What is it that I love about the RSNA? Well, it’s the only conference out there that I have found that can give you a flavor of the direction that radiology is moving. It’s where you can see the newest trends from vendors, educators, and researchers alike. Everyone gathers in one place, from all over the world. And, therefore, it gives you the Zeitgeist (I love that word!) of the state of radiology. Naturally, the only downside is the size of the conference. There’s so much going on that you can get lost in the shuffle if you don’t make any plans to know what you are attending beforehand. (Which I certainly did before I came!) So, according to what I saw at the 2019 RSNA, let me synthesize what is happening out there!
To give a brief answer, may I repeat the following phrase: artificial intelligence, artificial intelligence, artificial intelligence. To prove that point, for the first time, the 2019 RSNA dedicated an entire tech floor to these businesses (although it was a little off the beaten path of the main floor!) And, in the interim, radiologists, researchers, engineers, and large companies hosted numerous conferences and speaking events.
The Real Zeitgeist of 2019 RSNA
So what has changed from last year to this one? Well, first and foremost, the speakers were no longer trying to convince us that radiology is going to replace our jobs. That approach was so last year! Instead, it seemed that everyone already knows that artificial intelligence will become more like assistance devices for the radiologist. Whether it be data integration, automated detection, triage, or report formation, the nuts and bolts of artificial intelligence now assume a much more benign path that will ingratiate the radiologist’s whims. No more terminator bots to destroy radiology!
Confirming this notion, interestingly enough, for all the hype and bluster, few applications are ready for prime time. And even more, most applications are not even close to FDA approval. But, I will talk about some of the apps that will eventually become day-to-day tools that have the potential to become ubiquitous and readily available to radiologists. Moreover, I will discuss some others that just got my attention (for better or for worse!) Here were some of my favorite discussions during the conference.
Artificial Intelligence Technologies
Watson- All About Integration
Now, if IBM could swing it, Watson has the potential to be the best of all technologies coming down the pike. From my perspective, they have one of the most useful approaches to artificial intelligence for the radiologist. So, what will Watson eventually do? Well, it’s attempting to satisfy the dream of all us. It will take all the patient history, labs, progress notes, priors, and other tidbits of information that become useful, even data about the patient’s primary disease entity itself. And then, Watson will integrate all the relevant data buried in the digital world on any imaging case and display it in a readable format for the radiologist.
If successful, this technology can be a game-changer. But, it depends on the ability to sift through immense amounts of information in RIS, PACS, and EHR systems, among other individual databases in any given hospital. I am most excited about this technology because it will render our interpretations so much more useful. I am sick of the irrelevant one-word histories that we often receive!
Mammo Dreams
Mammography also is a primary target on the radar in radiology. Loads of lecturers were coming up with ways to incorporate some of the technologies. Out of the ones that I heard, one of the applications would screen all the mammograms and officially read about a quarter or third of the mammograms that were stone cold (Steven Austin) normal. According to the radiology research, AI could achieve 100 percent specificity for a negative study in this percentage of cases without the input of the radiologist.
Now, I loved the idea of decreasing a radiologist’s mammography workload. But, they were looking at cases numbering in the thousands. Let’s say you have a million cases. Would you also have 100 percent specificity? That remains to be seen. And, I don’t know if any company will be able to take on that liability in our litigious environment. Scary, to say the least. These companies may want to think twice about that ramification!
Low Liability Products
Lower liability AI products will be in the cards for the more immediate future for radiology. Whether it be bone age, triage, improvement of image quality, reconstruction assistance, or improved CAD, these foci are the targeted products that we will see first. Although most products are under the radar or not in current use in radiology departments throughout the country, I think we will see them incorporated over the next five years. And I am looking forward to seeing their results!
What Artificial Intelligence Products Will Fail In The Short Term?
As I roamed through the AI floor, I realized that lots of products offered detection with probabilities of diagnosis. For instance, I saw a chest x-ray diagnosis booth. And, their artificial intelligence product showed the abnormality along with tons of percentages for the likelihood of diseases. At least, in the United States, I don’t see much of a role in this technology. In those places with a lack of a radiology workforce (third world countries), it may take on a different relevance. But, lots of these technologies have limited applicability to the current status of the field. And, I don’t think they are anywhere near prime time.
My Final Take On This All From The 2019 RSNA!
Slowly, under the radar, we are beginning to see some of the fruition of the promises that artificial intelligence has made. And some companies are beginning to incorporate these more focused technologies into the hardware and software that imaging centers are buying. But, we are a bit farther away from seeing the explosive changes that AI potentially can offer. Whether it be true integration, mammography reads, and more, unfortunately, we are not quite there yet. Let’s continue to keep a watch and revisit the changes. Until next year at the RSNA!
