AI assisted mammogram readings

[anonperson]

---

Members do not see this ad.

I have seen a proliferation of imaging centers touting AI enhanced reads on mammogram studies. Of course it's an additional cash fee that is not covered by insurance.

What is the general consensus on this? It seems like a cash grab at this point.

I know there is some preliminary data indicating some utility but I wasn't aware of any guidelines at this time

I had a family member get a mammogram and basically get upselled on this so she paid the extra $80. No explanation on pros etc. And it was done right before the visit.

When I heard, I wasn't happy and complained to the office manager and got into an argument since I wanted a refund. I asked if they even provided information to the patients on what the actual benefit was. Basically, how many additional cancers did the AI enhanced reads catch within their group of radiologists. How many false positives etc.

She couldn't/wouldn't provide the information.

Eventually got the money back but it was a pain.

 

[colbgw02]

Without more specifics, you're most likely referring to Computer-Aided Detection (CAD), which has been around for decades. As I understand it, CAD is technically a form of AI, but not at all in the modern sense that we hear about on the daily right before SkyNet kills us all. If there is an FDA-approved more modern version of AI-enhanced mammography, then that's news to me.

CAD used to be a separate modifier on the mammography CPT code, which is why my brain still automatically puts that into the technique if I ever have to free dictate a mammogram, but that went away years ago.

The most cynical interpretation is that they're up charging for technology that's nominally new but actually ancient. Also, they were going to use the assistance anyway, because no one is going to turn off the CAD between studies, irrespective of how old the technology is.

 

[anonperson]

Without more specifics, you're most likely referring to Computer-Aided Detection (CAD), which has been around for decades. As I understand it, CAD is technically a form of AI, but not at all in the modern sense that we hear about on the daily right before SkyNet kills us all. If there is an FDA-approved more modern version of AI-enhanced mammography, then that's news to me.

CAD used to be a separate modifier on the mammography CPT code, which is why my brain still automatically puts that into the technique if I ever have to free dictate a mammogram, but that went away years ago.

The most cynical interpretation is that they're up charging for technology that's nominally new but actually ancient. Also, they were going to use the assistance anyway, because no one is going to turn off the CAD between studies, irrespective of how old the technology is.

They claimed they use Lunit AI platform.

 

[Cognovi]

This is the paper validating that tool, but it gives me pause that they described the study as preliminary in the title: Artificial intelligence for breast cancer screening in mammography (AI-STREAM): preliminary analysis of a prospective multicenter cohort study - Nature Communications

There isn't general consensus. The practice is just trying to get recoop its costs for buying the system.

Reading that paper:
As to how many additional cancers detected, about 1 additional for every 1000-1450 women screened.
As to how many false positives, about 1 additional for every 1724 women screened if the reader is not an academic breast radiology subspecialist with >10y experience.

 

[Melkor]

OP might also be talking about the calcium score/detection that some ai company/programs are toting for screeners. Essentially, they use ai to detect vascular calcs and give you a cardiovascular risk profile in the report. They also charge an extra fee, usually 60-120$ cash pay only on top of the regular mammogram. Lucrative business in affluent locales.

 

[vm26]

I have seen a proliferation of imaging centers touting AI enhanced reads on mammogram studies. Of course it's an additional cash fee that is not covered by insurance.

What is the general consensus on this? It seems like a cash grab at this point.

I know there is some preliminary data indicating some utility but I wasn't aware of any guidelines at this time

I had a family member get a mammogram and basically get upselled on this so she paid the extra $80. No explanation on pros etc. And it was done right before the visit.

When I heard, I wasn't happy and complained to the office manager and got into an argument since I wanted a refund. I asked if they even provided information to the patients on what the actual benefit was. Basically, how many additional cancers did the AI enhanced reads catch within their group of radiologists. How many false positives etc.

She couldn't/wouldn't provide the information.

Eventually got the money back but it was a pain.

I have not heard anything about AI for screeners though one would think it would be extremely lucrative given reimbursement for 3D-tomo....Guessing the medical liability is a hurdle and also having AI compare to multiple priors can be tricky (accounting for differences in positioning, compression, pt's weight etc).

 

[Cognovi]

OP might also be talking about the calcium score/detection that some ai company/programs are toting for screeners. Essentially, they use ai to detect vascular calcs and give you a cardiovascular risk profile in the report. They also charge an extra fee, usually 60-120$ cash pay only on top of the regular mammogram. Lucrative business in affluent locales.

I don't know anything about this product but that sounds absurd. A trained pigeon can tell you if you have vascular calcs on a mammogram.

 

[anonperson]

OP might also be talking about the calcium score/detection that some ai company/programs are toting for screeners. Essentially, they use ai to detect vascular calcs and give you a cardiovascular risk profile in the report. They also charge an extra fee, usually 60-120$ cash pay only on top of the regular mammogram. Lucrative business in affluent locales.

I looked at the report and it didn't comment on any cardiovascular risk profile.

I complained enough to get my money back though.

 

[Melkor]

I don't know anything about this product but that sounds absurd. A trained pigeon can tell you if you have vascular calcs on a mammogram.

Completely agree. A bit shady imo.