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///////////
Medical Imaging Challenges:
Everyone Deserves Clear
Answers about their Health
Nikos Kourentzis,
November 1st, 2022
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Rapid Population Growth
+83 mm people / year
~9 bn people by 2030
Digital Revolution
Broadband Communication
Big Data
Artificial Intelligence
3 RESTRICTED
Deep transformation in the Medical Imaging
ecosystem…
o Traditional Medical
Imaging Companies
o Digital Business
Consumer Goods
Companies
… is leading to new
entries in the industry
Steady growth of diagnostic procedures.
Increasing budget pressure.
Shortage of skilled, trained radiologists & physicians.
Fast-paced development of advanced analytical solutions.
Blurring sector boundaries between diagnosis and
therapy as well as along the radiology workflow.
o IT Technology
Companies
o New Startups
3
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… and to some
fundamental changes
RSLM – Day 1 /// January 26th, 2021
4
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DMP improve the health of persons and reduce associated by
identifying and treating chronic conditions more quickly and
more effectively, thus slowing the progression of those
diseases.
AI will not replace radiologists, but Radiologists who use AI
will replace Radiologists who don’t.
Value-based healthcare will continue to rise expectations
from Radiologists & Physicians for superior patient
outcomes.
Patients are increasingly empowered and motivated to take
a more proactive role about decisions affecting their health.
Integrated &
centralized workflow
Optimal Disease
Management
Diagnostic support
through AI
Outcome focus
Patient centricity
Radiologists are shifting their focus to value-creating tasks,
demanding further standardization, automation & workflow
integration.
RESTRICTED
10x increase in the annual departmental cross-
sectional images interpreted (1999 to 2010)1
Greater complexity
49% of radiologists reported
signs of burnout3
Radiology departments pushed to their limits
40m annual diagnostic
errors worldwide2
Diagnostic errors
1. McDonald RJ et al. The effects of changes in utilization and technological advancements of cross-sectional imaging on radiologist workload. Acad Radiol. 2015;22(9):1191-1198.
2. Itri JN et al. Fundamentals of Diagnostic Error in Imaging. Radiographics. 2018;38(6):1845-1865.
3. Medscape. Medscape Radiologist Lifestyle, Happiness & Burnout Report 2022. 2022.
HCOs & HCPs face
enormous quality
and efficiency
challenges as the
demand for
diagnostic imaging
increases
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6
Is it safe to do this exam? What about
the quality of the Diagnosis
They always seem to be short-staffed
and have very little time for me.
I have to go back for another scan
due to inaccurate diagnosis.
Exemplary quotes for illustration
The challenges HCPs face directly
impact our patients
RESTRICTED
RESTRICTED
8
According to
the WHO
https://www.who.int/news-room/fact-sheets/detail/breast-cancer
there were 2.3 million women
diagnosed with breast cancer and
685.000 deaths in 2020.
7.8 million women diagnosed with
breast cancer in the past 5 years
were alive end of 2020 making it
the world’s most prevalent cancer.
GBPC
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9
Vision: Improve breast
cancer survival by
increasing awareness of
risk factors and access to
effective screening and
earlier diagnosis
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CRIB – Global process x-modality breast indication
Screening
Selection
Mammography / DBT*
(Imaging center or ObGyn or hospital)
CEM Modality
(Imaging center or hospital or radiology site )
MRI modality
(hospital / Radiology site)
Average risk Cancer Survivors
Patient specifics vs. guidelines
(genetics, history, contraindications)
Higher than average risk
Recurring w/ respect to
local guidelines
General pop. risk assessment
(initially at age 15-30)
Diagnostic work-up
(Unclear results or anomaly found)
Diagnostic
selection
Result: no finding
Screening
Origination
Screening
Procedure /
results
Screening invite
(via public prog. or HCP)
L2
Pre-treatment staging
Disease extent, stage
(immediate) (post)-treatment tracking
(NAC response, re-occurrence)
HCP preference
(ObGyn/Surgeon (?) experience)
Factor weighting varies by region, dependent on
* ObGyn or Surgeon (?) in lead
* Patient / guideline/ indication specifics
* Reimbursability / payor system
* Availability of modality in general and on-site
Reimbursement eval.
(payors, guidelines, patient paid)
Availability eval.
(on-site/ off-site)
L4
L3
Biopsy
(US/ Xray guided / partially automated)
Ultrasound +
ABUS**
MRI / + CA Brand selection
Other HCP referral
(Nipple discharge, occult primary cancer, etc.)
Diagnostic
Origination
CEM / + CA Brand selection
Suspected Confirmed
Patient specifics vs. guidelines
(suspected disease, contraindications)
Reimbursement eval.
(payors, guidelines)
Availability eval.
(on-site/ off-site)
HCP preference
(ObGyn/Surgeon experience)
Diagnostic
procedure /
results
Result: Breast cancer confirmed /
staged / tracked
Result: No breast cancer
Factor weighting varies by region, dependent on
* ObGyn or Surgeon in lead
* Patient / guideline/ indication specifics
* Reimbursability / payor system
* Availability of modality in general and on-site
Process step
or outcome
Modality
Flow /
sequence
L1
L5
L7
L8
Unclear result
Unclear result
DBT /
Mammography
High Risk
Brand selection contrast agent Brand selection contrast agent
Treatment
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Radiology 2030
11
Intelligent Systems & AI
• Higher throughput
• Higher Diagnostic Quality
• Less Repeat Exams
New business Models
• Pay per use
• Subscription
• AI reimbursement
RESTRICTED
Thank You

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Νικόλαος Κουρεντζής, 8th MedTech Conference

  • 1. RESTRICTED /////////// Medical Imaging Challenges: Everyone Deserves Clear Answers about their Health Nikos Kourentzis, November 1st, 2022
  • 2. RESTRICTED Rapid Population Growth +83 mm people / year ~9 bn people by 2030 Digital Revolution Broadband Communication Big Data Artificial Intelligence
  • 3. 3 RESTRICTED Deep transformation in the Medical Imaging ecosystem… o Traditional Medical Imaging Companies o Digital Business Consumer Goods Companies … is leading to new entries in the industry Steady growth of diagnostic procedures. Increasing budget pressure. Shortage of skilled, trained radiologists & physicians. Fast-paced development of advanced analytical solutions. Blurring sector boundaries between diagnosis and therapy as well as along the radiology workflow. o IT Technology Companies o New Startups 3
  • 4. RESTRICTED … and to some fundamental changes RSLM – Day 1 /// January 26th, 2021 4 RESTRICTED DMP improve the health of persons and reduce associated by identifying and treating chronic conditions more quickly and more effectively, thus slowing the progression of those diseases. AI will not replace radiologists, but Radiologists who use AI will replace Radiologists who don’t. Value-based healthcare will continue to rise expectations from Radiologists & Physicians for superior patient outcomes. Patients are increasingly empowered and motivated to take a more proactive role about decisions affecting their health. Integrated & centralized workflow Optimal Disease Management Diagnostic support through AI Outcome focus Patient centricity Radiologists are shifting their focus to value-creating tasks, demanding further standardization, automation & workflow integration.
  • 5. RESTRICTED 10x increase in the annual departmental cross- sectional images interpreted (1999 to 2010)1 Greater complexity 49% of radiologists reported signs of burnout3 Radiology departments pushed to their limits 40m annual diagnostic errors worldwide2 Diagnostic errors 1. McDonald RJ et al. The effects of changes in utilization and technological advancements of cross-sectional imaging on radiologist workload. Acad Radiol. 2015;22(9):1191-1198. 2. Itri JN et al. Fundamentals of Diagnostic Error in Imaging. Radiographics. 2018;38(6):1845-1865. 3. Medscape. Medscape Radiologist Lifestyle, Happiness & Burnout Report 2022. 2022. HCOs & HCPs face enormous quality and efficiency challenges as the demand for diagnostic imaging increases
  • 6. RESTRICTED 6 Is it safe to do this exam? What about the quality of the Diagnosis They always seem to be short-staffed and have very little time for me. I have to go back for another scan due to inaccurate diagnosis. Exemplary quotes for illustration The challenges HCPs face directly impact our patients
  • 8. RESTRICTED 8 According to the WHO https://www.who.int/news-room/fact-sheets/detail/breast-cancer there were 2.3 million women diagnosed with breast cancer and 685.000 deaths in 2020. 7.8 million women diagnosed with breast cancer in the past 5 years were alive end of 2020 making it the world’s most prevalent cancer. GBPC
  • 9. RESTRICTED 9 Vision: Improve breast cancer survival by increasing awareness of risk factors and access to effective screening and earlier diagnosis
  • 10. RESTRICTED CRIB – Global process x-modality breast indication Screening Selection Mammography / DBT* (Imaging center or ObGyn or hospital) CEM Modality (Imaging center or hospital or radiology site ) MRI modality (hospital / Radiology site) Average risk Cancer Survivors Patient specifics vs. guidelines (genetics, history, contraindications) Higher than average risk Recurring w/ respect to local guidelines General pop. risk assessment (initially at age 15-30) Diagnostic work-up (Unclear results or anomaly found) Diagnostic selection Result: no finding Screening Origination Screening Procedure / results Screening invite (via public prog. or HCP) L2 Pre-treatment staging Disease extent, stage (immediate) (post)-treatment tracking (NAC response, re-occurrence) HCP preference (ObGyn/Surgeon (?) experience) Factor weighting varies by region, dependent on * ObGyn or Surgeon (?) in lead * Patient / guideline/ indication specifics * Reimbursability / payor system * Availability of modality in general and on-site Reimbursement eval. (payors, guidelines, patient paid) Availability eval. (on-site/ off-site) L4 L3 Biopsy (US/ Xray guided / partially automated) Ultrasound + ABUS** MRI / + CA Brand selection Other HCP referral (Nipple discharge, occult primary cancer, etc.) Diagnostic Origination CEM / + CA Brand selection Suspected Confirmed Patient specifics vs. guidelines (suspected disease, contraindications) Reimbursement eval. (payors, guidelines) Availability eval. (on-site/ off-site) HCP preference (ObGyn/Surgeon experience) Diagnostic procedure / results Result: Breast cancer confirmed / staged / tracked Result: No breast cancer Factor weighting varies by region, dependent on * ObGyn or Surgeon in lead * Patient / guideline/ indication specifics * Reimbursability / payor system * Availability of modality in general and on-site Process step or outcome Modality Flow / sequence L1 L5 L7 L8 Unclear result Unclear result DBT / Mammography High Risk Brand selection contrast agent Brand selection contrast agent Treatment
  • 11. RESTRICTED Radiology 2030 11 Intelligent Systems & AI • Higher throughput • Higher Diagnostic Quality • Less Repeat Exams New business Models • Pay per use • Subscription • AI reimbursement