4 takeaways for the future of radiology

As medicine continues to evolve thanks to technology, radiologists have an opportunity to become integral in precision medicine and develop a value-based healthcare system.

Hricak Hedvig, MD, PhD, made such arguments in an article published online Jan. 28 in Radiology, which was based on the New Horizons lecture at the 2016 Radiological Society of North America (RSNA) Annual Meeting. In the piece, Hedvig used oncology to show radiologists can realize the power of precision medicine in creating a more efficient health system.

Here are four key points:

1. Radiology cannot go at it alone

Appropriate treatment selection means understanding the differences in biology of sites within and around tumors, and the biology of tumors themselves. Precision oncology can complement various biomarkers as an in vivo companion diagnostic—a crucial role in treatment selection, treatment response assessment and follow-up, according to Hedvig.

Radiology alone, though, will not be sufficient in understanding the tumor types and behaviors.

“We must be partners in developing ‘next-generation diagnostics,’ which are diagnostics with precision measurements and quantitative expressions that, through computational analytics, will allow for development of predictive biomarkers,” Hedvig wrote.

2. Advances in imaging are already changing clinical trial design

Advances in imaging, along with other emerging diagnostic tools of precision medicine, are already enabling notable changes in clinical trial design.

Phase I of clinical trials are typically designed to determine the safety and tolerance of dosage amounts to be administered in phase II or III trials. However, targeted imaging has the potential to determine the biologically relevant dose and select the right treatment from the beginning, avoiding toxic doses and related expenses.

“Thus, through its abilities to improve treatment selection and determine biologically relevant doses, imaging can directly facilitate patient-centered value-driven precision oncology that enhances population health,” Hedvig wrote.

3. Interventional radiology is key to patient-centric healthcare

Interventional radiology approaches minimize invasiveness and recovery times, two factors that weigh heavily on patient-centered care. As advancements in imaging, robotics and other techniques develop, interventional radiology is continuously being improved.

However, resources and training for these highly specialized applications must be increased.

“When given the opportunity, interventional radiologists will continue to blaze a trail toward precision oncology,” Hedvig wrote.

4. Don’t fear AI

“Change is imminent, and it will bring both challenges and opportunities. If we embrace computer science innovations, there are good reasons to believe that technologic advances will increase rather than reduce the importance of our profession,” Hedvig wrote.

Some fear artificial intelligence (AI) and deep learning as threats, especially in medicine and radiology. However, Hedvig subscribes to the notion that those who do not embrace change will be left behind. She reiterated that radiology isn’t focused solely on reading images.

“Those who believe machine learning will displace much of the work of radiologists and anatomic pathologists are missing something crucial: radiologists’ and pathologists’ primary focus is not on reading digitized images but on solving clinical problems,” she wrote.