[RSNA 2024] Lunit and Volpara unite to transform healthcare through AI innovation

CHICAGO, Ill. -- By Lee Han-soo/Korea Biomedical correspondent --This year’s Radiological Society of North America (RSNA) 2024 was a special year for Korean medical AI imaging company Lunit.

The company showcased the first fruits of its synergistic collaboration with Volpara Health after completing the acquisition of the latter in May.

Lunit announced an ambitious AI Ecosystem initiative built on more than 130 million medical images and clinical data points gathered through their partnership, which involved the launch of two new products Lunit INSIGHT Risk, a sophisticated breast cancer risk assessment tool that analyzes mammography images to predict cancer risk within a one- to five-year timeframe, and an autonomous AI-based Chest X-ray Report Generation system that promises to streamline radiological workflows through automated analysis and reporting.

The company also presented a record-breaking 20 research abstracts focused on its Lunit INSIGHT solutions for breast cancer and chest disease diagnosis.

Against this backdrop, Korea Biomedical Review met with Teri Thomas, who holds the dual role of Volpara's Chief Executive Officer and Lunit's Chief Business Officer, to hear about the expansive vision of how the integration of these two companies is set to reshape the landscape of healthcare artificial intelligence.

According to Thomas, the merger represents more than just a business combination.

“It's a strategic union of complementary strengths aimed at revolutionizing medical imaging and cancer detection,” Thomas said. "The integrated company has this ecosystem concept that's all about organically growing and putting Lunit and Volpara together by combining Lunit’s depth of knowledge and global AI expertise and Volpara’s 15 years of deep customer experience and success.”

The combined strength of these companies is impressive.

“The combined entity has over 7,000 customers globally, more than 400 peer-reviewed articles, and access to over 130 million images for AI development,” she said. "When you just look at those numbers and look at other booths that say their AI is based on 10,000 images... what we come up with has to be much more powerful and more validated," Thomas emphasizes.

Thomas emphasized that there are a lot of other companies claiming articles in journals, and no one has the two companies' rigorous scientific validation process.

The integration of the two companies is progressing strategically, with careful attention to maintaining business continuity while fostering innovation.

Their comprehensive approach spans from risk assessment to treatment. "We go from risk assessment, even pre-imaging, to managing mammography workflow, to quality tools for mammography, some reporting elements, our own AI algorithms with breast density, then Lunit's AI for breast mammography, digital breast tomosynthesis, and chest X-rays. Then you add the next level of therapeutics with Scope – there's this kind of end-to-end solution that's beyond what anyone else can do," Thomas details.

The companies are particularly focused on addressing healthcare provider burnout, a major theme at RSNA 2024. "There's a shortage of radiologists, so the workload is higher and the number of people to do it is lower," Thomas notes. This shortage is a global phenomenon, with Thomas pointing out that "the Netherlands appears to be the only country currently maintaining adequate staffing levels, though even their population is aging so they won't be okay long term."

In addressing these workforce challenges, Thomas emphasizes the critical importance of understanding the human element in healthcare technology. "Fundamentally, we're all people who love our families and we want to go home to them," she said. "If you add steps, if you have to leave the workflow to see new and innovative tech, while it may be cool, it's not going to be used consistently and universally," she said.

The integration of AI into clinical workflow requires a delicate balance between technological advancement and practical usability.

"When you add value like this, it is about having another set of eyes that might find things that radiologist wouldn't see, we have to also put it into the context of making sure that radiologist go home in time for dinner,'" Thomas explains. " We assess even from a performance perspective as software has to be fast.”

This philosophy also drives their approach for other AI implementations, particularly in their Autonomous AI and report generation solutions.

Thomas draws parallels between human and AI capabilities in medical diagnosis.

"Humans and AI are both fallible,” she said. “However, when you combine a human who may have seen thousands of images with AI trained on millions, we can get something powerful.”

Market leadership and global expansion strategy

During the interview, Thomas emphasized their strategic approach to the challenging U.S. healthcare market, which she described as "a big pile of spaghetti" due to its complexity, particularly in areas like reimbursement and purchase motivations.

"Know your customer – that's where our strategy starts and ends," Thomas said. "It's our job to deeply understand radiologists and understand the impact of our technology.”

This involves answering questions such as whether the company’s software speeds up or slows down the workflow process, the reimbursement climate, and the potential value.

The company's U.S. market strategy is multifaceted, leveraging key partnerships and multiple integration pathways.

"Volpara has a great relationship with Microsoft, and Lunit is developing a deeper relationship with Microsoft. Microsoft's acquisition of Nuance, which is used by 85 percent plus of the radiologists in the U.S., opens up significant opportunities," Thomas said.

The integration of Volpara and Lunit brings unique advantages for U.S. market expansion.

"Volpara's long experience in the U.S. market, particularly with our acquisition of MRS systems in 2019, means we have employees who've been in the mammography sales field for over two decades," Thomas points out. "When you combine that with Lunit's groundbreaking AI technology, we can combine the power of the product with really understanding what's going on in our customers' heads."

Their approach to the U.S. market is particularly focused on a two-pronged approach -- on-site customization and centralized deployment.

"Small rural hospitals are always struggling with not having enough radiologists,” she said. “Being able to use our CXR report generation almost as a proxy for a radiologist to proceed with patient care is very different from a large urban setting where it's all about workflow and volume."

This is where a centralized deployment would take value.

"The ideal setting for centralized deployment is where you need consistent, reliable results but may not have the volume or technical resources for extensive customization," Thomas said.

In contrast, urban settings present different challenges and opportunities.

"On the other hand, we've got radiologists who are going through enormous volumes,” she said. “On-site customization requires a certain volume of images, a data strategy to be able to actually analyze those images, and a certain degree of technical expertise.”

Regarding global expansion plans, Thomas stressed that Lunit has strengths in Asia, while Volpara has strengths in the U.S., Australia, and New Zealand for Volpara, with a mutual strength in Europe.

“We can cover more of the globe with more people on the ground in different countries," Thomas said.

The company's infrastructure sets them apart from competitors. "

We've invested in building the infrastructure to ensure that the people and processes necessary to get value out of the technology are established early on,” she said. “Our customer support infrastructure is also a significant differentiator as one of the problems for a lot of AI vendors is providing the right information to users about how to use these cool techs and fit it into their workflow."

Stability and innovation in a changing industry

In an industry where many AI companies are struggling to find their footing, Thomas highlighted their stability.

"We're not a startup as it's been almost 15 years since Volpara got its first FDA approval,” she said. “Volpara's been cash flow positive for a couple of years now at a time when hardly anyone in our industry is making money."

This will further add value to Lunit as the company is looking to pass the break-even point (BEP) next year.

The distinction between their approach and that of other companies in the space is stark, according to Thomas.

"There's a lot of sort of old school AI that's not evolving or was just short-sighted by creating again the thing that adds extra work instead of adds real value,” she said. “Too many vendors out there are trying to get high valuation, have somebody acquire us, but not really thinking about the user, and a lot of them are going to die."

The company's vision for the future is ambitious yet grounded in practical experience. "The ecosystem will grow and we will cover more than breast and chest,” she said. “We will also cover more than oncology and radiology and go outside of X-rays into other areas.

Drawing from her Wisconsin roots, Thomas quotes hockey legend Wayne Gretzky to describe their strategy.

"Our job is not to be where the hockey puck is, it's to be where the hockey puck is going." She said. “The integrated company has had plenty of opportunities to make something look really cool and be acquired by global companies.”

The company’s goal is simple.

“It is to work towards being the dominant player that others will follow, but nobody will be ahead of us," she added.