Radiologists exhorted to take charge of change (or learn to live with receding relevance)
1. Radiology workflow and teleradiology. By 2040, patients will receive many aspects of medical care at home. Imaging will only be an exception for a limited time, predict Brink and Hricak. “AI-assisted autonomous or semi-autonomous ultrasound with inexpensive transducers powered by smartphone technology will allow patients to perform simple US data acquisition themselves, with images being automatically reconstructed,” they write. More:
In the future, further examinations can be carried out on site, including with hand-held radiography, CT (still) and MRI (low field strength) equipment.”
2. Artificial intelligence. As the general population engages with AI for all types of daily activities, radiologists will routinely use the technology for clinical, operational, and administrative tasks, Brink and Hricak suggest. “AI will also enable better assessment of disease likelihood and potential treatment outcomes through seamless integration of imaging findings with other clinical indicators,” they add. More:
The role of radiologists in this continuum is uncertain. We have to make sure that we add value at every step.”
3. Value-based care. Brink and Hricak foresee the day when visual interpretations are automatically rendered in lay language—not just for reading, but for viewing, listening, and otherwise consuming. “Recommended follow-up imaging or other diagnostic tests are communicated, confirmed and, if warranted, automatically arranged via robust care coordination systems.”
These changes will further marginalize radiologists and threaten our relevance unless we integrate into the continuum of care and add value beyond machine-generated interpretations and recommendations.”
4. Environmental, Social and Governance Concerns. The carbon footprint of medical imaging is under intense scrutiny, forcing product manufacturers and end-users to reduce energy consumption at every point of its uptime. This applies to observation stations as well as imaging equipment, Brink and Hricak forecasts.
Renewable sources for consumables in diagnostic and interventional radiology are becoming mainstream.”
5. Development of imaging technologies. “Bioengineering will advance rapidly and will have explosive potential to transform medical practice, with outsized implications for medical imaging,” write Brink and Hricak. “Phenotypic data generated by the physical interaction of an external energy source with biological tissue is input into multiomic databases that traverse multiple levels of biological regulation, potentially bypassing the need for imaging (i.e., fingerprinting).” More:
Images are reconstructed in selected cases where human understanding can best be achieved through visual means, for example for surgical or interventional radiological treatment planning.”
6. Precise imaging and image-guided intervention. Driven by AI, many intervention procedures are being automated, according to Brink and Hricak.
This will allow less trained staff to perform some less complicated image-guided procedures, potentially at home and in other locations that are beyond the reach of standard healthcare facilities.”
7. radiotheranostics. The rapid rise of theranostics will fuel the advance of radiotheranostics, which combines molecular imaging with radionuclide therapies and “uses small drugs, peptides, and antibodies to deliver therapeutic radionuclides (alpha, beta, or Auger emitters),” write Brink and Hricak . “The growth of radiotheranostics will expand the ability of clinicians to first ‘see clearly’ and then ‘target treatment’.” More:
While oncology radiotheranostics already has numerous contemporary applications, it has tremendous untapped potential for the treatment of a variety of cancer types because it can be tailored to multiple targets and maximize tumor kill while minimizing side effects.”