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.
IMPORTANT SAFETY INFORMATION | INDICATIONS AND USAGE
EmpowerCTA®+ Injector System
Caution: Federal law restricts this device to sale by or on the order of a physician.
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).
INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION
EmpowerCTA®+ Injector System
Caution: Federal law restricts this device to sale by or on the order of a physician.
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).
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.; 510 Carnegie Center, Suite 300, Princeton, NJ 08540 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Scientific Information: 1-800-257-5181 (Option 2); EmpowerCTA+ Email: empowerinfo@diag.bracco.com; Website: https://smartinject.com/ct-solutions/
EmpowerCTA+ is manufactured by 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.; 510 Carnegie Center, Suite 300, Princeton, NJ 08540 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Scientific Information: 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 can 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 appropriately licensed healthcare facility.
The NEXO Contrast Management System is compatible with the EmpowerCTA Injector System version 8.0, and EmpowerCTA®+ Injector System version 10.0 and higher.
Not all products are available in all global markets.
NEXO is distributed by Bracco Diagnostics Inc.; 510 Carnegie Center, Suite 300, Princeton, NJ 08540 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 ACIST Medical Systems, 7905 Full Road, Eden Prairie, MN 55344 USA.
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 EmpowerCTA®+ Injector System and EmpowerMR Injector System Bracco Imaging will be able to focus on constant innovation, not only for devices but also for software development and data management.
EmpowerCTA, EmpowerMR, NEXO, and IRiSMR are registered trademarks of ACIST Medical Systems, Inc.
FastLoad is a trademark of ACIST Medical Systems, Inc.
ulricheasyINJECT Max 3™ (the Bracco-branded Max 3™, a Rapid Exchange and Syringeless MR Injector System) is distributed by Bracco Diagnostics Inc.
Indications for use
ulricheasyINJECT Max 3 is a contrast media (CM) management system that is indicated for the controlled, automatic administration, on the venous side, of contrast media and saline (NaCl), to human subjects undergoing diagnostic examinations in magnetic resonance (MR) applications.
ulricheasyINJECT Max 3 (XD 10180) is specifically indicated for use in MRI procedures for the delivery of VUEWAY® (gadopiclenol) solution for injection – Bracco Diagnostics Inc., MultiHance® (gadobenate dimeglumine) injection – Bracco Diagnostics Inc., Clariscan™ (gadoterate meglumine) injection – GE Healthcare Inc., DOTAREM®(gadoterate meglumine) Injection – Guerbet, LLC, Gadavist® (gadobutrol) injection – Bayer HealthCare Pharmaceuticals Inc., and Gadobutrol Injection – Fresenius Kabi AG, contrast media as supplied in approved single dose vials and Gadavist (gadobutrol) Injection – Bayer HealthCare Pharmaceuticals Inc. and Gadobutrol Injection – Fresenius Kabi AG, contrast media as supplied in approved Imaging Bulk Packages (IBPs).
The ulricheasyINJECT Max 3 is not intended for injection of contrast media for high-pressure angiography.
Easy-Click-Cassette – flex Max 3 is used for a maximum time of twenty-four (24) hours or a maximum of 96 bottles of contrast media, whichever comes first.
Use time expiration per single dose contrast media container is a maximum of four (4) hours per contrast media container, unless otherwise stated by the contrast media labeling.
Use time expiration per IBP contrast media container is a maximum of twenty-four (24) hours per contrast media container, unless otherwise stated by the contrast media labeling.
Spike for MRI disposable is for single-bottle use only and must be discarded with the media container. The Patient tubing must be discarded after each patient procedure.
ulricheasyINJECT Max 3 (XD 10180) is to be used only by and under quasi-continuous supervision of trained healthcare professionals in an appropriate licensed healthcare facility, in a room designated for radiological procedures that involve intravascular administration of contrast agent.
Contraindications
ulricheasyINJECT Max 3 injectors are not intended for the administration of contrast medium during high-pressure angiography or other applications that do not comply with the intended use.
The injector is not protected against the effects of defibrillation. Before a defibrillator is used, the patient must be disconnected from the ulricheasyINJECT Max 3 injector.
Do not add any disposables (i.e. connector tubing or valves) to the ulricheasyINJECT Max 3 with the patient tubing that are not provided by ulrich medical. No valves or other connectors may be placed in-line between the patient tubing and the patient cannula. The disposables identified in this IFU are designed, manufactured, and tested for connection with cannulas for pressure injections.
Do not use ulricheasyINJECT Max 3 injectors with any other contrast media (other than those described in the IFU). Any other contrast media are inappropriate and should not be used. Do not operate the injector and terminal, including any accessories, in potentially explosive atmospheres or in the vicinity of combustible materials (especially anesthetic drugs, detergents, and oxygen-enriched environments).
ulricheasyINJECT Max 3 is manufactured by ulrich GmbH & Co. KG.
ulrich medical is a registered trademark of ulrich GmbH & Co. KG.
ulricheasyINJECT Max 3 is a trademark of ulrich GmbH & Co. KG.
ulricheasyINJECT Max 3 is distributed as the Bracco-branded Max 3, a Rapid Exchange and Syringeless MR Injector System, by Bracco Diagnostics Inc.; 510 Carnegie Center, Suite 300, Princeton, NJ 08540 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Scientific Information: 1-800-257-5181(Option 2); Website: https://smartinject.com/max3/
All other trademarks and registered trademarks are the property of their respective owners.