jmhmd

5 ms·

1.
by jmhmd 3mo ago
This is a critical point. I am curious what the team building this looks like? Do they have ultrasound physicists and clinical practitioners in addition to the AI researchers?
2.
by jmhmd 3mo ago
Yes, I was thinking about FUS as well! There are clearly ways to penetrate bone, but I have not seen it used for imaging, only for ablation. But I am not an expert there and it sounds like you have more knowledge in that area than I do. Ped
3.
by jmhmd 3mo ago
The machines are expensive (millions range per MRI scanner), staffing the machines nearly around the clock with highly educated technologists, repair/maintenance of expensive specialized machinery, radiologists to read each scan (esp w
4.
by jmhmd 3mo ago
Given that current ultrasound probe technology (including butterfly) relies on the probe being essentially in contact with the tissue being imaged, it’s hard to imagine how this set up can be effective with the imaged volume so far from the
5.
by jmhmd 3mo ago
Not taken negatively, and you're right. This is even more difficult with things that are opinion, and not clearly verifiable.
6.
by jmhmd 3mo ago
Hah, I'm neither a bot nor written with any help from an LLM, but I'll take the fact that you can't tell the difference as a compliment :)
7.
by jmhmd 3mo ago
That's because there isn't any data yet, at least not enough from real patients to be meaningful. I would love to see some of the raw imaging data they have generated though, if that's what you mean.
8.
by jmhmd 3mo ago
Your points are well taken, and I think this is the fundamental struggle of anyone who works in a narrow and deep field. It's truly difficult to see things from a different point of view sometimes. It certainly could turn out that this
9.
by jmhmd 3mo ago
That's generally exactly what we do, which if we need to follow 2x or 10x incidental lesions in the population, leads to cost and availability problems. A lymphoma patient in remission needs follow up scans too, and I don't want t
10.
by jmhmd 3mo ago
Some initial thoughts as a practicing radiologist: - This looks really cool and I hope they keep innovating on this. I love seeing new modalities develop and despite my (many) reservations and criticisms, if even one good use case comes out
11.
by jmhmd 10mo ago
It depends on the indication for the scan. Some indications do not require contrast, others MUST have contrast in order to have any value. If you refuse contrast without understanding the reason, you may be simply wasting your time and mone
12.
by jmhmd 11mo ago
I think you must have misunderstood where the artifact was coming from. Gadolinium retention has been shown to occur, but has not been reliably linked to any clinical symptoms. Gadolinium tissue retention also does not interfere in interpre
13.
by jmhmd 11mo ago
I agree with this sentiment. I have always wished, maybe naively, for the type of computing environment that makes possible things you see in sci-fi movies and shows, where someone can simple "route all power to the forward lazers!&quo
14.
by jmhmd 1y ago
The issue is that in medicine, much like automobiles, unexpected failure modes may be catastrophic to individual people. “Fixing” failure modes like the above comment is not difficult from a technical standpoint, that’s true, but you can on
15.
by jmhmd 1y ago
Poorer performance in real hospital settings has more to do with the introduction of new/unexpected/poor quality data (i.e. real world data) that the model was not trained in or optimized for. They still do very well generally, bu
16.
by jmhmd 1y ago
While a lot of this rings true, I think the analysis is skewed towards academic radiology. In private practice, everything is optimized for throughput, so the idea that most rads spend less than half of their time reading studies i think is
17.
by jmhmd 1y ago
As a radiologist and full stack engineer, I’m not particularly worried about the profession going away. Changing, yes, but not more so than other medical or non-medical careers.
18.
by jmhmd 1y ago
litevna.app - a DICOMweb compatible medical imaging archive, built on cloudflare workers, to optimize fast image delivery globally. Images are all encoded as HTJ2K for progressive image loading, and the popular OHIF zero-footprint DICOM vie
19.
by jmhmd 1y ago
I use JWTs to let me do auth on cached resources. I can verify permissions in an edge worker and deliver the cached resource without needing to roundtrip to the database. Not sure how to implement that without JWT (or rolling my own solutio
20.
by jmhmd 2y ago
Portable low field bedside MRI has been on the market in the US for a few years. See Hyperfine Swoop.
21.
by jmhmd 3y ago
S3 is really cheap, and from the beginning I spent a lot of time optimizing for simplicity and efficiency, so I don’t have much overhead. Since this is targeted towards residents and academic radiologists, it’s important to me to keep the p
22.
by jmhmd 3y ago
I started and run https://pacsbin.com , a radiology teaching file/research platform. I’m a radiologist and started this as a resident while unsatisfied with all existing options. It has been really gratifying to work on a ni
23.
by jmhmd 3y ago
It’s funny to me as a physician to see “you’re not a hospital” as an example of a system that cannot tolerate downtime. Epic, probably the biggest EHR provider in the US, has planned downtime for upgrades at least monthly, for 30-60 min eac
24.
by jmhmd 3y ago
To be fair, this is not how doctors want to practice medicine.
25.
by jmhmd 3y ago
You are partially correct, but I think the value is not in generating a draft for the radiologist to review, but to take a radiologists “raw” dictation, which pertains only to relevant findings in a case, and transform that into a complete,
26.
by jmhmd 4y ago
The main thing that House MD has, that no other doctor in the world has, is not so much his superior intellect. It's that he and five other doctors spend 100% of their time on a single case, and can sit around all day discussing it,
27.
by jmhmd 4y ago
> There was this giant thing called healthcare right, and its main purpose is improving health—trillions of dollars are spent trying to do this. As a physician, lol. Lmao
28.
by jmhmd 5y ago
The BBB is a part of capillary walls and so there really isn’t a good way to “manually” inject beyond it. That said, there are current trials ongoing to temporarily disrupt the BBB using high intensity focused ultrasound, allowing injected
29.
by jmhmd 5y ago
No, identifying the tumor is only step 1, and is the easiest step. Most non-radiologists can identify whether a tumor is present. The harder part (and the true value of radiologist reads) is everything that comes after finding the tumor: w
30.
by jmhmd 6y ago
CT is often done both as a non-contrast study (to exclude hemorrhage or large established stroke) and also as a CTA and sometimes with perfusion. This data at most stroke centers is all that is needed acutely to decide whether and how to tr

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