The publication of the Centennial edition of the prestigious journal, Radiology, brings two must-read editorials by a pair of distinguished thought leaders offering insightful predictions into the future of artificial intelligence (AI) and radiology informatics. Those who follow developments in this space are familiar with the work of Stanford University's Curtis Langlotz, MD, PhD, and the University of Chicago's Paul Chang, MD. When they speak, people listen.

Dr. Langlotz believes that the field of radiology will continue to lead the way for AI in medicine, notably in the development of new capabilities to reduce the current and relatively small human error rate in perceiving significant findings in diagnostic images. He predicts a world where automatically protocoled imaging studies will arrive in the radiologist’s work queue preprocessed by AI algorithms, with patient history summarized, organs segmented and measured, abnormalities highlighted, and even the radiology report already drafted. Even as he acknowledges that AI expertise may someday replace human review of images such as mammography screening studies, Dr. Langlotz believes the human factor will remain essential, as radiologists will be necessary to modify and finalize reports using speech recognition and by clicking the image and choosing from a structured list of suggested imaging findings. He describes this work environment as the cloud-based “cockpit” where the radiologist works using a unified radiology workstation, with image display, reporting, and AI all seamlessly integrated.

I was pleased to read Dr. Langlotz's conclusion that “patient-friendly explanations of radiology reports will transform patients’ relationship with their imaging information and will bring radiologists and patients closer together.” This transformation in patient engagement is well underway and one can expect it to become universal sometime soon.

Happily, he expects that eventually the #ditchthedisc movement will succeed, with images exchanged using CDs and DVDs replaced by electronic image exchange resulting in reduction of delays in care, improvement in patient satisfaction, and lowered cost.

I am such a huge fan of Dr. Chang, the inventor of picture archiving and communications systems (PACS), and he does not disappoint with his essay. Many who have heard Dr. Chang's entertaining and thoughtful lectures know the story he tells about his radiologist father's lament that universal access to reports and images by clinicians ended much of clinical collaboration by radiologists. Before widespread use of PACS, medicine and surgery rounds often started in the hospital's radiology department. Radiologists perceived themselves as engaged members of the clinical team with meaningful collaborations with clinical colleagues several times a day. After PACS, Dr. Chang's father believed that radiologists had been converted into "isolated commodities in a reading room assembly line.” 

In his editorial, Dr. Chang offers his predictions (and wishes) that IT and imaging informatics in the future will restore radiologists to their key role as the “doctor's doctor.” 

These two essays remind me of the days of the old television ads, "When EF Hutton talks, people listen!" When Drs. Langlotz and Chang talk, we should all listen to their words of wisdom as well.