| 1. | EXECUTIVE SUMMARY |
| 1.1. | Report scope |
| 1.2. | Image recognition AI in medical imaging |
| 1.3. | Drivers & constraints of AI in medical imaging |
| 1.4. | Benefits of using AI in medical diagnostics |
| 1.5. | Clinical applications of image recognition AI covered in this report |
| 1.6. | Investments into image recognition AI companies by disease application |
| 1.7. | Image recognition AI: Performance comparison by application |
| 1.8. | Cancer detection AI: State of development and market readiness |
| 1.9. | Cancer detection AI companies: State of product development |
| 1.10. | Cancer detection AI: Conclusions and outlook |
| 1.11. | Cancer detection AI: Conclusions and outlook (2) |
| 1.12. | CVD detection AI: State of development and market readiness |
| 1.13. | CVD detection AI companies: State of product development |
| 1.14. | CVD detection AI: Conclusions and outlook |
| 1.15. | Respiratory diseases detection AI: State of development and market readiness |
| 1.16. | Respiratory diseases detection AI companies: State of product development |
| 1.17. | Respiratory diseases detection AI: Conclusions and outlook |
| 1.18. | Retinal diseases detection AI: State of development and market readiness |
| 1.19. | Retinal diseases detection AI companies: State of product development |
| 1.20. | Retinal diseases detection AI: Conclusions and outlook |
| 1.21. | Retinal diseases detection AI: Conclusions and outlook (2) |
| 1.22. | NDD detection AI: State of development and market readiness |
| 1.23. | NDD detection AI companies: State of product development |
| 1.24. | NDD detection AI: Conclusions and outlook |
| 1.25. | Image recognition AI: Technological roadmap |
| 1.26. | Image recognition AI: Roadmap of factors limiting penetration |
| 1.27. | Image recognition AI: Market penetration 2020-2040 |
| 1.28. | Market forecast 2020-2031 by disease application |
| 1.29. | AI provides real value and the market is rapidly growing |
| 1.30. | Remaining challenges |
| 1.31. | Opportunities for technological improvements |
| 1.32. | Why do image recognition AI companies struggle to achieve profitability? |
| 2. | INTRODUCTION |
| 2.1. | Report scope |
| 2.2. | Medical imaging advances diagnostics |
| 2.3. | Types of medical imaging |
| 2.4. | Uses, pros and cons of each type of imaging |
| 2.5. | X-radiation (X-ray) |
| 2.6. | Computed tomography (CT) |
| 2.7. | Positron emission tomography (PET) |
| 2.8. | Magnetic resonance imaging (MRI) |
| 2.9. | Ultrasound |
| 2.10. | Imaging devices: Regulations & path to approval |
| 2.11. | Radiation from imaging devices: Safety regulations |
| 2.12. | Image recognition AI in medical imaging |
| 2.13. | Drivers & constraints of AI in medical imaging |
| 2.14. | AI in healthcare: Existing regulations |
| 2.15. | AI in healthcare: Regulations & path to approval |
| 2.16. | Clinical applications of image recognition AI covered in this report |
| 2.17. | Interest in AI and deep learning has soared in the last five years... |
| 2.18. | ... And so have investments into image recognition AI companies |
| 2.19. | CVD and cancer have generated the most funding |
| 3. | ARTIFICIAL INTELLIGENCE, DEEP LEARNING AND CONVOLUTIONAL NEURAL NETWORKS |
| 3.1. | What is artificial intelligence (AI)? Terminologies explained |
| 3.2. | The two main types of AI in healthcare |
| 3.3. | Requirements for AI in medical imaging |
| 3.4. | Main deep learning (DL) approaches |
| 3.5. | DL makes automated image recognition possible |
| 3.6. | Image recognition AI is based on convolutional neural networks (CNNs) |
| 3.7. | Workings of CNNs: How are images processed? |
| 3.8. | Workings of CNNs: Another example |
| 3.9. | Common CNN architectures for image recognition |
| 3.10. | Milestones in DL: Image recognition surpasses human level |
| 3.11. | How do image recognition AI algorithms learn to detect disease? |
| 3.12. | The depth and variation of training data dictate the robustness of image recognition AI algorithms |
| 3.13. | Assessing algorithm performance: The importance of true/false positives/negatives |
| 3.14. | Measures in deep learning: Sensitivity and Specificity |
| 3.15. | DL algorithms assess the rate of true/false positives/negatives to determine sensitivity and specificity |
| 3.16. | Measures in deep learning: Area Under Curve (AUC) or area under curve of receiver operating characteristics (AUCROC) |
| 3.17. | When AUC is not a good measure of the algorithm success? |
| 3.18. | Measures in deep learning: Reproducibility |
| 3.19. | F1 Score |
| 3.20. | Benefits of using AI in medical diagnostics |
| 3.21. | Drivers of image recognition AI usage |
| 3.22. | Limiting factors of image recognition AI using CNNs |
| 4. | CANCER |
| 4.1. | Image recognition enhances cancer diagnostic solutions |
| 4.2. | Investments into cancer detection AI companies |
| 4.3. | Image recognition AI for cancer detection: Key players |
| 4.4. | Breast cancer |
| 4.5. | Breast cancer: Detection and quantification of breast densities via mammography (2018) |
| 4.6. | Breast cancer screening via mammograms and pathology slides |
| 4.7. | Lunit: Breast cancer screening via mammography |
| 4.8. | Reproducible breast cancer screening: Densitas, Kheiron Medical, and Therapixel |
| 4.9. | Therapixel: Early breast cancer detection |
| 4.10. | CureMetrix: AI estimates the risk of disease |
| 4.11. | Google: Surpassing human performance regardless of patient population type |
| 4.12. | Google: Surpassing human performance regardless of patient population type (2) |
| 4.13. | On the market: Intrasense, ScreenPoint Medical, Qlarity Imaging and Koios Medical |
| 4.14. | Currently on the market or upcoming: Qview Medical, PathAI and Zebra Medical Vision |
| 4.15. | AI performance comparison: Methodology |
| 4.16. | Breast cancer detection AI: Performance comparison |
| 4.17. | Breast cancer detection AI: Performance comparison (2) |
| 4.18. | Lung cancer |
| 4.19. | Lung cancer: NYU uses DL on lung cancer histopathological images to identify cancer cells, determine their type, and predict what somatic mutations are present in the tumour |
| 4.20. | Lung cancer: Detection made easier |
| 4.21. | Infervision: Detecting nodules three times faster than radiologists |
| 4.22. | Enlitic: Identifying malignant lung nodules 18 months sooner |
| 4.23. | Arterys: Accelerating reading time by 45% |
| 4.24. | Additional players: VUNO, Lunit, Intrasense & VoxelCloud |
| 4.25. | Additional players: Behold.ai, Aidence, Mindshare Medical & Riverain Technologies |
| 4.26. | Lung cancer detection AI: Performance comparison |
| 4.27. | Lung cancer detection AI: Performance comparison (2) |
| 4.28. | Skin cancer |
| 4.29. | Skin cancer: Key players |
| 4.30. | Skin cancer: Machine learning algorithms |
| 4.31. | Skin cancer: The ABCDE criteria |
| 4.32. | Skin cancer: Dermoscopic melanoma recognition (2018) |
| 4.33. | Skin cancer: Dermoscopic melanoma recognition and its challenges |
| 4.34. | Miiskin: Tracking skin changes over time |
| 4.35. | SkinVision: Risk assessment and unparalleled accuracy at a low cost |
| 4.36. | MetaOptima: Medical grade image quality for the consumer |
| 4.37. | Stanford University: Automated classification of skin lesions |
| 4.38. | Mole mapping apps track skin changes over time: SkinIO, Skin Analytics & University of Michigan |
| 4.39. | Skin cancer detection AI: Performance comparison |
| 4.40. | Skin cancer detection AI: Performance comparison (2) |
| 4.41. | Thyroid cancer: AmCad BioMed automatically identifies nodules |
| 4.42. | Prostate cancer: Cortechs Labs improves a key visualisation and quantification method |
| 4.43. | Prostate cancer: Intrasense and YITU Technology |
| 4.44. | Microsoft: Using AI for cancer detection, radiotherapy planning and outcome monitoring |
| 4.45. | AI-driven histological analysis of tissue slides for cancer detection: Paige & Primaa |
| 4.46. | Cancer detection AI: Performance comparison |
| 4.47. | Cancer detection AI: State of development and market readiness |
| 4.48. | Cancer detection AI applications: State of development |
| 4.49. | Cancer detection AI companies: State of product development |
| 4.50. | Cancer detection AI companies: Software complexity |
| 4.51. | Conclusions and outlook |
| 4.52. | Conclusions and outlook (2) |
| 5. | CARDIOVASCULAR DISEASE |
| 5.1. | What is cardiovascular disease (CVD) and where does image recognition AI apply? |
| 5.2. | AI can provide solutions to improve CVD management |
| 5.3. | Investments into CVD detection AI companies |
| 5.4. | Using imaging & AI to detect clots and blockages |
| 5.5. | Key players |
| 5.6. | Stroke |
| 5.7. | Stroke detection AI: Key players |
| 5.8. | MIT: A DL solution for stroke detection from CT scans |
| 5.9. | iSchemaView: Categorising the extent and location of ischemic injury up to 30 hours post-symptoms onset |
| 5.10. | Infervision: Dynamic and risk assessment of active bleeding |
| 5.11. | MaxQ AI: Near real-time detection, triage and annotation of stroke injury |
| 5.12. | Qure.ai: Identifying 5 types of intracranial haemorrhages |
| 5.13. | Other stroke detection companies: Aidoc, Zebra Medical Vision and Quantib |
| 5.14. | Stroke detection AI: Performance comparison |
| 5.15. | Stroke detection AI: Performance comparison (2) |
| 5.16. | Coronary heart disease (CHD) & myocardial infarction |
| 5.17. | CHD detection AI: Key players |
| 5.18. | CHD: Cornell & NYU's DL approach to diagnosis |
| 5.19. | HeartFlow: Assessing the impact of coronary blockages on cardiac blood supply |
| 5.20. | Circle Cardiovascular Imaging: Automated plaque assessment |
| 5.21. | Other CHD detection AI companies: Intrasense, CASIS & VoxelCloud |
| 5.22. | Assessing blood flow |
| 5.23. | Assessing blood flow: Key players |
| 5.24. | Arterys: Quantifying blood flow in minutes |
| 5.25. | Pie Medical Imaging: Calculating blood flow from 3D phase-contrast MR images |
| 5.26. | On the market: NeoSoft, HeartFlow, iSchemaView & Circle Cardiovascular Imaging |
| 5.27. | Blood flow detection AI: Performance comparison |
| 5.28. | Cardiac function |
| 5.29. | Ejection fraction is key for evaluating cardiac function, and AI allows for more accurate measurements |
| 5.30. | Cardiac function detection AI: Key players |
| 5.31. | Philips: Assessing cardiac performance, strength and structure |
| 5.32. | NeoSoft: automated segmentation for cardiac function and myocardial characterisation |
| 5.33. | Other cardiac function players: TomTec, DiA Imaging Analysis, GE Healthcare & BioMedical Image Analysis Group |
| 5.34. | Cardiac function detection AI: Performance comparison |
| 5.35. | CVD detection AI: Performance comparison |
| 5.36. | CVD detection AI: State of development and market readiness |
| 5.37. | CVD detection AI applications: State of development |
| 5.38. | CVD detection AI companies: State of product development |
| 5.39. | CVD detection AI companies: Software complexity |
| 5.40. | Conclusions and outlook |
| 6. | RESPIRATORY DISEASES |
| 6.1. | How can AI improve respiratory disease diagnosis? |
| 6.2. | Investments into respiratory diseases detection AI companies |
| 6.3. | Key players |
| 6.4. | VIDA: Identifying asthma and COPD |
| 6.5. | Infervision: Level of pneumonia infection as a percentage |
| 6.6. | SemanticMD: Probability score for tuberculosis |
| 6.7. | Lunit: Algorithm detects 9 different respiratory disorders |
| 6.8. | VUNO: Cutting image reading time by half |
| 6.9. | Arterys: Displaying negative findings for rule out support |
| 6.10. | Qure.ai: Detecting multiple chest abnormalities |
| 6.11. | AI embedded into imaging device: GE Healthcare |
| 6.12. | On the market: Aidoc, Zebra Medical Vision, Intrasense & Behold.ai |
| 6.13. | In development: Artelus, Enlitic & SigTuple |
| 6.14. | Respiratory diseases detection AI: Performance comparison |
| 6.15. | Respiratory diseases detection AI: Algorithm comparison (2) |
| 6.16. | COVID-19 |
| 6.17. | COVID-19: Key players |
| 6.18. | COVID-19: Infervision |
| 6.19. | COVID-19: Other companies |
| 6.20. | COVID-19 detection AI: Performance comparison |
| 6.21. | COVID-19 detection AI: Algorithm comparison (2) |
| 6.22. | Respiratory diseases detection AI: Performance comparison |
| 6.23. | Respiratory diseases detection AI: State of development and market readiness |
| 6.24. | Respiratory diseases detection AI applications: State of development |
| 6.25. | Respiratory diseases detection AI companies: State of product development |
| 6.26. | Respiratory diseases detection AI companies: Software complexity |
| 6.27. | Conclusions and outlook |
| 7. | RETINAL DISEASES |
| 7.1. | What are retinal diseases and how are they detected? |
| 7.2. | AI can reach expert level of disease detection in 10 days, compared to 20 years for humans |
| 7.3. | Investments into retinal diseases detection AI companies |
| 7.4. | Key players |
| 7.5. | Artelus: Detecting DR by ensuring image quality |
| 7.6. | VUNO: Identifying 12 types of eye disorders |
| 7.7. | SemanticMD: AI solution for use offline |
| 7.8. | SigTuple: Applying AI to multiple imaging modalities |
| 7.9. | Pr3vent: Detects 50+ pathologies in newborns |
| 7.10. | Currently in clinical trials: Novai, Verily & Capital University of Medical Sciences |
| 7.11. | On the market or upcoming: VoxelCloud, Singapore National Eye Centre & CERA |
| 7.12. | Retinal diseases detection AI: Performance comparison |
| 7.13. | Retinal diseases detection AI: Performance comparison (2) |
| 7.14. | Retinal diseases detection AI: Performance comparison (3) |
| 7.15. | Retinal diseases detection AI: State of development and market readiness |
| 7.16. | Retinal diseases detection AI companies: State of product development |
| 7.17. | Retinal diseases detection AI companies: Software complexity |
| 7.18. | Conclusions and outlook |
| 7.19. | Conclusions and outlook (2) |
| 8. | NEURODEGENERATIVE DISEASES |
| 8.1. | AI can identify signs of dementia years before its onset |
| 8.2. | Investments into neurodegenerative diseases detection AI companies |
| 8.3. | Key players |
| 8.4. | Quantib: Measuring brain size and atrophy |
| 8.5. | Icometrix: Diagnosing various NDDs |
| 8.6. | Cortechs Labs: Automated quantification of brain structure volume |
| 8.7. | Avalon AI: Interpreting multiple MRI modalities |
| 8.8. | VUNO: Immediate segmentation and parcellation |
| 8.9. | University of Bari: Predicting Alzheimer's disease up to a decade before onset |
| 8.10. | On the market: Qure.ai & Siemens Healthineers |
| 8.11. | In development: IDx, Icahn School of Medicine, UCSF |
| 8.12. | Research only: BioMedical Image Group, Imperial College London & University of Edinburgh |
| 8.13. | Research only: McGill & University College London |
| 8.14. | NDD detection AI: Performance comparison |
| 8.15. | NDD detection AI: Performance comparison (2) |
| 8.16. | NDD detection AI: Performance comparison (3) |
| 8.17. | NDD detection AI: State of development and market readiness |
| 8.18. | NDD detection AI companies: State of product development |
| 8.19. | NDD detection AI companies: Software complexity |
| 8.20. | Conclusions and outlook |
| 9. | MARKET ANALYSIS |
| 9.1. | Geographic segmentation: Almost 50% of medical diagnostics AI companies are based in the USA |
| 9.2. | Modality segmentation: Over half of medical diagnostics AI companies focus on CT and X-ray imaging |
| 9.3. | Image recognition AI: Technological roadmap |
| 9.4. | Image recognition AI: Technological roadmap (2) |
| 9.5. | Image recognition AI: Technological roadmap (3) |
| 9.6. | Image recognition AI: Roadmap of factors limiting penetration |
| 9.7. | Image recognition AI: Roadmap of factors limiting penetration (2) |
| 9.8. | Image recognition AI: Roadmap of factors limiting penetration (3) |
| 9.9. | Market analysis methodology |
| 9.10. | Addressable markets are growing, with some exceptions, and AI use is expected to mirror this trend |
| 9.11. | Scan volume per year: AI use will rise as its adoption increases |
| 9.12. | Image recognition AI: Market penetration 2020-2040 |
| 9.13. | Image recognition AI: Market penetration 2020-2040 (2) |
| 9.14. | Image recognition AI: Market penetration 2020-2040 (3) |
| 9.15. | Image recognition AI: Market penetration 2020-2040 (4) |
| 9.16. | Business models: Subscription vs Pay Per Use |
| 9.17. | Market share in 2019: CVD detection |
| 9.18. | Market forecast 2020-2031 by disease application |
| 9.19. | Market forecast 2020-2031: CVD detection |
| 9.20. | Market forecast 2020-2031: Cancer detection |
| 10. | CONCLUSIONS & OUTLOOK |
| 10.1. | AI provides real value and the market is rapidly growing |
| 10.2. | Remaining challenges: Improving data curation and algorithm training procedures |
| 10.3. | Remaining challenges: Need for clearer images |
| 10.4. | Remaining challenges: Regulations and data privacy |
| 10.5. | Opportunities for technological improvements |
| 10.6. | Cloud-based vs offline software |
| 10.7. | Moving towards equipment-integrated AI software? |
| 10.8. | Why do image recognition AI companies struggle to achieve profitability? |
| 11. | LIST OF COMPANIES |
| 11.1. | Cancer detection AI |
| 11.2. | CVD detection AI |
| 11.3. | Respiratory diseases detection AI |
| 11.4. | Retinal diseases detection AI |
| 11.5. | Neurodegenerative diseases detection AI |