling many advanced imaging applications, and extending the function of traditional radiology systems.

For example, Carestream’s newest advanced medical imaging technologies – Digital Tomosynthesis and Dual Energy – provide radiologists with more information for diagnosis. Both improve the visualization of overlying and underlying patient anatomy, and provide enhanced detection of subtle features that can be difficult to visualize in traditional 2D radiographs.

Digital Tomosynthesis software acquires a series of individual images from a range of different angles that are analyzed to provide depth information regarding patient anatomy. By separating overlying structures, it provides enhanced detection of subtle features that can be difficult to visualize in traditional 2D radiographs.

“We lose a lot of information when anatomy and pathology are overlaid,” explains Dr. Narinder Paul of Western University. “Digital Tomosynthesis allows us to slice away the overlying pathology to reveal underlying diseases. This is beneficial in cases where the underlying pathology might be masked by the overlying anatomy, like the lung.”

The second advanced visualization technology from Carestream in 2020 is Dual Energy. Our Dual Energy technology switches between high- and low-energy exposures, using a patented differential filtration to capture two images in succession. Two images are produced: a soft-tissue-only image and a bone-only image – but the dose is the same as a standard chest X-ray. This gives radiologists the ability to remove or emphasize structures. For example, a radiologist can emphasize bone to see a rib fracture that might otherwise be missed. Or conversely, remove bone from the image to see the underlying anatomy.

Another innovation for improved chest X-ray image capture is SmartGrid software. The image capture software reduces the damaging effects of scatter radiation in an image – helping to improve the contrast of the image when a physical anti-scatter grid is not used. A clinical study evaluating paired grid and non-grid portable chest images at the University of Rochester Medical Center found that the SmartGrid processing had significantly higher preference overall compared to images without SmartGrid enhancement.

Other recent advancements in image processing from Carestream that will continue to help improve diagnosis in 2020 and beyond include:

• EVP (Enhanced Visualization Processing) Plus
• Tube and Line Visualization
• Bone Suppression
• Long-length Imaging
• Pneumothorax Visualization
• Pediatric Capabilities

These capabilities are built on our Eclipse imaging processing engine that uses powerful, proprietary algorithms to provide automated and robust image processing that delivers superb image quality and consistent presentation.

Also in 2020, expect detector specifications to continue to keep pace with advanced image processing applications. A recent example is the CARESTREAM DRX Plus 2530C Detector that delivers enhanced resolution to capture the fine detail of smaller anatomical structures in pediatric patients.

Trend 2: Gains in optimal dose efficiency

Achieving optimal dose efficiency has long been a core competency of Carestream, and we are building on this competitive advantage in 2020.

For example, the radiation dose of our Dual Energy solution is equivalent to that of a single chest PA X-ray, yet it provides much more diagnostic information. For these reasons, we believe that Dual Energy has the potential to become the new standard of care in chest imaging.

Further, our Digital Tomosynthesis exam has less dose than a diagnostic CT exam; and SmartGrid reduces the damaging effects of scatter radiation in an image – helping to improve the contrast of the image when a physical anti-scatter grid is not used. All these dose-efficient applications are enabled by the higher DQE in our DRX plus detectors.  

For orthopaedic applications, the radiation dose of the CARESTREAM OnSight 3D Extremity System is 1/3 that of a traditional CT. Depending on the patient, one CT image from the Carestream OnSight System might save the patient from receiving multiple non-definitive X-rays, explains Anish R. Kadakia, MD, Professor of Orthopedic Surgery at Northwestern University/Northwestern Memorial Hospital.

In addition to technology advancements, radiology-led initiatives will continue to curb patient exposure. A report published by the National Council on Radiation Protection and Measurements in 2019, showed doses dropped by 15% to 20% among U.S. patients between 2006 and 2016. The report credits the drop in dose to radiology-led initiatives such as the Image Gently and Image Wisely campaigns, along with an increased utilization of the ACR Dose Index Registry and mandatory imaging center accreditation requirements. (1)

Trend 3 – 2D image capture evolving to 3D

For decades, 2D X-ray has been the backbone of diagnostic imaging. But is 3D the future of medical imaging?

“Without a doubt, 2D X-ray has limitations,” explains Dr. Paul. “You are imposing a 3D structure on a 2D plate.”

Carestream is investing in advanced imaging applications to overcome these limitations. For example, our Digital Tomosynthesis software is bringing 3D imaging capability to DR rooms.

We already provide 3D imaging in the orthopaedic market in the form of our OnSight 3D Extremity System. Dr. Brendan Adler of Envision Medical Imaging, who uses the OnSight System, believes 3D imaging applications will continue to evolve. “There is a trend generally in radiology that 2D imaging will be quite a useful management tool. But basically the diagnostic test will be a 3D body metric test, and that is not just in orthopaedics.”

CT and MRI scanners also are evolving to produce clearer 3D images with extremely high resolution, less noise and at lower dose. 3D visualization such as cinematic rendering creates photorealistic images of the anatomy help with surgery planning and interpretation of whether a tumor is cancerous.

Additionally, breast tomosynthesis is now the standard of care for mammography screening; while 3D ultrasound assures that the sonographer has captured the entire anatomy with the scan.

Many of these advancements in 3D medical imaging are made possible by the computational power that is now available at a relatively low cost as well as the tremendous increase in networking speed that allows transmission of large data sets in 3D images.

Networking speed has experienced a “thousand-fold increase,” from 10 megabits per second to 10 gigabits per second, according to Gordon Harris, director of the 3D Imaging Service at Massachusetts General Hospital’s Department of Radiology. “This increase in networking speed has enabled us to work with much larger data sets, to be able to download and move them,” he told Health Tech Magazine. (2)

Trend 4– AI as a supplemental lens for medical image analysis

Artificial intelligence has dominated session tracks and titles at imaging conferences and industry headlines for several years. While it has the potential in the long term to dramatically alter medical imaging, at the moment there are limited FDA-cleared applications for the use of AI in DR; and adoption in the healthcare sector overall has been slow.

In the near term, AI will have a role as a supplemental lens for medical image analysis by identifying subtler changes in scans while reducing treatment planning time by analyzing vast amounts of data. AI also has much potential to improve operational efficiency, freeing up experts from repetitive and mundane tasks.

The use of AI and the move to 3D imaging complement each other as there is a tremendous amount of information in the images that could be analyzed by a computer and presented to the radiologist or referring physician.

Which technologies and trends do you believe will have the most impact on medical imaging in 2020? Please comment below.

References:

1. Radiology Efforts Over Past Decade Led to 20% Drop in Patient’s Radiation Dose, Report Shows – Health Imaging
2. How 3D Technology is Transforming Medical Imaging – Health Tech Magazine

Learn More:

• 3 Strategies for Radiology Administrators in 2020
• Video: Digital Tomosynthesis and Dual Energy Software
• Blog: Improving the Quality of Mobile Chest X-rays with SmartGrid Software
• Eclipse Image Processing
• Blog: Cost-Benefit Analysis of AI in Radiology

Xiaohui (Ed) Wang, Ph.D. is the Director of Imaging Systems, R+D Innovation and Platforms at Carestream Health. He has 26 years of experience in research and development of medical imaging systems, including digital radiography and computed tomography.