The World Health Organization (WHO) reports that over two-thirds of the global population lacks access to radiology services. Emerging markets such as island nations and 14 African nations face critical shortages, where limited access to hospitals, advanced imaging equipment, and medical professionals impacts millions in need of radiological diagnosis and treatment. Even countries with robust healthcare systems, such as the US and Australia, face disparities in access between major cities and rural areas.
The rapid pace of innovation in radiology holds the promise of improving diagnostic accuracy, reducing costs, and enhancing accessibility in healthcare. This transformative evolution in imaging technology has the potential to address the talent shortage while providing clinicians with more precise and timely diagnostic information to improve patient outcomes and overall healthcare efficiency. The year 2023 paved the way for several key breakthroughs that cement wider adoption of several new radiology technologies.
Enhancing mobile medical imaging
The post-pandemic emergence of mobile medical imaging technology, image sharing, and storage has made it easier than ever to capture and share patient information such as x-ray, CT scans and MRIs with practitioners, while remaining HIPAA compliant and protecting patient privacy. This trend is expected to pick up pace as mobile medical imaging technologies continue to enable clinicians to deliver swift and cost-effective diagnostic imaging services to patients in remote or underserved areas. Notably, mobile computed tomography (CT) and mobile magnetic resonance (MR) imaging stand out as promising technologies, diagnosing and treating various medical conditions in diverse clinical settings.
These mobile units retain all the capabilities of their stationary counterparts but with the added advantage of portability. This allows physicians to take the equipment to the patient, saving time and reducing costs associated with patient transfers to imaging centres or hospitals. Particularly beneficial in emergency situations or areas with limited access to medical imaging services, mobile medical imaging ensures more efficient and accessible radiology services.
Apart from its use in remote areas, the technologies can be used in long-term care facilities, nursing homes, and outpatient clinics, paving the way for rapid, convenient, and cost-effective radiology services across diverse settings. As an added benefit, this year, new helium-free mobile imaging technology has entered the market. Phillips introduced the BlueSeal MR Mobile in November, the industry’s first and only 1.5T fully sealed helium-free magnet mobile unit that addresses resource constraints and sustainability issues associated with conventional scanners.
“Having access to mobile MRI scanners is a real game-changer for remote and rural communities around the world,” said Ruud Zwerink, General Manager, Magnetic Resonance at Philips at the launch event. “By introducing our breakthrough technology into the mobile MR market, we are significantly reducing the operational and sustainability issues associated with conventional scanners and helping healthcare providers to deliver fast, patient-friendly quality of care.”
Revolutionising access to imaging data
Web-based enterprise imaging systems are replacing traditional picture archiving and communication systems (PACS), eliminating siloes between modalities. Clinicians can now access images and reports from anywhere without the need for specific workstations. Integration of AI and advanced imaging tools into these systems facilitates seamless interaction with electronic medical records, providing greater access to images and reports across health systems and enabling sharing with patients.
Third-party server farm firms like Google Health and Amazon are driving the shift towards cloud-based archive storage. In 2022, Amazon introduced HealthLake Imaging, a HIPAA-eligible capability aimed at addressing challenges in managing the increasing volume and complexity of medical imaging data to simplify storage, access, and analysis of medical images at a petabyte scale. HealthLake Imaging is estimated to reduce the total cost of medical imaging storage by up to 40 per cent.
Hospitals recognise the benefits of outsourcing storage to companies with around-the-clock monitoring and the flexibility to scale storage without the need for additional hardware. This approach proves to be more economically viable, freeing hospitals from the burden of maintaining large IT storage areas and support infrastructure.
Transforming diagnosis with POCUS
Point-of-care ultrasound (POCUS) has revolutionised medical imaging, providing real-time images that enable physicians to assess organ function, evaluate cancer risk, and diagnose various medical conditions quickly and accurately. The pandemic has underscored the importance of POCUS, particularly in diagnosing and monitoring COVID-19 patients. The development of portable, handheld POCUS devices further minimises the risk of disease transmission.
With applications in emergency medicine, critical care, cardiology, and obstetrics-gynaecology, POCUS is poised to become a standard triage tool, offering detailed and accurate information to guide clinicians in making informed decisions about patient care.
In Abu Dhabi, Sheikh Shakhbout Medical City (SSMC) became the first in the Middle East to launch an academy for upskilling medical practitioners using an AI-guided POCUS device in 2022. “This multidisciplinary course is important as it improves the initial assessment process, advances the timelines and quality of care for patients and, ultimately, saves more lives,” says Dr. Siddiq Anwar, a consultant nephrologist at SSMC.
The rise of hyperspectral and molecular imaging
Hyperspectral and molecular imaging technologies are on the rise, driven by the demand for more detailed and accurate diagnostic information. Hyperspectral imaging captures images at multiple wavelengths, facilitating the identification and analysis of specific tissues or substances within the body. Molecular imaging, utilising targeted probes, visualises specific molecular targets.
Examples like X-ray spectroscopy (XS) and micro-CT showcase the traction gained by hyperspectral and molecular imaging in the medical field. XS, a non-invasive imaging technique, offers high-resolution information about the elemental composition of tissues and organs, enhancing the accuracy of diagnosis. Micro-CT, a high-resolution imaging modality, uses X-rays to produce detailed images of small structures, such as bone microarchitecture and small tumors.
These advanced imaging technologies surpass traditional X-ray imaging, providing higher resolution, greater specificity, and increased sensitivity. Consequently, clinicians gain a more accurate and detailed understanding of the body’s internal structures and functions, enabling earlier detection and more targeted treatment of diseases.
The emergence of photon-counting CT marks a future wave for CT imaging systems, promising reduced radiation dose, improved image quality, and built-in spectral imaging capabilities.
In the case of detecting congenital heart defects among infants, a new study reveals that photon-counting computed tomography (PCCT) offers better cardiovascular imaging quality at a similar radiation dose, compared to dual-source CT (DSCT). More than 97 per cent of the PCCT images were at least diagnostic quality, compared to 77 per cent of the DSCT images.
“Infants and neonates with suspected congenital heart defects are a technically challenging group of patients for any imaging method, including CT,” says Dr.Timm Dirrichs, senior physician and specialist in cardiothoracic radiology at RWTH Aachen University Hospital, Germany. To effectively plan for surgery and generate virtual and printed 3D reconstructions of the heart, a thorough assessment involving ultrasound, MRI, and CT exams is typically required.
“PCCT is a promising method that may improve diagnostic image quality and efficiency compared to DSCT imaging,” Dr. Dirrichs adds. “This higher efficiency can be used to reduce the radiation dose at a given image quality level or to improve image quality at a given radiation level.”
Maximising the potential of MRI
Magnetic resonance imaging (MRI) has become indispensable in modern medicine, offering high-resolution images of the body’s internal structures. Anticipated advancements in 2024 focus on developing more powerful magnets for higher-resolution images in less time. This not only enhances diagnostic accuracy but also improves patient comfort by reducing scan times.
In the pursuit of more cost-effective MRI technology, artificial intelligence (AI) and machine learning algorithms play a pivotal role. These technologies identify artifacts and noise in images, allowing real-time adjustments during scans and leading to more accurate diagnoses.
This year, a multi-institutional Adolescent Brain Cognitive Development Study used deep learning AI to identify markers of ADHD. This study combined brain imaging and clinical surveys, incorporating specialised MRI data, diffusion-weighted imaging (DWI).
“ADHD often manifests early and profoundly impacts one’s quality of life and societal functioning,” says study co-author Justin Huynh, a research specialist in the Department of Neuroradiology at the University of California, San Francisco, and a medical student at the Carle Illinois College of Medicine at Urbana-Champaign.
“There is definitely an unmet need for more objective metrics for diagnosis. That’s the gap we are trying to fill.” The study’s findings, published in November, offer promise for an objective diagnostic method for a condition impacting 129 million children and adolescents globally.
3D imaging goes mainstream
A study involving over a million women revealed that digital breast tomosynthesis (DBT) outperforms standard digital mammography in breast cancer screening outcomes. The cancer detection rate with DBT was higher at 5.3 per 1,000 screened, compared to 4.5 per 1,000 screened with 2D digital mammography alone. Additionally, DBT demonstrated a lower rate of false positives and recalls during screening.
Beyond DBT, mammography is rapidly transitioning to 3D tomosynthesis systems, constituting nearly 50 per cent of breast imaging systems in the US, according to FDA data. Despite the additional read time and increased archive storage space, 3D systems offer advantages such as reduced false positives, fewer unnecessary biopsies, and improved assessments for radiologists by allowing them to examine slices of breast tissue.
As we look to the future, the ongoing growth and development in medical imaging technology promise clinicians more powerful and effective tools for disease diagnosis and treatment. By fully harnessing these technologies, we can anticipate improved patient outcomes, enhanced care quality, and increased accessibility and cost-effectiveness of healthcare services for all.
