The Impact of Data on

Personalized Medicine

 By Editorial Staff

The amount of patient information collected and electronically transmitted during patient visits has grown significantly in recent years, generating interest among the radiology community to leverage Big Data in order to provide better, faster, and more affordable services.

A recent expert panel discussion, moderated by Lawrence Tanenbaum, MD, Vice President and Chief Technology Officer, Medical Director Eastern Division, Director of CT, MRI and Advanced Imaging, RadNet Inc., explored how emerging advanced technologies are being implemented across medical imaging.

Workflow efficiency remains a key issue in many radiology practices. High patient volumes, multiple imaging modalities and techniques, supporting rapid patient throughput demands, have created an environment where every second of a radiologist’s time counts. And while data flow in radiology has become largely seamless, a lack of enterprise integration and process-related inefficiencies continue to hinder productivity.

Fortunately, smart injectors, contrast and radiation dose monitoring systems, artificial intelligence (AI), and other new technologies are emerging to help imaging providers achieve improved workflow efficiency and consistency in complex imaging studies, providing better diagnostic accuracy, and increasingly personalized patient care.

Take power injectors, for example. Power injectors in various configurations have been available for some years. But new, syringe-less injector systems are dramatically improving CT imaging workflows; some increase throughput by as many as 2.6 patients per day, on average, compared with dual syringe injectors.¹

Some vendors have developed integrated software capable of monitoring and recording contrast and radiation dose. These server-based systems standardize documentation and reporting with radiology information systems, and dictation and electronic medical record software. Boasting seamless connectivity and data collection, these tools can now automate tasks that were previously performed manually, ensuring patient safety while achieving good image quality, freeing radiologists to focus on patient diagnosis and care.

In this video, Dr. Daniele Marin, Medical Director of Multi-Dimensional Image Processing Laboratory at the Duke University School of Medicine, and Dr. Mahadevappa Mahesh, Chief Physicist at The Johns Hopkins Hospital discuss the balancing act between radiation dose and importance of image quality.

Ryan Lee, MD, Section Chief of Neuroradiology and Vice Chair of Safety and Quality at the Einstein Healthcare Network, expanded upon the ability to move toward personalized care using machine learning in contrast monitoring.

“Where we want to go is to use machine learning to tailor care specific to each patient, and we want to identify any variables,” Dr. Lee said. “For example, by using AI assisted protocols and existing software, we can configure CT protocols to optimize radiation dose for individual patients, and in a similar fashion, we may be able to optimize CT contrast dose, for each individual patient, accounting for multiple different factors.” During his presentation at the panel discussion, Dr. Lee explained how a contrast monitoring program helped his practice achieve lower extravasation rates and overall reduce costs.

Panel member Matthew J. Kuhn, MD, FACR, a clinical professor of Radiology at the University of Illinois College of Medicine who also serves as chief medical officer at  A.I. Analysis, Seattle, Washington, has also seen the benefits of machine learning to reduce contrast dose. The concept of personalizing contrast dose as a result of algorithmic learning has translated into significant improvement in patient safety, he said.

Emilio Vega, manager of CT Quality and Safety at NYU Langone Health, pointed out that AI algorithms are also being used at his practice to detect anatomical landmarks and remove operator inconsistency during image post-processing.

Emilio Vega describes the use of AI in his department. View video.

Dr. Marin agreed that consistency can be achieved through the use of these tools, “If you have the same patient, coming multiple times and you have inconsistent enhancement or image quality because you are changing your injection protocol, that’s a big deal for some applications where you’re trying to identify the enhancement of a tumor. I think its critically important for certain applications to be consistent.”

This inevitable shift towards harnessing informatics and AI is expected to improve best practices in imaging. By incorporating these tools and learning capabilities too aggregate quantitative diagnostic information, radiologists are poised to play a central role in personalized medicine.

“This artificial intelligence augmentation of human capabilities is going to help us be better radiologists,” Dr. Tanenbaum said. “It’s going to make us more efficient and more productive.”

In this video, Dr. Tanenbaum explains the importance of becoming value-driven and patient-focused in radiology.

“I think we’re moving in from a thirty-thousand-foot point of view towards personalized medicine, precision medicine. Doing the right thing for the right patient and giving the right dose of contrast media is part of that.”

– Matthew J. Kuhn, MD, FACR

Reference:

1. Ma X, Singh A, Fay J, Boland G, Sahani DV. Comparison of dual-syringe and syringeless power injectors in outpatient MDCT practice: impact on the operator’s performance, CT workflow, and operation cost. J Am Coll Radiol. 2012;9:578-582.

The views, information, or opinions expressed in the video(s) or article(s) above are solely those of the individuals involved and do not necessarily represent those of Bracco Diagnostics Inc. (“BDI”). The primary purpose of this video(s) or article(s) is to educate and inform. This information does not constitute medical or other professional advice or services.

EmpowerCTA^®+ Injector System

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INDICATIONS:

The EmpowerCTA^®+ Injector System is indicated for the vascular administration of contrast and flushing media in conjunction with computed tomography (CT) scanning of the body with an optional interface to a CT scanner and an optional calculator for glomerular filtration rate (GFR).

The Extravasation Detection Accessory (EDA^™) is an optional accessory and is indicated for the detection of extravasations of ionic and nonionic contrast during CT procedures using a power injector.

Protocols have been independently developed and are not intended as medical advice. Bracco and Bracco Injeneering S.A. shall not be responsible for any physicians’ reliance on these or any other products.

CONTRAINDICATIONS:

The EmpowerCTA^®+ Injector System is not intended for use as a long-term infusion pump, nor is it intended to be used to inject any agents other than contrast or flushing media. Do not attempt to use the Injector for any other purpose (such as chemotherapy or drug infusion). The EmpowerCTA⁺ Injector System should not be used to inject substances into nonvascular body cavities. Any applications of the EmpowerCTA⁺ Injector System other than those described in its Operator Manual are inappropriate and should not be attempted.

Not all products are available in all global markets.

EmpowerCTA⁺ is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Bldg. H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Professional Services: 1-800-257-5181 (Option 2); EmpowerCTA⁺ Email: empowerinfo@diag.bracco.com; Website: https://smartinject.com/ct-solutions/

EmpowerCTA⁺ is manufactured for Bracco Injeneering S.A., Avenue de Sevelin 46, CH – 1004 Lausanne, Switzerland. https://www.bracco.com/

EmpowerMR^® Injector System

Caution: Federal law restricts this device to sale by or on the order of a physician.

INDICATIONS:

The EmpowerMR^® Injector System is indicated for vascular administration of contrast media and flushing media in conjunction with magnetic resonance imaging (MRI).

Protocols have been independently developed and are not intended as medical advice and Bracco shall not be responsible for any physicians' reliance on these or any other protocols.

Bracco Injeneering S.A. reserves the right at any time and without notice, to change the specifications and features described herein, or to change the production or adjust the product described.

Not all products are available in all global markets.

EmpowerMR is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Bldg. H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Professional Services: 1-800-257-5181 (Option 2); Website: https://smartinject.com/mr-solutions/

EmpowerMR is manufactured for Bracco Injeneering S.A., Avenue de Sevelin 46 CH – 1004 Lausanne, Switzerland. https://www.bracco.com/

NEXO^® Contrast Management System

Intended Use:

The NEXO^® Contrast Management System is a server-based application intended to be used as a data-management and visualization system. The NEXO Contrast Management System is able to read, store, share, compare/relate, as well as graphically display data and injection programs coming from RIS, PACS and multiple enabled EmpowerCTA^®Injector Systems. This device provides users with record-lists, graphics and reports about data and performances.

This device is intended for retrospective and statistical data management and visualization. It is not intended for real-time data visualization, diagnostic applications or for any other use for which the device is not indicated. This device is only to be operated by and under quasi-continuous supervision of qualified and trained staff in an appropriate licensed healthcare facility.

The NEXO Contrast Management System is compatible with the EmpowerCTA Injector System version 8.0, and EmpowerCTA^®+ Injector System version 9.0 and higher.

Bracco Injeneering S.A. reserves the right at any time and without notice, to change the specifications and features described herein, or to change the production or adjust the product described.

Not all products are available in all global markets.

NEXO is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Building H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; NEXO Customer Service: 1-877-BRACCO 9 (1-877-272-2269); NEXO questions: Nexo.Answers@diag.bracco.com; NEXO U.S. Technical Service and Support: Phone: 888-670-7701; Fax: 609-514-2448; NEXO Email: customer.support@acistmedical.com; Website: https://smartinject.com/digital-solutions

NEXO is manufactured by Bracco Injeneering S.A., Avenue de Sévelin 46, CH-1004 Lausanne, Switzerland. https://www.bracco.com/

NEXO [DOSE]^® Multi-Modality Radiation Informatics

Intended Use:

NEXO [DOSE]^® Multi-Modality Radiation Informatics is a server-based application that acquires, stores, and reports radiation dose index data from medical imaging procedures.

NEXO [DOSE] Multi-Modality Radiation Informatics is intended to be used by qualified medical personnel only.

NEXO [DOSE] is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Building H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; NEXO [DOSE] Customer Service: 1-877-BRACCO 9 (1-877-272-2269); NEXO [DOSE] questions: Nexo.Answers@diag.bracco.com; Website: https://smartinject.com/digital-solutions

NEXO [DOSE] Technical Support provided by PACSHealth, L.L.C:  1-877-299-6587

NEXO [DOSE] is manufactured by and is licensed from PHS Technologies Group, L.L.C, 32531 N. Scottsdale Road, Suite #105-282, Scottsdale, AZ 85266; a wholly-owned subsidiary of PACSHealth, L.L.C.

About Bracco Injeneering S.A.

Bracco Injeneering S.A., located in Lausanne, Switzerland, is the most recently added Business Unit of Bracco Imaging. Bracco Injeneering is committed to developing the best-in-class integrated injection solutions with a strong heritage in research and innovation. It provides quality solutions for state-of-the-art radiology centers, offering proven injection technology, built on Bracco Imaging’s expertise.

Thanks to this strengthened product portfolio, including the CT Exprès^® 3D Contrast Media Delivery System, EmpowerCTA⁺ Injector System, EmpowerMR^® Injector System, NEXO^® Contrast Management System, and NEXO [DOSE]^® Multi-Modality Radiation Informatics, Bracco Imaging will be able to focus on constant innovation, not only for devices but also for software development and data management.

CT Exprès, EmpowerCTA, EmpowerMR, IRiSCT, NEXO, and NEXO [DOSE] are registered trademarks of Bracco Injeneering S.A.

EDA and FastLoad are trademarks of Bracco Injeneering S.A.

These are representative images from reference studies; individual results may vary.

© 2023 Bracco Diagnostics Inc. All Rights Reserved.